达格列净联合沙库巴曲缬沙坦治疗老年心力衰竭患者疗效及对血清NT-proBNP、hs-TnT水平的影响

Efficacy of dapagliflozin combined with sacubitril/valsartan in treatment of elderly heart failure patients and its effect on levels of serum NT-proBNP and hs-TnT

中文关键词: 老年  心力衰竭  达格列净  沙库巴曲缬沙坦  N末端B型钠尿肽前体  超敏肌钙蛋白T

英文关键词: elderly  heart failure  dapagliflozin  sacubitril/valsartan  N-terminal pro-B-type natriuretic peptide  hyper-sensitive cardiac troponin T

中文摘要:

      目的 探究达格列净联合沙库巴曲缬沙坦治疗老年射血分数降低心力衰竭(HFrEF)患者疗效及对血清N末端B型钠尿肽前体(NT-proBNP)、超敏肌钙蛋白T(hs-TnT)水平的影响,为治疗该病症提供方法.方法 回顾性选取2021年10月—2024年3月亳州市中医院收治的90例老年射血分数降低的心力衰竭(HFrEF)患者为研究对象,按照治疗方式不同分为观察组(n=45)和对照组(n=45).2组均接受常规抗心衰治疗,对照组给予沙库巴曲缬沙坦治疗,观察组在对照组治疗的基础上加用达格列净治疗,治疗周期均为3个月.评估并比较2组治疗总有效率、Lee氏心衰积分、心功能指标值及血清NT-proBNP、hs-TnT水平;比较2组患者不良反应总发生率.结果 观察组治疗总有效率高于对照组(91.11％vs 73.33％,P＜0.05).2组治疗后的Lee氏心衰积分较治疗前更低(P＜0.05);且相较于对照组,观察组治疗后上述评分低于对照组(P＜0.05).2组治疗后左射血分数(LVEF)相较于治疗前均升高,左室舒张末期内径(LVEDD)和左室收缩期内径(LVESD)相较于治疗前均下降(P＜0.05);且治疗后观察组LVEF相较于对照组更高,LVEDD和LVESD相较于治疗前更低(P＜0.05).2组治疗后血清NT-proBNP、hs-TnT水平相较于治疗前均下降(P＜0.05);且治疗后观察组上述血清指标相较于对照组更低(P＜0.05).2组不良反应总发生率比较无统计学意义(P＞0.05).结论 在老年HFrEF患者的治疗中,应用达格列净联合沙库巴曲缬沙坦治疗表现出了显著的疗效,能够有效缓解心衰症状,改善心功能,并且降低血清NT-proBNP和hs-TnT水平,同时具备较好的安全性.这一疗法显示出一定的临床应用前景和价值.

英文摘要:

      Objective To investigate the efficacy of dapagliflozin combined with sacubitril/valsartan in the treatment of elderly heart failure patients with reduced ejection fraction(HFrEF)and its effects on the levels of serum N-terminal pro-B-type natriuretic peptide(NT-proBNP)and high-sensitivity troponin T(hs-TnT),and provide a therapeutic approach for this condi-tion.Methods A retrospective study included 90 elderly HFrEF patients admitted to Traditional Chinese Medicine Hospital of Bozhou City from October 2021 to August 2023.They were divided into observation group(n=45)and control group(n=45)according to different treatment methods.Both groups received conventional anti-heart failure therapy.The control group was treated with sacubitril/valsartan,while the observation group was treated with dapagliflozin on the basis of the control group.All patients were treated for 3 months.The total clinical effective rate,Lee's heart failure scores,cardiac function indi-ces[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)],levels of serum NT-proBNP and hs-TnT,and total incidence of adverse reactions were compared be-tween the two groups.Results The total clinical effective rate in the observation group(91.11％)was higher than that in the control group(73.33％,P＜0.05).After treatment,Lee's heart failure scores significantly decreased in both groups(P＜0.05),and Lee's heart failure score in the observation group was lower than that in the control group(P＜0.05).After treat-ment,LVEF increased significantly,while LVEDD and LVESD decreased significantly in both groups post-treatment(P＜0.05),and the observation group demonstrated higher LVEF and lower LVEDD and LVESD compared with the control group(P＜0.05).After treatment,the levels of serum NT-proBNP and hs-TnT decreased significantly in both groups(P＜0.05),and the observation group was lower than the control group(P＜0.05).There was no statistical significance in the total inci-dence of adverse reactions between the two groups(P＞0.05).Conclusion In the treatment of elderly HFrEF patients,the combination of dapagliflozin and sacubitril/valsartan demonstrates significant therapeutic efficacy.This regimen not only effec-tively alleviates heart failure symptoms and improves cardiac function,but also reduces the levels of serum NT-proBNP and hs-TnT.It has good safety and shows certain clinical application prospect and value.