目的 观察维立西呱联合达格列净在射血分数减低型心力衰竭(heart failure with reduced ejection fraction,HFrEF)中的应用效果.方法 选择2023年1月至2024年1月我院HFrEF患者98例,按随机数字表法分为联合组和对照组,每组49例.在常规HF治疗基础上,予对照组达格列净,予联合组达格列净联合维立西呱,两组均治疗6个月.比较两组临床效果、不良反应、HF再住院率、主要不良心血管事件(major adverse cardiovascular event,MACE)发生率与治疗前后心功能指标、N-末端脑钠肽前体(N-terminal brain natriuretic peptide precursor,NT-proBNP)、中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、C 反应蛋白(C-reactive protein,CRP)、明尼苏达心力衰竭生活质量量表(Minnesota living with heart failure questionnaire,MLHFQ)评分、6 min 步行试验(6-minute walking test,6MWT)距离.结果 治疗后,联合组总有效率高于对照组(93.62％vs 70.83％,P＜0.05).两组LVEF水平、6MWT距离均升高,且联合组高于对照组(P＜0.05).LVEDD、LVESD、NT-proBNP、NLR、CRP水平及MLHFQ评分均降低,且联合组低于对照组(P＜0.05).两组不良反应发生情况无显著差异(P＜0.05).在HF再住院(6.38％vs 20.83％,P＜0.05)、MACE发生率(12.77％vs 31.25％,P＜0.05)方面,联合组均分别低于对照组.结论 维立西呱联合达格列净可显著减轻HFrEF患者心室重构与炎症反应,增强疗效,改善生活质量及预后,且安全性佳.
Application of vericiguat combined with dapagliflozin in patients with heart failure with reduced ejection fraction
Objective To observe the effect of vericiguat combined with dapaglifiozin in patients with heart failure with reduced ejection fraction(HFrEF).Methods A total of 98 patients with HFrEF in our hospital from January 2023 to January 2024 were selected and divided into combination group and control group according to random number table method,with 49 cases in each group.On the basis of conventional HF treatment,the control group was given dapagliflozin,the combination group was given dapagliflozin combined with vericiguat.Both groups were treated for 6 months.The clinical effect,adverse reactions,HF rehospitalization rate and major adverse cardiovascular event(MACE)were compared between the two groups.The cardiac function indexes,N-terminal brain natriuretic peptide precursor(NT-proBNP),neutrophil-to-lymphocyte ratio(NLR),C-reactive protein(CRP),Minnesota living with heart failure questionnaire(MLHFQ)score,6-minute walking test(6MWT)distance were compared between the two groups before and after treatment.Results After treatment,the total effective rate of combination group was higher than that of control group(93.62％vs 70.83％,P＜0.05).The LVEF level and 6MWT distance were increased in both groups,and the combination group was higher than the control group(P＜0.05).The levels of LVEDD,LVESD,NT-proBNP,NLR,CRP and MLHFQ score were all decreased,and the combination group was lower than the control group(P＜0.05).There was no significant difference in the occurrence of adverse reactions between the two groups(P＜0.05).The incidence of HF rehospitalization(6.38％vs 20.83％,P＜0.05)and MACE(12.77％vs 31.25％,P＜0.05)in the combination group were lower than those in the control group,respectively.Conclusion Vericiguat combined with dapagliflozin can significantly reduce ventricular remodeling and inflammatory response in HFrEF patients,enhance efficacy,improve quality of life and prognosis,and have good safety.
vericiguatdapagliflozinheart failure with reduced ejection fractionventricular remodeling
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