Page 97 - 《中国药房》2025年11期

·药物与临床·

达格列净治疗稳定性冠心病合并心力衰竭的临床观察
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董耀辉 ，胡 钢 ，王晓慧（长江大学附属荆州医院心血管内科，湖北 荆州 434000）
中图分类号 R969.4；R541 文献标志码 A 文章编号 1001-0408（2025）11-1375-04
DOI 10.6039/j.issn.1001-0408.2025.11.15

摘 要 目的 探讨达格列净治疗稳定性冠心病合并心力衰竭（HF）患者的临床疗效。方法 采用前瞻性研究法，将2023年1月1
日至2024年1月1日我院收治的稳定性冠心病合并HF患者158例按照随机数字表法分为达格列净组（n＝76）和常规治疗组（n＝
82）。所有患者均接受利尿剂、阿司匹林、氯沙坦、美托洛尔、他汀类药物等常规治疗；达格列净组患者在常规治疗基础上联用达格
列净片，每次10 mg，每天1次；疗程均为6个月。比较两组患者治疗前后左室射血分数（LVEF）、左室收缩末期内径（LVESD）、左
室舒张末期内径（LVEDD）、空腹血糖、氨基末端脑利钠肽前体（NT-proBNP）、心绞痛发作次数、心绞痛发作持续时间、脂蛋白相关
磷脂酶A2等指标的变化，并评估两组患者治疗期间肾功能不全、肝功能不全、泌尿系统感染、新发透析、低血压、低血糖等不良反
应的发生情况。结果 治疗过程中共有16例患者脱落，最终达格列净组70例、常规治疗组72例患者完成研究。治疗前，两组患者
上述各项指标比较，差异均无统计学意义（P＞0.05）。与治疗前相比，治疗后两组患者的LVESD、LVEDD均显著缩短，LVEF均显
著升高，NT-proBNP、脂蛋白相关磷脂酶A2水平均显著降低，心绞痛发作次数、心绞痛发作持续时间均显著减少（P＜0.05），且达
格列净组患者较常规治疗组改善得更为明显（P＜0.05）。两组患者的空腹血糖水平以及上述各项不良反应发生率比较，差异均无
统计学意义（P＞0.05）。结论 在常规治疗上加用达格列净能够缩短稳定性冠心病合并HF患者的LVESD、LVEDD，提高LVEF水
平，降低NT-proBNP、脂蛋白相关磷脂酶A2水平，减少心绞痛发作次数和心绞痛持续时间，从而改善其心功能，且安全性较好。
关键词 达格列净；稳定性冠心病；心力衰竭；心功能；临床疗效

Clinical observation of dapagliflozin for stable coronary heart disease combined with heart failure
DONG Yaohui，HU Gang，WANG Xiaohui（Dept. of Cardiovascular Medicine， Jingzhou Hospital Affiliated to
Changjiang University， Hubei Jingzhou 434000， China）

ABSTRACT OBJECTIVE To explore the clinical efficacy of dapagliflozin for stable coronary heart disease combined with heart
failure （HF）. METHODS A prospective study method was employed. A total of 158 patients with stable coronary heart disease and
HF admitted to our hospital from January 1， 2023， to January 1， 2024， were enrolled. Using a random number table method， they
were divided into dapagliflozin group （n＝76） and conventional treatment group （n＝82）. All patients received conventional
treatment， including diuretic， aspirin， losartan， metoprolol and statins. Patients in the dapagliflozin group were additionally
administered Dapagliflozin tablets at a dose of 10 mg once daily on top of the conventional treatment. The treatment duration was
six months. The changes in left ventricular ejection fraction （LVEF）， left ventricular end-systolic diameter （LVESD）， left
ventricular end-diastolic diameter （LVEDD）， fasting blood glucose， N-terminal pro-brain natriuretic peptide （NT-proBNP）， the
number of angina attacks， the duration of angina attacks， and lipoprotein-associated phospholipase A2 before and after treatment
were compared between the two groups. The occurrence of adverse reactions such as renal dysfunction， liver dysfunction， urinary
system infections， new-onset dialysis， hypotension and hypoglycemia was evaluated in the two groups during treatment. RESULTS
During the study， 16 patients were lost to follow-up. Ultimately， 70 patients in the dapagliflozin group and 72 patients in the
conventional treatment group completed the study. Before treatment， there were no statistically significant differences in the
aforementioned indicators between the two groups （P＞0.05）. Compared with before treatment， after treatment， both groups
showed significant shortening in LVESD and LVEDD， significant increases in LVEF， significant reductions in NT-proBNP and
lipoprotein-associated phospholipase A2 levels， and significant reductions in the number of angina attacks and the duration of
angina attacks （P＜0.05）； the improvements in the dapagliflozin group were more significant than those in the conventional
treatment group （P＜0.05）. There was no statistically significant difference between the two groups in fasting blood glucose levels
and the incidence of the aforementioned adverse reactions （P＞0.05）. CONCLUSIONS Adding dapagliflozin to conventional
treatment can shorten LVESD and LVEDD， increase LVEF levels， reduce NT-proBNP and lipoprotein-associated phospholipase A2
levels， and decrease the number and duration of angina attacks
Δ 基金项目 湖北省自然科学基金一般面上项目（No.2022CFB392） in patients with stable coronary heart disease combined with
＊第一作者 主治医师，硕士。研究方向：心血管内科。E-mail： HF， thereby improving their cardiac function， and
dongyaohui@yangtzeu.edu.cn demonstrates good safety.
# 通信作者 主 任 医 师 。 研 究 方 向 ：心 血 管 内 科 。 E-mail： KEYWORDS dapagliflozin； stable coronary heart disease；
hugangjzyy@163.com heart failure； cardiac function； clinical efficacy

中国药房 2025年第36卷第11期 China Pharmacy 2025 Vol. 36 No. 11 · 1375 ·