摘要
目的探讨依那普利联合达格列净对急性心肌梗死(AMI)患者急诊经皮冠状动脉介入治疗(PCI)术后心力衰竭的临床疗效。方法选取2020年2月至2022年2月唐山市人民医院收治的124例AMI急诊PCI术后心力衰竭患者进行回顾性分析。按照随机数字表法分为对照组和观察组,每组62例,对照组采用常规药物+依那普利治疗、观察组采用常规药物+依那普利+达格列净治疗。比较两组患者基线资料;比较两组患者治疗前、后血清中高敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽(GSH)、肌酐(Cr)、尿酸(UA)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、24 h尿量、氨基末端脑利钠肽前体(NT-proBNP)、内皮素-1(ET-1)、基质金属蛋白酶-9(MMP-9)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)和左室射血分数(LVEF),并对治疗3个月后临床疗效进行评估。结果两组患者性别、年龄、吸烟史、饮酒史、高血压、心房颤动、植入支架个数等差异无统计学意义(P>0.05)。治疗前,两组患者所有指标差异均无统计学意义(P>0.05);治疗后,与对照组相比,观察组患者hs-CRP、IL-6、TNF-α、MDA、UA、Cr、TC、TG、LDL-C、NT-proBNP、ET-1、MMP-9、LVESD和LVEDD表达水平降低(P<0.05),SOD、GSH、24 h尿量、HDL-C、LVEF以及治疗总有效率升高(P<0.05)。结论依那普利联合达格列净能够有效缓解AMI患者急诊PCI术后心力衰竭的进展。
Objective To investigate the clinical efficacy of enalapril combined with dapagliflozin on heart failure(HF)following emergency percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods A total of 124 patients with HF following emergency PCI for AMI admitted to Tangshan People's Hospital from February 2020 to February 2022 were selected for a retrospective analysis.They were divided into a control group(n=62,treated with conventional drugs+enalapril)and an observation group(n=62,treated with conventional drugs+enalapril+dapagliflozin)according to a computer-generated random number table.The baseline data were compared between the two groups.The inflammatory and oxidative stress markers[high sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),malondialdehyde(MDA),superoxide dismutase(SOD),and glutathione(GSH)],renal and liver function parameters[creatinine(Cr),uric acid(UA),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),and 24-h urine output],and cardiac biomarkers[N-terminal pro-brain-type natriuretic peptide(NT-proBNP),endothelin-1(ET-1),matrix metalloproteinase-9(MMP-9),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),and left ventricular ejection fraction(LVEF)]before and after treatment were compared between the two groups.Clinical efficacy after 3 months of treatment was assessed.Results There was no significant difference in gender,age,smoking history,drinking history,hypertension,atrial fibrillation and number of implanted stents between the two groups(P>0.05),indicating comparability.Before treatment,there was no statistically significant difference in all the indexes between the two groups(P>0.05).After treatment,compared with the control group,the observation group exhibited decreased levels of hs-CRP,IL-6,TNF-α,MDA,UA,Cr,TC,TG,LDL-C,NT-proBNP,ET-1,MMP-9,LVESD,and LVEDD,along with increased levels of SOD,GSH,24-h urine output,HDL-C,LVEF,and overall clinical efficacy(P<0.05).Conclusion The combination of enalapril and dapagliflozin can effectively alleviate the progression of heart failure following emergency PCI in AMI patients.
作者
吴曼
潘超
董雪姣
郭俊玲
张媛媛
Wu Man;Pan Chao;Dong Xuejiao;Guo Junling;Zhang Yuanyuan(Department of Critical Care Medicine,Tangshan People's Hospital,Tangshan 063000,China)
出处
《成都医学院学报》
2025年第5期763-768,共6页
Journal of Chengdu Medical College
基金
河北省科学技术厅重点研发计划项目(No:22019810817D)。
