达格列净与恩格列净治疗心力衰竭合并心脏起搏器植入老年患者的效果及预后比较 点击下载
论文标题： 达格列净与恩格列净治疗心力衰竭合并心脏起搏器植入老年患者的效果及预后比较
英文标题：
中文摘要： 目的 比较达格列净与恩格列净治疗心力衰竭（HF）合并心脏起搏器植入老年患者的效果及预后。方法回顾性收集南阳医学高等专科学校第一附属医院心血管内科2023年7月1日至2025年1月1日收治的237例HF合并心脏起搏器植入老年患者的临床资料，根据用药情况分为对照组（常规治疗，n＝90）、达格列净组（常规治疗+达格列净，n＝77）和恩格列净组（常规治疗+恩格列净，n＝70）。评估3组患者治疗前和治疗6个月后的心功能、HF相关指标，并比较3组患者的主要不良心血管事件（MACE）发生率和HF再住院率，以及不良反应发生情况。结果治疗6个月后，与同组治疗前比较，3组患者的左心室射血分数均显著升高，6分钟步行距离均显著延长，左心室舒张末内径、左心室收缩末内径均显著缩短，氨基末端B型利钠肽前体、超敏C反应蛋白水平均显著降低（P＜0.05）；达格列净组和恩格列净组上述大多数指标的改善效果均显著优于对照组（P＜0.05），恩格列净组的改善效果均显著优于达格列净组（P＜0.05）。达格列净组和恩格列净组患者的HF再住院率均显著低于对照组（P＜0.05），且恩格列净组显著低于达格列净组（P＜0.05）。3组患者的MACE发生率比较，差异无统计学意义（P＞0.05），但达格列净组和恩格列净组在数值上低于对照组。3组患者的不良反应发生率比较，差异无统计学意义（P＞0.05）。结论达格列净与恩格列净均可在常规治疗基础上改善HF合并心脏起搏器植入老年患者的心功能和HF相关指标，降低HF再住院风险，且未增加不良反应发生风险；与达格列净相比，恩格列净的作用效果更显著。
英文摘要： OBJECTIVE To compare the efficacy and prognosis between dapagliflozin and empagliflozin in elderly patients with heart failure （HF） complicated by cardiac pacemaker implantation.METHODS The clinical data of 237 elderly patients with HF complicated by cardiac pacemaker implantation， who were admitted to the Department of Cardiovascular Medicine at the First Affiliated Hospital of Nanyang Medical College from July 1， 2023， to January 1， 2025， were retrospectively collected. According to medication use， the patients were divided into the control group （conventional therapy， n ＝90）， dapagliflozin group （conventional therapy plus dapagliflozin， n ＝77）， and empagliflozin group （conventional therapy plus empagliflozin， n ＝70）. Cardiac function and HF-related indicators were evaluated before treatment and after 6 months of treatment among the 3 groups. The incidence of major adverse cardiovascular events （MACE）， HF rehospitalization rate， and the occurance of adverse reaction were compared among the 3 groups.RESULTS After 6 months of treatment， compared with the same group before treatment， left ventricular ejection fraction was significantly increased， 6-minute walk distance was significantly prolonged， left ventricular end-diastolic diameter and left ventricular end-systolic diameter were significantly shortened， and N-terminal pro-B-type natriuretic peptide and high-sensitivity C-reactive protein levels were significantly decreased in all 3 groups （ P ＜0.05）. The improvements in most of the above indicators were greater in the dapagliflozin and empagliflozin groups than in the control group （ P ＜0.05）， and were all greater in the empagliflozin group than in the dapagliflozin group （ P ＜0.05）. The HF rehospitalization rate was significantly lower in both dapagliflozin and empagliflozin groups than in the control group （ P ＜0.05）， and was significantly lower in the empagliflozin group than in the dapagliflozin group （ P ＜0.05）. There was no statistically significant difference in the incidence of MACE among the 3 groups （ P ＞0.05）， although the incidence was numerically lower in the dapagliflozin and empagliflozin groups than in the control group. There was also no statistically significant difference in the incidence of adverse reactions among the 3 groups （ P ＞0.05）.CONCLUSIONS Both dapagliflozin and empagliflozin can improve cardiac function and HF-related indicators and reduce the risk of HF rehospitalization in elderly patients with HF complicated by cardiac pacemaker implantation on the basis of conventional therapy， without increasing the risk of adverse reactions. Compared with dapagliflozin， empagliflozin shows more pronounced effects.
期刊： 2026年第37卷第16期
作者： 王勃；张鸥；李杰；韩冬
英文作者： WANG Bo，ZHANG Ou，LI Jie，HAN Dong
关键字： 达格列净；恩格列净；心力衰竭；心脏起搏器；老年患者；心功能；预后
KEYWORDS： Dapagliflozin;empagliflozin;Heart failure;cardiac pacemaker;Elderly patient;Cardiac function;prognosis
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