中国临床药理学杂志2024，Vol.40Issue(7)：954-958,5.DOI:10.13699/j.cnki.1001-6821.2024.07.004
达格列净联合沙库巴曲缬沙坦钠治疗急性心肌梗死介入术后心力衰竭患者的临床研究
Clinical trial of dapagliflozin combination with sacubitril/valsartan sodium in the treatment of patients with heart failure after acute myocardial infarction intervention
摘要
Abstract
Objective To observe the efficacy of dapagliflozin tablets combination with sacubitril/valsartan sodium tablets in the treatment of patients with heart failure(HF)after acute myocardial infarction(AMI)intervention.Methods Patients with HF after AMI intervention were randomly divided into control group and treatment group.The control group was given conventional anti-heart failure therapy+sacubitril/valsartan sodium tablets(50 mg for the first time,then gradually increased to 200 mg each time,twice a day),and the treatment group was additionally treated with dapagliflozin(10 mg every time,once a day)on the basis of the control group,and the course of treatment was 6 months.The two groups were compared in terms of clinical efficacy,cardiac function[left ventricular ejection fraction(LVEF),left ventricular remodeling index(LVRI),6-minute walking distance(6MWD)],heart failure markers[brain natriuretic peptide(BNP),N-terminal pro-brain natriuretic peptide(NT-proBNP),troponin(Tn)],and serum related biochemical indicators[soluble human stromelysin-2(ST2),angiotensin 2(AT-Ⅱ),soluble intercellular adhesion molecule-1(sICAM-1)],incidence rates of major adverse cardiovascular events(MACE)during follow-up and adverse drug reactions during treatment.Results Six cases dropped out during treatment,and finally 46 cases were included in control group and treatment group,respectively.After treatment,the effective rates of treatment in treatment group(91.30％)was significantly higher than that in control group(76.09％,P＜0.05).After treatment,the LVEF values in control group and treatment group were(51.38±4.82)％and(54.43±4.63)％;LVRI values were(1.47±0.15)and(1.35±0.17)g·mL-1;6MWD values were(390.53±40.32)and(362.61±38.51)m;the BNP levels were(28.34±2.47)and(26.51±2.16)pmol·L-1;NT-proBNP levels were(262.61±53.18)and(227.68±46.73)ng·L-1;sICAM-1 levels were(84.61±7.14)μg·L-1 and(74.68±7.08)μg·L1,and there were statistical differences between both groups(all P＜0.05).During follow-up,the incidence rate of MACE in treatment group(6.52％)was significantly lower than that in control group(21.74％,P＜0.05).The main adverse drug reactions in the two groups were renal dysfunction,hypotension,urogenital infection and hyperkalemia,but there was no significant difference in the incidence of adverse reactions between treatment group(13.04％)and control group(10.87％,P＞0.05).Conclusion Dapagliflozin tablets combined with sacubitril/valsartan sodium tablets can significantly improve cardiac function and related indicators and reduce the incidence of MACE in patients with HF after AMI intervention.关键词
达格列净片/沙库巴曲缬沙坦钠片/急性心肌梗死/心力衰竭/临床疗效/心功能/主要不良心血管事件Key words
dapagliflozin tablet/sacubitril/valsartan sodium tablet/acute myocardial infarction/heart failure/clinical efficacy/cardiac function/major adverse cardiovascular event分类
医药卫生引用本文复制引用
李美美,林晖莉,陈少鹏,洪新宝..达格列净联合沙库巴曲缬沙坦钠治疗急性心肌梗死介入术后心力衰竭患者的临床研究[J].中国临床药理学杂志,2024,40(7):954-958,5.基金项目
福建省自然科学基金资助项目(2023J01747) （2023J01747）
