达格列净治疗急性心肌梗死合并心力衰竭的疗效研究

目的 探讨联合达格列净治疗急性心肌梗死（acute myocardial infarction，AMI）合并心力衰竭患者的疗效及安全性。方法 选取2021年5月至2022年5月于浙江大学医学院附属金华医院住院的AMI合并心力衰竭患者80例，根据随机数字表法将患者分为达格列净组和对照组，每组各40例。比较两组患者治疗前后脑钠肽（brain natriuretic peptide，BNP）水平、心脏结构和功能指标，随访6个月，观察两组患者的心血管不良事件及达格列净不良反应发生情况。结果 治疗后，两组患者的BNP、左心室舒张末期内径（left ventricular end diastolic diameter，LVEDD）、左心室收缩末期内径（left ventricular end systolic diameter，LVESD）均显著低于本组治疗前，左室射血分数（left ventricular ejection fraction，LVEF）、左心室短轴缩短率（left ventricular fractional shortening，LVFS）均显著高于本组治疗前（P<0.05）；达格列净组患者的BNP、LVEDD、LVESD均显著低于对照组，LVEF、LVFS均显著高于对照组（P<0.05）。达格列净组患者的心血管事件发生率低于对照组，但两组比较差异无统计学意义（7.5% vs. 15.0%，2=1.127，P=0.288）。达格列净组出现1例尿路感染，1例低血压，两组患者的不良反应发生率比较差异无统计学意义（2=2.051，P=0.152）。结论 联合达格列净治疗AMI合并心力衰竭可有效改善患者的心功能及心室重构，且相对安全，临床应用价值较高。

Curative effect of dapagliflozin on acute myocardial infarction complicated with heart failure

Objective To investigate the efficacy and safety of dapagliflozin in the treatment of acute myocardial infarction (AMI) complicated patients with heart failure. Methods A total of 80 patients with AMI complicated with heart failure admitted to Affiliated Jinhua Hospital, Zhejiang University School of Medicine from May 2021 to May 2022 were selected and divided into dapagliflozin group and control group according to random number table method, with 40 patients in each group. Brain natriuretic peptide (BNP) level, cardiac structure and function indexes were compared between the two groups before and after treatment. After 6 months of follow-up, the incidence of cardiovascular adverse events and adverse reactions of dapagliflozin in the two groups were observed. Results After treatment, BNP, left ventricular end diastolic diameter (LVEDD) and left ventricular end systolic diameter (LVESD) in two groups were significantly lower than before treatment, while left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were significantly higher than before treatment (P<0.05). BNP, LVEDD and LVESD in dapagliflozin group were significantly lower than those in control group, while LVEF and LVFS were significantly higher than those in control group (P<0.05). The incidence of cardiovascular adverse events in dapagliflozin group was lower than that in control group, but there was no significant difference between the two groups (7.5% vs. 15.0%, 2=1.127, P=0.288). There was one case of urinary tract infection and one case of hypotension in dapagliflozin group. There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Combined with dapagliflozin in treatment of AMI complicated with heart failure can effectively improve the cardiac function of patients and is relatively safe, with good clinical application value.