摘要
目的:分析探讨达格列净对重症心力衰竭患者心功能及丝裂原活化蛋白激酶(MAPK)、诱导型一氧化氮合酶(iNOS)、细胞外调节蛋白激酶1/2(ERK1/2)的影响.方法:选择本院收治的122例重症心力衰竭患者,以随机数字表法分为常规治疗组(以利尿扩血管为主的基础疗法)和达格列净组(在常规治疗组基础上增加达格列净),每组61例.治疗3个月后评估比较两组患者的临床疗效、心功能、冠脉血流动力学指标、治疗安全性等.结果:达格列净组总有效率显著高于常规治疗组(91.80％比77.05％,P=0.025).治疗后,与常规治疗组比较,达格列净组左室射血分数(LVEF)、每搏输出量(SV)及舒张期峰流速(DPV)、收缩期峰流速(SPV)、冠状动脉血流量(CBF)均显著增加,QT间期离散度(QTd)、左室舒张末内径(LVEDd)、冠脉循环阻力(CR)和MAPK[(46.79±7.02)ng/L 比(39.38±5.82)ng/L]、iNOS[(88.93±10.02)μmol/L比(79.61±9.04)μmol/L]、ERK1/2[(27.03±5.83)ng/L比(21.62±4.18)ng/L]均显著降低(P均=0.001).两组不良反应发生率无显著差异(P=0.408).结论:达格列净联合利尿扩血管治疗对重症心力衰竭患者治疗效果显著,能够改善患者的心功能和冠脉血流动力学,降低MAPK、iNOS、ERK1/2水平,安全性较好.
Abstract
Objective:To analyze and explore the effect of dapagliflozin on cardiac function,mitogen activated protein ki-nase(MAPK),inducible nitric oxide synthase(iNOS)and extracellular regulated protein kinase 1/2(ERK1/2)in patients with severe heart failure(SHF).Methods:A total of 122 SHF patients treated in our hospital were selected,randomly and equally divided into routine treatment group(received diuretic vasodilation-dominant basic therapy)and dapagliflozin group(received dapagliflozin based on routine treatment group).After three-month treatment,therapeutic effect,cardi-ac function,coronary hemodynamic indexes and therapeutic safety were compared between two groups.Results:The total effective rate of dapagliflozin group was significantly higher than that of routine treatment group(91.80％vs.77.05％,P=0.025).Compared with routine treatment group after treatment,there were significant rise in left ventricular ejection fraction(LVEF),stroke volume(SV),diastolic peak velocity(DPV),systolic peak velocity(SPV)and coronary blood flow(CBF),and significant reductions in QT interval dispersion(QTd),left ventricular end-diastolic diameter(LVEDd),coronary resistance(CR)and levels of MAPK[(46.79±7.02)ng/L vs.(39.38±5.82)ng/L],iNOS[(88.93±10.02)μmol/L vs.(79.61±9.04)μmol/L]and ERK1/2[(27.03±5.83)ng/L vs.(21.62±4.18)ng/L]in dapagliflozin group,P=0.001 all.There was no significant difference in incidence rate of adverse reactions between two groups,P=0.408.Conclusion:Dapagliflozin combined with diuretic and vasodilator therapy has a significant therapeutic effect on patients with severe heart failure,which can improve cardiac function and coronary hemodynamics,reduce the levels of MAPK,iNOS,and ERK1/2 with good safety.
维普
万方数据