摘要
目的观察不同时间服用达格列净对急性心肌梗死(acute myocardial infarction,AMI)经皮冠状动脉介入术(percutaneous coronary intervention,PCI)患者冠状动脉微循环、心功能及生活质量的影响。方法选取92例接受PCI手术的AMI患者作为研究对象,按照随机数字表法将患者分为A组和B组,每组46例。A组在PCI术后72 h内服用达格列净,B组在术后72 h之后服用达格列净。比较2组患者的临床疗效,监测服药前和服药1周后的心功能指标[左心室射血分数(left ventricular ejection fraction,LVEF)、左心室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左心室收缩末期内径(left ventricular end systolic diameter,LVESD)]、血流动力学参数[心率(heart rate,HR)、每搏输出量(stroke volume,SV)]、冠状动脉微循环状态、生活质量[以中国心血管病人生活质量评定问卷(Chinese questionnaire of quality of life in patients with cardiovascular disease,CQQC)评分评估],以及生物标志物[血清生长刺激表达基因2蛋白(growth stimulation expressed gene 2 protein,ST2)、胱抑素C(cystatin C,CysC)和N末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)]的水平;统计随访期心血管不良事件(major adverse cardiovascular events,MACE)和治疗期间不良反应的发生情况。结果A组患者的治疗总有效率(95.65%)显著高于B组(80.43%),P<0.05。治疗1周后,2组患者的SV、LVEF、CQQC评分均显著升高,且A组的SV、LVEF、CQQC评分均显著高于B组(P<0.05);2组患者的LVEDD、LVESD、HR、冠脉微循环评分以及血清ST2、CysC和NT-proBNP水平均显著降低(P<0.01),且A组患者的LVEDD、LVESD、HR、冠状动脉微循环评分以及血清ST2、CysC和NT-proBNP水平均显著低于B组(P<0.05)。2组患者随访期MACE和治疗期间不良反应发生率比较,差异均无统计学意义(P>0.05)。结论AMI患者PCI术后72 h内服用达格列净,在促进患者心功能恢复、改善微循环方面具有更优的疗效,为临床用药时机选择提供参考。
Objective To observe the effect of taking dapagliflozin at different times on coronary microcirculation,cardiac function,and quality of life in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods 92 AMI patients who underwent PCI at the Department of Cardiology of the Second Affiliated Hospital of Hebei North University were randomly divided into 2 groups(46 patients each)using a random number table method.Group A received dapagliflozin within 72 hours after PCI,while Group B received it more than 72 hours after surgery.The clinical efficacy of the 2 groups of patients was compared.The cardiac function indicators[left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD)],hemodynamic parameters[heart rate(HR),and stroke volume(SV)],coronary microcirculation status,and quality of life[using the Chinese questionnaire of quality of life in patients with cardiovascular disease(CQQC)]before and 1 week after medication were monitored and compared.Vascular disease scoring evaluation,as well as biomarkers such as serum growth stimulation expressed gene 2 protein(ST2),the levels of cystatin C(CysC)and N-terminal pro brain natriuretic peptide(NT proBNP)were also compared;Statistical analysis of major adverse cardiovascular events(MACE)during the follow-up period and the occurrence of adverse reactions during treatment were performed.Results The total effective rate of treatment was significantly higher in Group A than in Group B(P<0.05).After 1 week of medication,SV,LVEF,and quality of life scores(assessed using CQQC)significantly increased in the 2 groups(P<0.05),while LVEDD,LVESD,HR,coronary microcirculation score,and serum ST2,CysC,and NT-proBNP levels significantly decreased(P<0.05).Group A exhibited significantly higher SV,LVEF,and CQQC scores compared with Group B(P<0.05),while LVEDD,LVESD,HR,coronary microcirculation score,and serum ST2,CysC,and NT-proBNP levels were significantly lower(P<0.05).No significant difference was observed in the incidence of adverse reactions or MACE between the 2 groups during follow-up(P>0.05).Conclusion Administering dapagliflozin within 72 hours after PCI in AMI patients results in better therapeutic outcomes,promoting recovery of left ventricular function and improvement of coronary microcirculation.
作者
修天元
吕晓翠
张津宁
陈玲
时秀文
王紫监
XIU Tianyuan;LU Xiaocui;ZHANG Jinning;CHEN Ling;SHI Xiuwen;WANG Zijian(Department of Cardiology,the Second Affiliated Hospital of Hebei North University,Zhangjiakou 075100,China;Department of Catheterization,the Second Affiliated Hospital of Hebei North University,Zhangjiakou 075100,China)
出处
《西北药学杂志》
2025年第4期99-105,共7页
Northwest Pharmaceutical Journal
基金
河北省卫生健康委科研基金项目(编号:20241647)。
关键词
急性心肌梗死
经皮冠脉介入术
达格列净
心功能
冠状动脉微循环
acute myocardial infarction
percutaneous coronary intervention
dapagliflozin
cardiac function
coronary microcirculation
