| 张晓迪.恩格列净联合美托洛尔对非糖尿病射血分数保留心力衰竭患者心功能、血管内皮功能及血清IL-33、FGF21水平的影响[J].安徽医药,待发表. |
| 恩格列净联合美托洛尔对非糖尿病射血分数保留心力衰竭患者心功能、血管内皮功能及血清IL-33、FGF21水平的影响 |
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| 投稿时间：2026-08-20 录用日期：2026-10-13 |
| DOI： |
| 中文关键词: 恩格列净 美托洛尔 非糖尿病射血分数保留心力衰竭 心功能 |
| 英文关键词: |
| 基金项目:邢台市重点研发计划自筹项目(编号:2024ZC195) |
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| 中文摘要: |
| 【】目的:观察恩格列净联合美托洛尔对非糖尿病射血分数保留心力衰竭(HFpEF)的治疗效果。方法:按随机数字表法将2024年1月－12月邢台市中心医院收治的144例非糖尿病HFpEF患者分成A组(n=48,在基础治疗上加用美托洛尔)、B组(n=48,在基础治疗上加用恩格列净)和C组(n=48,在基础治疗上加用恩格列净和美托洛尔)。比较心功能、运动耐量、血管内皮功能(VEF)、血清学指标、药物不良反应(ADR)、心血管不良事件。经多因素线性回归或多因素Logistic回归模型校正混杂因素。结果:治疗后,三组的左心室射血分数(LVEF)、6分钟步行试验(6MWT)、峰值摄氧量(Peak VO2)、肱动脉血流介导的血管舒张功能(FMD)、血管内皮生长因子(VEGF)高于治疗前(P＜0.05),且C组高于A组(P＜0.05)、B组(P＜0.05),B组高于A组(P＜0.05)；三组的二尖瓣舒张早期血流速度/二尖瓣环舒张早期运动速度(E/e’)、N末端B型利钠肽原(NT-proBNP)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、内皮素-1、白介素33(IL-33)、成纤维细胞生长因子21(FGF21)、可溶性生长刺激表达基因2蛋白(sST2)低于治疗前(P＜0.05),且C组低于A组(P＜0.05)、B组(P＜0.05),B组低于A组(P＜0.05)。经多因素线性回归校正混杂因素后,上述指标组间比较差异仍具有统计学意义(P＜0.05)。C组ADR总发生率(14.58%,7/48)、心血管不良事件总发生率(10.42%,5/48)和A组［(8.33%,4/48)、(16.67%,8/48)］、B组［(8.33%,4/48)、(12.50%,6/48)］相近(P＞0.05)。校正后三组ADR总发生率、心血管不良事件总发生率比较差异无统计学意义(P＞0.05)。结论:恩格列净联合美托洛尔可改善非糖尿病HFpEF患者的心功能、运动耐量、VEF,下调IL-33、FGF21、sST2,且不增加ADR、心血管不良事件。 |
| 英文摘要: |
| Objective: To observe the therapeutic effect of empagliflozin combined with metoprolol on non-diabetic heart failure with preserved ejection fraction (HFpEF). Methods: Using the random number table method, 144 non-diabetic HFpEF patients accepted by Xingtai Central Hospital from January to December 2024 were separated into the Group A (n=48, treated with metoprolol in addition to the basic therapy), the Group B (n=48, treated with empagliflozin in addition to the basic therapy) and the Group C (n=48, treated with both empagliflozin and metoprolol in addition to the basic therapy). The cardiac function, exercise tolerance, vascular endothelial function (VEF), serological indicators, adverse drug reaction (ADR), and cardiovascular adverse events were compared. The confounding factors were corrected through multiple-factor linear regression or multiple-factor Logistic regression models. Results: After medication, the left ventricular ejection fraction (LVEF), 6-minute walk test (6MWT), peak oxygen uptake (Peak VO2), brachial artery flow-mediated dilation (FMD), and vascular endothelial growth factor (VEGF) in all three groups were higher than those before medication (P < 0.05), and the values in the Group C were higher than those in the Group A (P < 0.05) and Group B (P < 0.05), and Group B was higher than Group A (P < 0.05). The early mitral inflow velocity/early diastolic mitral annular velocity (E/e"), N-terminal pro-B-type natriuretic peptide (NT-proBNP), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), endothelin-1, interleukin 33 (IL-33), fibroblast growth factor 21 (FGF21), and soluble suppression of tumorigenicity 2 (sST2) in all three groups were all lower than those before medication (P < 0.05), and the values in the Group C were lower than those in the Group A (P < 0.05) and Group B (P < 0.05), and Group B was lower than Group A (P < 0.05). After correcting for confounding factors through multiple-factor linear regression, the differences in the above indicators between groups still showed statistically significant results (P < 0.05). The total incidence of ADR (14.58%, 7/48) and the total incidence of cardiovascular adverse events (10.42%, 5/48) in the Group C, and the Group A ［ (8.33%, 4/48) and (16.67%, 8/48)］ and group B ［(8.33%, 4/48), (12.50%, 6/48)］ were similar (P > 0.05). After correction, there was no statistically significant difference in the total incidence rates of ADRs and cardiovascular adverse events among the three groups (P > 0.05). Conclusion: Empagliflozin combined with metoprolol can improve the cardiac function, exercise tolerance, and VEF of non-diabetic HFpEF patients, down-regulate IL-33, FGF21, and sST2, and does not increase ADR or cardiovascular adverse events. |
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