摘要
目的探讨联合应用达格列净与诺欣妥治疗心脏瓣膜病并心力衰竭(心衰)病人的临床效果及其对B型脑钠肽(BNP)影响。方法选取秦皇岛第一医院2020年3月—2022年3月收治的心脏瓣膜病并心衰病人372例为研究对象,以简单随机分组方法分为对照组与研究组,每组186例。对照组单独采用诺欣妥治疗,研究组在对照组的基础上联合应用达格列净。比较两组临床疗效、血清因子、心功能指标和不良反应发生率等。结果研究组总有效率(95.7%)明显高于对照组(89.2%),差异有统计学意义(χ^(2)=5.561,P<0.05)。治疗后两组左室舒张末期内径(LVEDd)和左室收缩末期内径(LVESD)较治疗前均显著降低,而左室射血分数(LVEF)较治疗前显著升高(t=14.282~70.283,P<0.05),但研究组治疗后LVEDd、LVESD和LVEF的改善程度均显著优于对照组(t=6.403~9.021,P<0.05)。治疗后两组血清BNP、超敏C-反应蛋白(Hs-CRP)和心肌肌钙蛋白(cTnI)等指标均显著降低(t=19.236~69.772,P<0.05),但研究组治疗后血清BNP、Hs-CRP和cTnI等指标的降低程度均显著优于对照组(t=5.024~63.176,P<0.05)。研究组不良反应总发生率(3.8%)明显低于对照组(9.1%),差异有统计学意义(χ^(2)=4.454,P<0.05)。结论达格列净联合诺欣妥治疗心脏瓣膜病伴心衰病人疗效确切,可有效改善病人心功能,降低BNP水平,延缓心衰发展进程,改善预后,安全性高,值得推广。
Objective To investigate the clinical efficacy of dapagliflozin combined with Entresto in the treatment of patients with valvular heart disease and heart failure and its effect on brain natriuretic peptide(BNP).Methods A total of 372 patients with valvular heart disease and heart failure who were admitted to Qinhuangdao First Hospital from March 2020 to March 2022 were enrolled as subjects and were divided into control group and study group using the simple randomization method,with 186 patients in each group.The patients in the control group received Entresto alone,and those in the study group received dapagliflozin in addition to the treatment in the control group.The two groups were compared in terms of clinical outcome,serum factors,car-diac function parameters,and the incidence rate of adverse reactions.Results The study group had a significantly higher overall response rate than the control group(95.7%vs 89.2%,χ^(2)=5.561,P<0.05).After treatment,both groups had significant reductions in left ventricular end-diastolic diameter(LVEDd)and left ventricular end-systolic diameter(LVESD)and a significant increase in left ventricular ejection fraction(LVEF)(t=14.282-70.283,P<0.05),and the study group had significantly better improvements in LVEDd,LVESD,and LVEF compared with the control group(t=6.403-9.021,P<0.05).After treatment,both groups had significant reductions in the serum levels of BNP,high-sensitivity C-reactive protein(Hs-CRP),and cardiac troponin I(cTnI)(t=19.236-69.772,P<0.05),and compared with the control group,the study group had significantly greater reductions in serum BNP,Hs-CRP,and cTnI after treatment(t=5.024-63.176,P<0.05).The study group had a significantly lower overall incidence rate of adverse reactions than the control group(3.8%vs 9.1%,χ^(2)=4.454,P<0.05).Conclusion Dapagliflozin combined with Entresto has a marked clinical effect in the treatment of patients with valvular heart disease and heart failure and can effectively improve cardiac function,reduce the level of BNP,delay the prog
作者
张丽芳
李润军
高俊杰
汤秀英
ZHANG Lifang;LI Runjun;GAO Junjie;TANG Xiuying(Department of Cardiovascular Medicine(Chest Pain Center),Qinhuangdao First Hospital,Qinhuangdao 066001,China)
出处
《青岛大学学报（医学版）》
CAS
2024年第5期729-732,共4页
Journal of Qingdao University(Medical Sciences)
基金
河北省高层次人才资助项目(C20221116)
秦皇岛市科学技术研究与发展计划资助项目(202301A048)。
