达格列净治疗慢性射血分数降低的心力衰竭的效果及对心室重塑和心功能的影响

Effect of Dapagliflozin on Chronic Heart Failure with Reduced Ejection Fraction and Its Influence on Ventricular Remodeling and Cardiac Function

摘要: 目的：探讨达格列净治疗慢性射血分数降低的心力衰竭(HFrEF)的临床效果，以及其对患者心室重塑和心功能的影响。方法：选取2023年1月至2024年1月本院收治的45例HFrEF患者作为研究对象，采用随机数字表法分为对照组(22例)和观察组(23例)。对照组给予心力衰竭常规标准化治疗，观察组在对照组基础上联合达格列净片治疗，两组均连续治疗6个月。比较两组患者治疗前后纽约心脏病协会(NYHA)心功能分级、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、N末端B型脑钠肽前体(NT-proBNP)水平及6分钟步行距离(6 MWD)，记录治疗期间不良反应发生情况。结果：治疗6个月后，两组患者NYHA心功能分级均较治疗前改善，且观察组改善程度优于对照组(P < 0.05)；两组患者LVEF、6 MWD均较治疗前升高，LVEDD、LVESD及NT-proBNP水平均较治疗前降低，且观察组上述指标改善幅度均显著大于对照组(P < 0.05)。治疗期间，观察组不良反应发生率为8.70% (2/23)，对照组为9.09% (2/22)，两组比较差异无统计学意义(P > 0.05)。结论：达格列净联合常规治疗可显著改善HFrEF患者的心功能，抑制心室重塑，提高运动耐力，且安全性良好。

Abstract: Objective: To explore the clinical effect of dapagliflozin in the treatment of chronic heart failure with reduced ejection fraction (HFrEF) and its influence on ventricular remodeling and cardiac function in patients. Methods A total of 45 HFrEF patients admitted to our hospital from January 2023 to January 2024 were selected as the research objects, and divided into control group (22 cases) and observation group (23 cases) by random number table method. The control group was given routine standardized treatment for heart failure, and the observation group was treated with dadadadapagliflozin tablets on the basis of the control group. Both groups were treated continuously for 6 months. The New York Heart Association (NYHA) cardiac function classification, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), N-terminal pro-B-type natriuretic peptide (NT-proBNP) level and 6-minute walk distance (6MWD) were compared between the two groups before and after treatment, and the occurrence of adverse reactions during treatment was recorded. Results After 6 months of treatment, the NYHA cardiac function classification of both groups was improved compared with before treatment, and the improvement degree of the observation group was better than that of the control group (P < 0.05); the LVEF and 6MWD of both groups were increased compared with before treatment, the LVEDD, LVESD and NT-proBNP levels were decreased compared with before treatment, and the improvement range of the above indicators in the observation group was significantly greater than that in the control group (P < 0.05). During treatment, the incidence of adverse reactions in the observation group was 8.70% (2/23), and that in the control group was 9.09% (2/22), with no statistically significant difference between the two groups (P > 0.05). Conclusion DaDaDaDapagliflozin combined with conventional treatment can significantly improve the cardiac function of HFrEF patients, inhibit ventricular remodeling, improve exercise tolerance, and has good safety.