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患有心力衰竭的体重不足患者的-葡萄糖共运输体2抑制剂:一个病例系列
Masaki Nakagaito1, Teruhiko Imamura1, Toshihide Izumida1
1Second Department of Internal Medicine, University of Toyama, Toyama 930-0194, Japan.
Journal of clinical medicine
|March 14, 2026
概括
-葡萄糖携带载体2抑制剂 (SGLT2i) 在体重不足的心力衰竭患者中没有减少心血管事件. 这种疗法与这一群体的整体住院病例增加和BMI下降有关.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- -葡萄糖共运输体2抑制剂 (SGLT2i) 是已确立的心力衰竭 (HF) 治疗方法,改善死亡率和发病率.
- 在体重不足的高血压患者 (BMI <18.5 kg/m2) 中,SGLT2i的有效性和安全性尚未得到充分了解.
- 在HF患者中,体重不足的状况为治疗优化带来了独特的挑战.
研究的目的:
- 研究SGLT2i在心力衰竭的体重不足患者中减少心血管事件的疗效.
- 评估SGLT2i的安全性,包括医院住院率和身体质量指数 (BMI) 变化,在这个患者群体.
- 评估SGLT2i对低体重心力衰竭患者整体住院率和BMI的影响.
主要方法:
- 一个单一的中心,前性观察性研究.
- 在2020年12月至2023年10月期间,招募了131名体重不足的HF患者 (BMI>18.5公斤/米2).
- 对28名启动SGLT2i的患者和103名未启动SGLT2i的患者的结局进行比较,随访时间中位数为20.4个月.
主要成果:
- 主要结局 (HF住院或心血管死亡) 发生在SGLT2i和非SGLT2i组的21.4%的患者中 (p=0.758).
- 接受SGLT2i治疗的患者因各种原因住院的病例显著增加 (82.1%与63.1%,p=0.009).
- 与对照组相比,SGLT2i启动与出院时,出院1个月后和出院3个月后的BMI显著下降有关.
结论:
- 在体重不足的心力衰竭患者中,SGLT2i疗法可能不会给心血管带来益处.
- 在这个人群中使用SGLT2i与整体住院的风险增加有关.
- 在体重不足的心力衰竭患者中,SGLT2i治疗导致体重指数的降低.
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