摘要
目的研究钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂(达格列净)联合新活素治疗高血压伴心力衰竭(心衰)的临床效果及对患者外周血单核细胞Toll样受体4/核转录因子-κB(TLR4/NF-κB)信号通路指标的影响。方法前瞻性选取2021年5月至2023年6月郑州大学第一附属医院收治的138例高血压伴心衰患者作为研究对象,采用随机数表法分为对照组、单一组和联合组各46例。对照组接受常规基础治疗,单一组在此基础上接受新活素治疗,联合组在此基础上接受达格列净联合新活素治疗。治疗7 d后比较三组患者的临床疗效,以及治疗前后的心功能[左室收缩末期内径(LVESD)、左室射血分数(LVEF)、心率(HR)]、运动耐力[6 min步行试验距离(6 MWT)]、血压[收缩压(SBP)、舒张压(DBP)]、氧化应激指标[丙二醛(MDA)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-Px)]和TLR4/NF-κB信号通路相关指标[TLR4、NF-κB、白细胞介素-1β(IL-1β)、IL-6、肿瘤坏死因子-α(TNF-α)],同时比较三组患者的不良反应发生情况。结果联合组患者的治疗总有效率为95.65%,明显高于单一组的86.96%和对照组的73.91%,差异均有统计学意义(P<0.05);治疗后,联合组患者的LVEF、6 MWT分别为(43.28±3.16)%、(336.48±32.49)m,明显高于单一组的(40.54±2.68)%、(306.45±40.26)m和对照组的(38.07±2.89)%、(280.69±36.98)m,LVESD、HR分别为(35.29±4.26)mm、(71.34±3.62)次/min,明显低于单一组的(38.75±3.64)mm、(74.25±3.59)次/min和对照组的(42.36±4.05)mm、(76.46±3.98)次/min,且单一组变化幅度大于对照组,差异均有统计学意义(P<0.05);治疗后,联合组患者的SBP、DBP分别为(110.36±5.02)mmHg、(81.42±2.56)mmHg,明显低于单一组的(114.83±4.76)mmHg、(84.39±2.88)mmHg和对照组的(117.25±5.18)mmHg、(86.05±2.62)mmHg,且单一组低于对照组,差异均有统计学意义(P<0.05);治疗后,联合组患者的GSH-Px、CAT分别为(105.24±20.29)U/g·Hb、(148.35±32.46
Objective To investigate the clinical effect of sodium-glucose cotransporter 2(SGLT2)inhibitor(dagliagrazin)combined with natriuretic peptide in the treatment of hypertension with heart failure and its influence on toll-like receptor 4/nuclear transcription factor-κB(TLR4/NF-κB)signaling pathway in patients'peripheral blood monocytes.Methods A prospective study was conducted on 138 patients with hypertension and heart failure admitted to the First Affiliated Hospital of Zhengzhou University from May 2021 to June 2023.They were randomly divided into a control group,a single group,and a combined group,with 46 patients in each group.The control group received conventiondoi al basic treatment,the single group received natriuretic peptide therapy on the basis of conventional basic treatment,and the combined group received dapagliflozin combined with neoadjuvant therapy on the basis of conventional basic treatment.After 7 days of treatment,the clinical efficacy of the three groups of patients was compared,as well as their cardiac function[left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF),heart rate(HR)],exercise tolerance[6-minute walk test distance(6 MWT)],blood pressure[systolic blood pressure(SBP),diastolic blood pressure(DBP)],oxidative stress indicators[malondialdehyde(MDA),catalase(CAT),glutathione peroxidase(GSH-Px)],and TLR4/NF-κB signaling pathway-related indicators[TLR4,NF-κB,interleukin-1β(IL-1β),IL-6,tumor necrosis factor-α(TNF-α)].The incidence of adverse reactions among the three groups of patients was also compared.Results The total effective rate of patients in the combined group was 95.65%,which was significantly higher than that of the single group(86.96%)and the control group(73.91%),with statistically significant differences(P<0.05).After treatment,the LVEF and 6MWT in the combined group were(43.28±3.16)%,(336.48±32.49)m,which were significantly higher than(40.54±2.68)%,(306.45±40.26)m in the single group and(38.07±2.89)%,(280.69±36.98)m in the cont
作者
彭娜娜
王小雅
贾启华
张金生
PENG Na-na;WANG Xiao-ya;JIA Qi-hua;ZHANG Jin-sheng(Department of Emergency Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan,CHINA;Cardiovascular and Cerebrovascular Department,the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450052,Henan,CHINA)
出处
《海南医学》
CAS
2024年第6期761-766,共6页
Hainan Medical Journal
基金
中原科技创新领军人才项目(编号:214200510022)。
关键词
高血压伴心力衰竭
新活素
达格列净
氧化应激
外周血单核细胞Toll样受体4/核转录因子-κB信号通路
临床效果
Hypertension with heart failure
Natriuretic peptide
Dapagliflozin
Oxidative stress
Peripheral blood mononuclear cell Toll-like receptor 4/nuclear transcription factor-κB signaling pathway
Clinical effect
