达格列净联合左西孟旦治疗慢性心力衰竭患者伴心律失常的疗效及安全性分析

Efficacy and safety of dapagliflozin combined with levosimendan in treating patients with chronic heart failure complicating arrhythmia

摘要:

目的 探讨达格列净联合左西孟旦治疗慢性心力衰竭（CHF）伴心律失常的疗效及安全性。方法 选取2021年3月—2023年3月滕州市中心人民医院收治的192例CHF伴心律失常患者，采用随机数字表法分为对照组和研究组，每组96例（研究组最终脱落3例，对照组脱落2例）。对照组给予左西孟旦注射液，研究组在对照组的基础上给予达格列净片。两组持续治疗1个月后观察疗效。比较两组临床疗效、室性心律失常、心功能、心肌损伤指标及药物不良反应发生情况，对比两组治疗后30 d内因心力衰竭再住院情况。结果 研究组总有效率高于对照组（P <0.05）。研究组治疗前后室性早搏、成对室性早搏、短阵室速发作次数的差值高于对照组（P <0.05）。研究组治疗前后左心室射血分数、左室舒张末期内径、左心室收缩末期内径的差值高于对照组（P <0.05）。研究组治疗前后N末端脑钠肽前体、心肌肌钙蛋白Ⅰ的差值高于对照组（P <0.05）。两组总药物不良反应发生率、治疗后30 d内因心力衰竭再住院率比较，差异均无统计学意义（P >0.05）。结论 达格列净联合左西孟旦治疗CHF伴心律失常患者可增强临床疗效，减少室性心律失常发作次数，改善心功能，减轻心肌细胞损伤，且安全性良好。

Abstract:

Objective To investigate the efficacy and safety of dapagliflozin combined with levosimendan in the treatment of chronic heart failure (CHF) complicating arrhythmia.Methods The 192 patients with CHF complicating arrhythmia admitted to our hospital from March 2021 to March 2023 were selected and divided into the control group and the study group by the random number table method, with 96 cases in each group (3 cases and 2 cases lost to follow-up in the study group and the control group). The control group was given levosimendan injection, and the study group was given dapagliflozin tablet plus levosimendan injection. The two groups were observed after continuous treatment for 1 month. The clinical efficacy, occurrence of ventricular arrhythmias, cardiac function, levels of markers for myocardial injury and the incidence of adverse drug reactions were compared between the two groups. The rate of re-hospitalization for heart failure within 30 days after treatment was compared between the two groups.Results The overall effective rate of the study group was higher than that of the control group (P < 0.05). The differences of the frequencies of premature ventricular contractions, a pair of premature ventricular contractions and short ventricular tachycardia before and after treatment in the study group were higher than those in the control group (P < 0.05). The differences of left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) before and after treatment in the study group were higher than those in the control group (P < 0.05). The differences of levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) before and after treatment in the study group were higher than those in the control group (P < 0.05). There was no significant difference in the overall incidence of adverse drug reactions or the rate of re-hospitalization for heart failure within 30 days after treatment between the two groups (P > 0.05).Conclusions Dapagliflozin combined with levosimendan enhances the clinical efficacy in the treatment of CHF patients with arrhythmia. Besides, it reduces the frequency of ventricular arrhythmias, improves cardiac function, and ameliorates myocardial cell damage with few safety concerns.