摘要
目的探究达格列净对高血压伴冠心病患者冠状动脉造影或介入治疗后肾功能影响。方法选取2022年5月至2024年5月金华市中心医院心血管内科收治的接受冠状动脉造影检查或介入治疗的高血压伴冠心病患者146例,根据是否服用达格列净分为对照组72例和观察组74例,对照组采用高血压合并冠心病常规治疗方案,包括氯吡格雷、阿司匹林和他汀类药物,观察组在对照组的基础上给予达格列净治疗,比较两组患者的临床资料、冠脉造影或介入治疗前后的肾功能指标,采用多因素Logistic回归方法分析患者冠脉造影或介入治疗后肾功能影响因素。结果观察组患者术前与术后肾损伤分子1、血肌酐、估算肾小球滤过率的差值[(6.50±2.14)ng·L^(-1),(6.92±1.95)μmol·L^(-1),(3.59±0.64)mL·min^(-1)·1.73m^(-2)]小于对照组[(8.23±3.05)ng·L^(-1),(12.25±2.16)μmol·L^(-1),(5.44±1.29)mL·min^(-1)·1.73m^(-2)],差异有统计学意义(t=3.976、15.659、11.022,均P<0.05)。观察组造影剂肾病发生率4.05%(3/74)低于对照组的15.28%(11/72),差异有统计学意义(χ^(2)=5.303,P=0.021)。所有患者中发生造影剂肾病14例,未发生造影剂肾病132例,经单因素和多因素Logistic回归分析结果显示,达格列净为冠脉造影或介入治疗后患者肾功能的保护因素(OR=0.240,P=0.036)。结论达格列净能够改善高血压伴冠心病冠脉造影或介入治疗后的肾功能指标,是患者肾功能的保护因素。
Objective To investigate the effect of dapagliflozin on renal function in patients with hypertension and coronary atherosclerotic heart disease after undergoing coronary angiography or interventions.Methods A total of 146 patients with hypertension and coronary atherosclerotic heart disease admitted to Jinhua Central Hospital from May 2022 to May 2024 for coronary angiography or interventional treatment were enrolled in this study.They were divided into the control group(72 patients)receiving standard therapy including clopidogrel,aspirin and statins,and the observation group(74 patients)receiving the same plus dapagliflozin.The study assessed clinical conditions,and renal function indicators before and after interventional therapy,while the multivariate logistic regression method was adopted to identify factors affecting post-procedure renal function.Results The differences in renal injury molecule-1,serum creatinine,and estimated glomerular filtration rate in the observation group((6.50±2.14)ng·L^(-1),(6.92±1.95)μmol·L^(-1),(3.59±0.64)mL·min^(-1)·1.73m^(-2))before and after the therapy were smaller than those in the control group((8.23±3.05)ng·L^(-1),(12.25±2.16)μmol·L^(-1),(5.44±1.29)mL·min^(-1)·1.73m^(-2)),which were statistically significant(t=3.976,15.659,11.022,all P<0.05).Contrast nephropathy incidence was 4.05%(3/74)in the observation group,which was lower than that of 15.28%(11/72)in the control group,and the difference was statistically significant(χ^(2)=5.303,P=0.021).Out of all patients,14 developed contrast nephropathy,while 132 did not.Univariate and multivariate Logistic regression analysis indicated that dapagliflozin was a protective factor for renal function after coronary angiography or interventional treatment(OR=0.240,P=0.036).Conclusion Dapagliflozin can improve renal function indicators in hypertensive patients with coronary atherosclerotic heart disease after coronary angiography or interventions,which is a protective factor for renal function.
作者
何鸣皓
杨伊萍
傅慎文
He Ming-hao;Yang Yi-ping;Fu Shen-wen(Department of Cardiology,Jinhua Central Hospital,Jinhua 321000,China)
出处
《中国药物应用与监测》
2025年第1期18-20,65,共4页
Chinese Journal of Drug Application and Monitoring
基金
金华市科技计划项目(2022-4-099)。
关键词
达格列净
高血压
冠状动脉粥样硬化性心脏病
造影剂肾病
介入治疗
血肌酐
Dapagliflozin
Hypertension
Coronary atherosclerotic heart disease
Contrast nephropathy
Interventional therapy
Serum creatinine
