达格列净对经皮冠状动脉介入治疗后患者非靶病变进展的影响

The Influence of Dapagliflozin on the Progression of Non-Target Lesions in Patients after Percutaneous Coronary Intervention

摘要: 目的：旨在分析降糖药达格列净对经皮冠状动脉介入治疗(PCI)后冠心病患者非靶病变进展的干预效果。方法：选取2020年3月至2024年3月在广州医科大学附属第四医院心内科接受PCI治疗并顺利出院的112例冠心病患者为研究对象，采用随机分组方法将其分为对照组与达格列净组。达格列净组在标准治疗方案基础上加用达格列净，所有患者在PCI术前24小时、术后24小时及随访冠状动脉造影(CAG)前24小时采集血液样本，测定高敏C反应蛋白(hs-CRP)以及白介素-6 (IL-6)浓度，同时记录并分析两组患者的临床基线资料与冠状动脉造影检查结果。结果：2组患者PCI术后hs-CRP、IL-6水平均较术前显著上升(P < 0.05)；在1年随访CAG检查前，达格列净组hs-CRP、IL-6水平较对照组明显下降(P < 0.05)；此外，达格列净组冠脉最小管腔面膜机、斑块负荷减少，非靶病变进展发生率下降(P < 0.05)。结论：PCI术后hs-CRP、IL-6水平呈现上升趋势，而达格列净能够有效抑制hs-CRP、IL-6升高，发挥抗炎效应，从而延缓非靶病变的进展。

Abstract: Objective: The aim is to analyze the intervention effect of the hypoglycemic drug dapagliflozin on the progression of non-target lesions in patients with coronary heart disease after percutaneous coronary intervention (PCI). Methods: A total of 112 patients with coronary heart disease who underwent PCI treatment and were successfully discharged from the Department of Cardiology of the Fourth Affiliated Hospital of Guangzhou Medical University from March 2020 to March 2024 were selected as the research subjects. They were randomly divided into the control group and the dapagliflozin group. In the dapagliflozin group, dapagliflozin was added to the standard treatment regimen. Blood samples were collected from all patients 24 hours before PCI, 24 hours after PCI, and 24 hours before follow-up coronary angiography (CAG) to determine the concentrations of high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6). Meanwhile, the clinical baseline data and coronary angiography examination results of the two groups of patients were recorded and analyzed. Results: The levels of hs-CRP and IL-6 in both groups of patients after PCI increased significantly compared with those before the operation (P < 0.05). Before the 1-year follow-up CAG examination, the levels of hs-CRP and IL-6 in the dapagliflozin group were significantly lower than those in the control group (P < 0.05). In addition, in the dapagliflozin group, the minimum lumen area of coronary arteries, plaque burden decreased, and the incidence of non-target lesion progression decreased (P < 0.05). Conclusion: The levels of hs-CRP and IL-6 show an upward trend after PCI. However, dapagliflozin can effectively inhibit the increase of hs-CRP and IL-6, exert anti-inflammatory effects, and thereby delay the progression of non-target lesions.