Abstract:

Objective　To investigate the clinical efficacy and safety of Dapagliflozin combined with sacubitril valsartan in the treatment of heart failure patients with reduced ejection fraction. Methods　A total of 86 heart failure patients with reduced ejection fraction admitted to Zhengzhou Seventh People's Hospital from January 2020 to June 2021 were selected as the study objects and were divided into two groups according to the envelope randomization method. In the experimental group, the ratio of male to female was 26/17, and the age was (65.08±5.52) years old. In the control group, the ratio of male to female was 27/16, and the age was (65.21±5.37) years old. Forty-three patients in the control group were treated with sacubitril valsartan, and 43 patients in the experimental group were treated with Dapagliflozin on this basis, continuous oral administration for 3 months. The therapeutic effect, cardiac function, 6-min walking distance (6MWD), N-terminal brain natriuretic peptide precursor (NT-proBNP), and inflammatory factors were compared between the two groups. t test and χ² test were used. Results　After 3 months of administration, the total effective rate of the heart failure patients with reduced ejection fraction in the experimental group was higher than that in the control group [95.35% (41/43) vs. 79.07% (34/43)], with a statistically significant difference (P<0.05). After 3 months of administration, the levels of left ventricular end-diastolic inner diameter (LVIDd), NT-proBNP, interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor α (TNF-α) in both groups were decreased compared with those before administration, and those in the experimental group were lower than those in the control group; the left ventricular ejection fraction (LVEF) and 6MWD levels in both groups were significantly increased compared with those before administration, and those in the experimental group were higher than those in the control group, with statistically significant differences (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the experimental group and the control group [13.95% (6/43) vs. 11.63% (5/43)] (P>0.05). Conclusion　In the treatment of heart failure patients with reduced ejection fraction, Dapagliflozin combined with sacubitril valsartan has significant efficacy, which can reduce the inflammation, improve the cardiac function, increase the cardiac ejection fraction, and is safe and worthy of application.

Key words:

Heart failure, Ejection fraction, Dapagliflozin, Sacubitril valsartan, Safety, Inflammatory factors

摘要：

目的　探讨在射血分数降低心力衰竭患者中以达格列净联合沙库巴曲缬沙坦治疗的效果与安全性。方法　选取2020年1月至2021年6月郑州市第七人民医院收治的射血分数降低心力衰竭患者86例作为研究对象，根据信封随机法分为两组。试验组中，男女比为26/17，年龄（65.08±5.52）岁；对照组中，男女比为27/16，年龄（65.21±5.37）岁。对照组43例予以沙库巴曲缬沙坦治疗，试验组43例在此基础上予以达格列净治疗，持续口服3个月。比较两组疗效、心功能、6 min步行距离（6MWD）、N末端脑钠肽前体（NT-proBNP）及炎症因子水平等。采用t检验、χ²检验。结果　给药3个月后，试验组射血分数降低心力衰竭患者的总有效率高于对照组［95.35%（41/43）比79.07%（34/43）］，差异有统计学意义（P<0.05）。给药3个月后，两组左心室舒张末期内径（LVIDd）、NT-proBNP、白细胞介素-6（IL-6）、C-反应蛋白（CRP）及肿瘤坏死因子α（TNF-α）水平相较于给药前下降，且试验组低于对照组；两组左心室射血分数（LVEF）、6MWD水平相较于给药前显著上升，且试验组高于对照组，差异均有统计学意义（均P<0.05）。试验组射血分数降低心力衰竭患者不良反应发生率和对照组相比差异无统计学意义［13.95%（6/43）比11.63%（5/43）］（P>0.05）。结论　在射血分数降低心力衰竭患者治疗中，达格列净联合沙库巴曲缬沙坦的疗效显著，可减轻机体炎症反应，改善心脏功能，增加心脏射血分数，且安全性良好，值得应用。

关键词:

心力衰竭, 射血分数, 达格列净, 沙库巴曲缬沙坦, 安全性, 炎症因子