达格列净联合基础药物治疗老年高血压并发射血分数降低心力衰竭的效果及对心脏结构的影响OA

Objective To investigate the efficacy of Dapagliflozin combined with standard medical therapy in the treatment of elderly hypertensive patients with heart failure with reduced ejection fraction(HFrEF)and its effect on cardiac structure.Methods A total of 120 elderly hypertensive patients with HFrEF admitted to the First People's Hospital of Chuzhou City from April 2022 to April 2024 were selected and divided into two groups by random number table method,with 60 patients in each group.The control group received standard medical therapy(Metoprolol,Sacubitrilvalsartan and Spironolactone),while the observation group received Dapagliflozin combined with standard medical therapy;both groups were treated for six consecutive months.The therapeutic efficacy,incidence of adverse reactions were compared between the two groups,as well as the blood pressure,left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left atrial diameter(LAD),left ventricular posterior wall thickness(LVPWT),interventricular septal thickness(IVST),left ventricular end-systolic diameter(LVESD),high-sensitivity C-reactive protein(hs-CRP),cardiac troponin I(cTnI),interleukin-6(IL-6),N-terminal pro-brain natriuretic peptide(NT-proBNP),6 minute walking distance(6MWD)and Minnesota Living with Heart Failure Questionnaire(MLHFQ)scores before treatment,and at 3 and 6 months after treatment.Results The total effective rate of the observation group was 95.00％(57/60),which was higher than 81.67％(49/60)of the control group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).At 3 and 6 months after treatment,diastolic blood pressure and systolic blood pressure in the observation group were lower than those in the control group(P＜0.05).At 6 months after treatment,LVEF was higher,while LVEDD,IVST,LVESD,LAD and LVPWT were lower in the observation group than in the control group(P＜0.05).At 3 and 6 months after treatment,serum levels of cTnI,hs-CRP,NT-proBNP,IL-6 and MLHFQ scores in the observation group were lower,and 6MWD was longer than those in the control group(P＜0.05).Conclusion Peripheral blood AFR and sUAR are associated with complicated AKI complicating ARDS.Their combination can provide reference for predicting AKI risk in ARDS patients and assist clinical prevention and treatment.