达格列净对射血分数降低的心力衰竭患者的效果观察

Effect observation of dagliazine in treatment of patients with heart failure with reduced ejection fraction

  • 摘要:
    目的 探讨达格列净对射血分数降低的心力衰竭(HFrEF)患者CXC趋化因子配体16(CXCL16)、基质细胞衍生因子-1(SDF-1)及亲环素A(CypA)水平的影响。
    方法 将156例HFrEF患者按照干预治疗方案的不同分为干预组和对照组,每组78例。对照组采用常规标准化药物干预治疗,干预组在对照组基础上加用达格列净治疗。比较2组总有效率; 比较2组治疗前后CXCL16、SDF-1、CypA水平的变化; 采用Spearman相关系数分析CXCL16、SDF-1、CypA与临床疗效的相关性; 比较2组治疗前后N末端B型利钠肽原(NT-proBNP)、超敏C反应蛋白(hs-CRP)、心肌肌钙蛋白I(cTnI)、肿瘤坏死因子-α(TNF-α)水平; 比较2组治疗前后心室重塑指标左室舒张末期内径(LVEDd)、左室收缩末期内径(LVESd)、左心室射血分数(LVEF)的变化; 采用Pearson相关系数分析CXCL16、SDF-1、CypA与心室重塑指标的相关性。
    结果 干预组总有效率为89.74%, 高于对照组的73.08%, 差异有统计学意义(P < 0.05)。2组治疗后CXCL16、CypA水平较治疗前降低, SDF-1水平较治疗前升高,且干预组治疗后CXCL16、CypA水平低于对照组, SDF-1水平高于对照组,差异均有统计学意义(P < 0.05)。Spearman相关系数分析显示, CXCL16、CypA水平与临床疗效呈显著正相关(P < 0.05), SDF-1水平与临床疗效呈显著负相关(P < 0.05)。2组治疗后NT-proBNP、hs-CRP、cTnI、TNF-α水平较治疗前降低,且干预组治疗后各指标水平低于对照组,差异有统计学意义(P < 0.05)。2组治疗后LVEDd、LVESd均较治疗前降低, LVEF较治疗前升高,且干预组治疗后LVEDd低于对照组, LVEF高于对照组,差异均有统计学意义(P < 0.05)。Pearson相关系数分析显示, CXCL16、SDF-1、CypA与LVEF、LVEDd均有显著相关性(P < 0.05)。
    结论 达格列净治疗HFrEF患者的疗效较好,可改善CXCL16、SDF-1、CypA及心室重塑指标的水平,提高患者生存质量。

     

    Abstract:
    Objective To investigate the effect of dagliazine on the levels of CXC chemokine ligand 16 (CXCL16), stromal cell-derived factor-1 (SDF-1) and cyclophilin A (CypA) in patients with heart failure with reduced ejection fraction (HFrEF).
    Methods A total of 156 HFrEF patients were divided into intervention group and control group according to different intervention plans, with 78 cases in each group. The control group was treated with conventional standardized drug intervention therapy, while the intervention group was treated with dagliazine on the basis of the control group. The total effective rate was compared between the two groups; the changes of CXCL16, SDF-1 and CypA levels before and after treatment were compared between the two groups; the Spearman correlation coefficient was used to analyze the correlations of CXCL16, SDF-1 and CypA with clinical efficacy; the levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C reactive protein (hs-CRP), cardiac troponin I (cTnI) and tumor necrosis factor-α (TNF-α) before and after treatment were compared between the two groups; the changes of ventricular remodeling indexes left ventricular end-diastolic diameter (LVEDd), left ventricular end-systolic diameter (LVESd), left ventricular ejection fraction (LVEF)before and after treatment were compared between the two groups; the Pearson correlation coefficient was used to analyze the correlations of CXCL16, SDF-1 and CypA with ventricular remodeling indexes.
    Results The total effective rate of the intervention group was 89.74%, which was significantly higher than 73.08% of the control group (P < 0.05). After treatment, the levels of CXCL16 and CypA in both groups were significantly lower than those before treatment, while the SDF-1 level was significantly higher than that before treatment, and the levels of CXCL16 and CypA in the intervention group were significantly lower than those in the control group, while the SDF-1 level was significantly higher than that in the control group (P < 0.05). Spearman correlation coefficient analysis showed that CXCL16 and CypA levels were significantly positively correlated with clinical efficacy (P < 0.05), while SDF-1 level was significantly negatively correlated with clinical efficacy (P < 0.05). After treatment, the levels of NT-proBNP, hs-CRP, cTnI and TNF-α in both groups decreased significantly, and the levels of these indexes in the intervention group were significantly lower than those in the control group (P < 0.05). After treatment, the LVEDd and LVESd in both groups were significantly lower than those before treatment, while the LVEF was significantly higher than that before treatment, and the LVEDd in the intervention group was significantly lower than that in the control group, while the LVEF was significantly higher than that in the control group (P < 0.05). Pearson correlation coefficient analysis showed that CXCL16, SDF-1 and CypA were significantly correlated with LVEF and LVEDd (P < 0.05).
    Conclusion Dagliazine is effective in the treatment of patients with HFrEF, which can increase the levels of CXCL16, SDF-1, CypA and cardiac remodeling indexes, and improve the patient's quality of life.

     

/

返回文章
返回