沙库巴曲缬沙坦联用达格列净对老年慢性心力衰竭患者心肾功能的影响

Effects of sacubitril/valsartan combined with dapagliflozin on cardiac and renal function in elderly patients with chronic heart failure

中文关键词: 沙库巴曲缬沙坦  达格列净  老年  慢性心力衰竭

英文关键词: sacubitril/valsartan  dapagliflozin  elderly  chronic heart failure

中文摘要:

      目的 观察沙库巴曲缬沙坦联用达格列净对老年慢性心力衰竭患者的临床治疗效果.方法 回顾性选取2018年7 月—2022 年10 月期间,复旦大学附属华东医院心血管内科收治的老年慢性心力衰竭患者 271 例,其中,单纯应用缬沙坦的治疗1 组89 例、应用沙库巴曲缬沙坦的治疗 2 组 90 例、应用沙库巴曲缬沙坦联用达格列净的治疗 3 组 92 例.3 组连续用药 12(10～13.5)个月,比较3 组治疗前后血肌酐、尿酸、左室舒张末内径(LVEDD)、左室射血分数(LVEF)、脑钠肽(BNP)水平.结果 经治疗12(10～13.5)个月后,治疗3 组的临床有效率95.7%,高于治疗1 组的 80.9%(P＜0.05).与治疗前比较,各组心功能指标均获得改善,治疗 3 组肾功能指标获得改善(P＜0.05).LVEF改善方面,治疗3 组及治疗2 组均优于治疗1 组;LVEDD、血肌酐和尿酸改善方面,治疗3 组优于治疗 2 组及治疗 1 组;BNP改善方面,治疗3 组优于治疗1 组,以上结果均具有统计学差异(P＜0.05).结论 3 组方案均可改善老年慢性心力衰竭患者的心、肾功能指标,但是相较于单纯应用缬沙坦或沙库巴曲缬沙坦,沙库巴曲缬沙坦联用达格列净治疗老年慢性心力衰竭患者,心肾获益最大.

英文摘要:

      Objective To observe the clinical therapeutic effects of sacubitril/valsartan combined with dapagliflozin on elderly patients with chronic heart failure.Methods A total of 271 elderly patients with chronic heart failure treated in Depart-ment of Cardiology of Huadong Hospital Affiliated to Fudan University from July 2018 to October 2022 were retrospectively se-lected.Among them,there were 89 cases in treatment group 1 treated with valsartan alone,90 ones in treatment group 2 treated with sacubitril/valsartan,and 92 ones in treatment group 3 treated with sacubitril valsartan combined with dapagliflozin.All three groups were treated continuously for 12(10-13.5)months.The levels of serum creatinine,uric acid,left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)and brain natriuretic peptide(BNP)were compared among the three groups before and after treatment.Results After 12(10-13.5)months of treatment,the clinical effective rate of the treatment group3 was95.7%,which was significantly higher than that of the treatment group 1(80.9%)(P＜0.05).Compared with before treatment,the cardiac function indexes in all groups were significantly improved,and renal func-tion indexes in the treatment group3 were significantly improved(P＜0.05).In terms of LVEF improvement,the treatment group 3 and treatment group 2 were superior to the treatment group 1.In terms of LVEDD,serum creatinine,and uric acid im-provement,the treatment group 3 was superior to the treatment group 2 and treatment group 1.In terms of BNP improvement,the treatment group 3 was superior to the treatment group 1.All the above results were statistically significant(P＜0.05).Conclusion All three treatment regimens can improve the cardiac and renal function indicators in elderly patients with chronic heart failure.However,compared to the use of valsartan alone or sacubactril/valsartan,the combination of sacubitril/valsartan with dapagliflozin in the treatment of elderly patients with chronic heart failure has the greatest cardiac and renal benefits.