达格列净在非糖尿病老年患者急性ST段抬高型心肌梗死PPCI术后的近期疗效观察

王要鑫; 刘洁云; 秦雷; 张帅

doi:10.13201/j.issn.1001-1439.2023.02.010

达格列净在非糖尿病老年患者急性ST段抬高型心肌梗死PPCI术后的近期疗效观察

- 开封市中心医院心血管内科(河南开封，475000)
基金项目:
河南省医学科技攻关联合共建项目(No：LHGJ20220929)

详细信息

通讯作者: 刘洁云, E-mail: ljy6051@126.com

中图分类号: R542.2

收稿日期: 2022-09-15

刊出日期: 2023-02-13

Short-term effect of dapagliflozin on non-diabetic elderly patients with acute ST-segment elevation myocardial infarction after primary percutaneous coronary intervention

- Department of Cardiology, Kaifeng Central Hospital, Kaifeng, Henan, 475000, China

More Information

Corresponding author: LIU Jieyun, E-mail: ljy6051@126.com

Received Date: 15 September 2022

Publish Date: 13 February 2023

摘要

摘要: 目的初步探讨达格列净对非糖尿病老年患者急性ST段抬高型心肌梗死(STEMI)直接经皮冠状动脉介入(PPCI)术后的近期临床疗效。方法选取2019年5月—2021年1月经我院胸痛中心行PPCI术并住院治疗的非糖尿病老年急性STEMI患者90例，随机分为观察组(常规治疗+达格列净片10 mg qd)45例，对照组(常规治疗)45例。比较两组服药前、服药6个月后临床资料，包括左室舒张末期容积(LVEDD)、左室射血分数(LVEF)、氨基末端脑钠肽前体(NT-proBNP)、白细胞介素6(IL-6)、血脂、尿酸(UA)及糖化血红蛋白(HbA1c)等指标。结果治疗6个月后，对照组与观察组IL-6、NT-proBNP及LVEDD水平均较治疗前显著下降，且观察组下降幅度更大(均P < 0.05)；两组LDL-C水平均较治疗前显著下降(均P < 0.05)，但两组下降幅度比较差异无统计学意义；观察组UA水平较治疗前显著下降(P < 0.05)。结论对于非糖尿病老年急性STIMI PPCI术后患者，达格列净可带来多种获益，近期疗效安全。
- ST段抬高型心肌梗死, 急性 /
- 达格列净 /
- 非糖尿病 /
- 老年
Abstract: Objective To investigate the short-term clinical efficacy of dapagliflozin in the treatment of non-diabetic elderly patients with acute ST-segment elevation myocardial infarction(STEMI) after primary percutaneous coronary intervention(PPCI).Methods Ninety non-diabetic elderly patients with STEMI who underwent PPCI in the Chest Pain Center of our hospital from May, 2019 to January, 2019 were selected, and randomly divided into the dapagliflozin group(conventional treatments plus dapagliflozin tablets 10 mg qd, n=45) and the control group(conventional treatments, n=45). The clinical data, including left ventricular end-diastolic volume(LVEDD), left ventricular ejection fraction(LVEF), N-terminal pro-brain natriuretic peptide(NT-probNP), interleukin-6(IL-6), blood lipid, uric acid(UA), glycosylated hemoglobin(HbA1c), and other indicators, were compared between the two groups before and after 6 months of medication.Results After 6 months of treatment, the levels of IL-6, NT-proBNP, and LVEDD in the control group and the dapagliflozin group were significantly lower than those before treatment, and the decrease in the dapagliflozin group was greater(all P < 0.05); LDL-C levels in both groups were significantly lower than those before treatment(all P < 0.05); The UA level in the dapagliflozin group was significantly lower than that before treatment(P < 0.05).Conclusion Dapagliflozin can bring a variety of benefits for non-diabetic elderly patients with STEMI after PPCI, and the short-term efficacy is safe.
- ST elevation myocardial infarction, acute /
- dapagliflozin /
- non-diabetic /
- old age

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表 1 对照组与观察组患者一般资料比较

Table 1. General data X±S

项目	对照组(45例)	观察组(45例)	t/χ²	P
年龄/岁	68.58±3.94	69.31±3.46	0.939	0.35
男/例(%)	23(51.11)	24(53.33)	0.045	0.833
高血压/例(%)	40(88.89)	43(95.56)	1.394	0.238
GLU/(mmol·L^-1)	4.97±0.54	5.05±0.53	0.754	0.453
HbA1C/%	5.02±0.56	5.22±0.50	1.774	0.079
UA/(μmol·L^-1)	293.44±63.90	296.91±67.07	0.251	0.802
NT-proBNP/(pg·mL^-1)	208.20±110.12	209.65±119.53	0.060	0.952
IL-6/(pg·mL^-1)	14.16±5.36	14.18±5.07	0.022	0.983
TC/(mmol·L^-1)	4.41±0.55	4.32±0.54	-0.813	0.419
LDL-C/(mmol·L^-1)	2.19±0.77	2.31±0.83	0.727	0.469
HDL-C/(mmol·L^-1)	1.01±0.23	1.00±0.23	-0.194	0.847
LVEF/%	66.71±7.98	65.11±7.04	-1.009	0.316
LVEDD/mm	45.09±4.69	45.8±4.19	0.758	0.451
注：TC：总胆固醇；HDL-C：高密度脂蛋白胆固醇；LDL-C：低密度脂蛋白胆固醇。

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表 2 对照组与观察组治疗6个月后临床资料比较

Table 2. General data before and after treatment X±S

项目	观察组(45例)				对照组(45例)				两组治疗后比较
项目	治疗前	治疗后	t	P	治疗前	治疗后	t	P	T	P
GLU/(mmol·L^-1)	5.05±0.53	5.12±0.51	-0.574	0.567	4.97±0.54	4.94±0.54	0.285	0.776	1.638	0.105
HbA1C/%	5.22±0.50	5.08±0.45	1.394	0.167	5.02±0.56	5.04±0.48	-0.227	0.821	0.334	0.739
UA/(μmol·L^-1)	296.91±67.07	262.64±60.72	2.541	0.013	293.44±63.90	291.29±64.41	0.159	0.874	-2.171	0.033
TC/(mmol·L^-1)	4.32±0.54	4.30±0.39	0.252	0.801	4.41±0.55	4.37±0.42	0.465	0.643	-0.817	0.416
LDL-C/(mmol·L^-1)	2.31±0.83	1.90±0.28	3.160	0.003	2.19±0.77	1.85±0.26	2.768	0.008	0.814	0.418
HDL-C/(mmol·L^-1)	1.00±0.23	1.02±0.19	-0.378	0.706	1.01±0.23	1.01±0.19	0.010	0.992	0.067	0.947
IL-6/(pg·mL^-1)	14.18±5.07	6.19±2.28	9.645	0.001	14.16±5.36	8.75±2.89	5.956	0.001	-4.67	0.001
NT-proBNP/(pg· mL^-1)	209.65±119.53	96.97±33.95	6.083	0.001	208.20±110.12	122.94±39.34	4.891	0.001	-3.353	0.001
LVEF/%	65.11±7.04	64.56±6.74	0.383	0.703	66.71±7.98	65.89±7.01	0.519	0.605	-0.920	0.36
LVEDD/mm	45.80±4.19	40.58±2.49	7.184	0.001	45.09±4.69	42.29±3.57	3.186	0.002	-2.639	0.010

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