摘要
目的:探讨并分析达格列净(Dapagliflozin,DAP)联合美托洛尔(Metoprolol,MET)及螺内酯(Spironolactone,SPI)治疗心力衰竭(Heart Failure,HF)的疗效及对N末端B型脑钠肽前体(N-terminal pro-B-type natriuretic peptide,N-proBNP)、超敏C反应蛋白(High-sensitivity C-reactive protein,hs-CRP)的影响。方法:选取2024年1月至2025年1月本院确诊收治的60例心力衰竭患者作为研究对象,使用简单随机分组将纳入患者分为对照组和研究组,各30例。对照组患者采用美托洛尔及螺内酯治疗,研究组在对照组基础上联合达格列净治疗,均持续治疗3 m。对比两组临床疗效、心功能[左心室射血分数(Left Ventricular Ejection Fraction,LVEF)、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)]、血清NT-proBNP、hs-CRP水平及不良反应。结果:治疗后,研究组治疗总有效率明显高于对照组(P<0.05);治疗后,研究组患者血清hs-CRP、NT-proBNP水平明显低于对照组(P<0.05);研究组患者心功能LVEF水平明显高于对照组,LVEDD、LVESD水平均明显低于对照组(P<0.05);对照组和研究组患者发生低血糖、低血压、尿路感染、心动过缓等不良反应情况无明显差异(P>0.05)。结论:达格列净联合美托洛尔及螺内酯治疗能够更有效地改善心力衰竭患者的心功能,降低N-proBNP和hs-CRP水平,且安全性良好。
Objective:To explore and analyze the curative effect of dapagliflozin(DAP)combined with metoprolol(MET)and spironolactone(SPI)in heart failure(HF)and its influences on N-terminal pro-B-type natriuretic peptide(NT-proBNP)and high-sensitivity C-reactive protein(hs-CRP).Methods:A total of 60 patients with heart failure diagnosed and treated in our hospital from January 2024 to January 2025 were selected.The included patients divided into control group and study group,30 cases in each group,using simple random grouping.The patients in control group were treated with metoprolol and spironolactone,and the patients in study group were treated with dapliflozin in addition to control group,and the treatment lasted for 3 months.The clinical efficacy,cardiac function[Left Ventricular Ejection Fraction(LVEF),Left Ventricular EndDiastolic Diameter(LVEDD),Left Ventricular End-Systolic Diameter(LVESD)],serum NT-proBNP hs-CRP levels and adverse reactions were compared between the two groups.Results:After treatment,the total effective rate of the study group was 93.33%,which was better than that the control group 77.33%(P<0.05).After treatment,the levels of hs-CRP and NTproBNP in the serum of patients in the study group were lower than those in the control group(P<005);the LVEF level of patients in the study group was higher than that in the control group,and the of LVEDD and LVESD were lower than those in the control group(P<0.05);There was no significant difference the occurrence of adverse reactions such as hypoglycemia,hypotension,urinary tract infection,and bradycardia between the control group and study group(P>0.05).Conclusion:Dapagliflozin combined with metoprolol and spironolactone can more effectively improve cardiac function,reduce levels of N-proBNP and hs-CRP in patients with heart failure,which has good safety.
作者
钟菁
Zhong Jing(Department of Internal Medicine,Quannan People's Hospital,Ganzhou 341800,Jiangxi,China)
关键词
达格列净
美托洛尔
螺内酯
心力衰竭
N末端B型脑钠肽前体
Dapagliflozin
Metoprolol
Spironolactone
Heart failure
N-terminal pro-B-type natriuretic peptide
