青岛大学学报（医学版）2024，Vol.60Issue(1)：52-56,5.DOI:10.11712/jms.2096-5532.2024.60.010
达格列净联合沙库巴曲缬沙坦治疗老年糖尿病合并射血分数保留心衰的效果
Efficacy of dapagliflozin combined with sacubitril/valsartan in elderly patients with diabetes mellitus and heart failure with preserved e-jection fraction
摘要
Abstract
Objective To investigate the clinical efficacy of dapagliflozin combined with sacubitril/valsartan in elderly pa-tients with diabetes mellitus and heart failure with preserved ejection fraction(HFpEF).Methods Elderly patients with HFpEF and diabetes mellitus(n=180)were treated for 6 months with dapagliflozin+sacubitril/valsartan(group C,n=60),sacubitril/valsartan(group B,n=60),and conventional heart failure therapy(group A,n=60).The efficacy was compared based on the cardiac function indicators such as left ventricular end-diastolic dimension(LVEDD),left atrial diameter(LAD),left ventricular ejection fraction(LVEF),ratio of the early diastolic velocity of mitral inflow to the early diastolic velocity of mitral annular motion(E/e'),blood pressure,and N-terminal prohormone of brain natriuretic peptide(NT-ProBNP)before and after treatment.Re-sults There were no significant differences between the groups at baseline before treatment(P＞0.05).Blood pressure,NT-pro-BNP,LVEDD,LAD,and E/e'were significantly lower after treatment(t=5.82-26.31,P＜0.05).Blood pressure and NT-pro-BNP decreased more significantly in group C than in the other two groups(F=11.53,33.14;H=42.48,P＜0.01).LVEDD,LAD,and E/e'decreased more significantly in group C than in group A(F=10.53-14.07,P＜0.01).The decreases in LVEDD,LAD,and E/e'were not significantly different between groups C and B(P＞0.05),The overall efficiency was significantly higher in group C compared to the other two groups(X2=22.047,P＜0.05).Readmission for cardiovascular reasons at 6 months of follow-up occurred in 5 patients(8.3％)in group C,8 patients(13.3％)in group B,and 18 patients(30.0％)in group A,with a signifi-cantly lower rate of cardiovascular readmission in groups B and C compared to group A(X2=11.446,6.730;P＜0.05).There was no significant difference between groups B and C(P＞0.05).There were no significant adverse reactions in groups.Conclusion Dapagliflozin combined with sacubitril/valsartan can rapidly lower blood pressure and NT-proBNP levels in the treatment of elderly patients with diabetes mellitus and HFpEF,and play a synergistic role in improving patients'cardiac function with a high safety pro-file.关键词
心力衰竭,舒张性/糖尿病,2型/达格列净/沙库巴曲缬沙坦/治疗结果Key words
heart failure,diastolic/diabetes mellitus,type 2/dapagliflozin/sacubitril/valsartan/treatment outcome分类
医药卫生引用本文复制引用
洪叶枫,阮士苗,郭梦琪,刘松,张文忠..达格列净联合沙库巴曲缬沙坦治疗老年糖尿病合并射血分数保留心衰的效果[J].青岛大学学报（医学版）,2024,60(1):52-56,5.基金项目
国家自然科学基金资助项目(82000417) （82000417）
