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SGLT-2i在射血分数保留型心力衰竭患者中使用现状及影响因素的真实世界研究
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| 篇名： | SGLT-2i在射血分数保留型心力衰竭患者中使用现状及影响因素的真实世界研究 |
| TITLE： | Real-world study on the application and influencing factors of SGLT-2i in patients with heart failure with preserved ejection fraction |
| 摘要： | 目的 探索钠-葡萄糖协同转运蛋白-2抑制剂（SGLT-2i）在真实世界射血分数保留型心力衰竭（HFpEF）患者中的使用现状及其影响因素。方法收集2023年5月至2024年5月在重庆医科大学附属第一医院住院的358例HFpEF患者资料，根据出院带药是否使用SGLT-2i，将患者分为SGLT-2i使用组和SGLT-2i未使用组。比较两组患者的基线特征、合并疾病及药物治疗差异，在单因素分析的基础上采用多因素Logistic回归分析筛选HFpEF患者使用SGLT-2i的独立影响因素，并进行分层分析。结果358例HFpEF患者中，SGLT-2i的总体使用率为33.5%。合并2型糖尿病[OR＝9.063，95%CI（4.924～16.679）]、合并房颤[OR＝3.135，95%CI（1.590～6.178）]、合并冠心病[OR＝1.888，95%CI（1.072～3.327）]以及使用袢利尿剂[OR＝3.822，95%CI（1.588～9.200）]均为HFpEF患者使用SGLT-2i的独立影响因素（P＜0.05）。分层描述结果与多因素分析结果一致，在合并2型糖尿病、房颤、冠心病及使用袢利尿剂的HFpEF患者中，SGLT-2i使用率更高（P＜0.05）；不同肾功能水平患者间的SGLT-2i使用率相近（P＞0.05）。结论真实世界中，HFpEF患者的SGLT-2i使用率较低，其治疗覆盖率仍需提升；该类药物在HFpEF患者中的使用主要受是否合并2型糖尿病、房颤、冠心病及袢利尿剂使用的影响。 |
| ABSTRACT： | OBJECTIVE To investigate the application and influencing factors of sodium-dependent glucose transporters 2 inhibitors（SGLT-2i） in patients with heart failure with preserved ejection fraction（HFpEF） in the real world. METHODS Data from 358 patients with HFpEF who were hospitalized at the First Affiliated Hospital of Chongqing Medical University from May 2023 to May 2024 were retrospectively collected. The patients were divided into the SGLT-2i group and the non-SGLT-2i group based on whether they were prescribed SGLT-2i upon discharge. Baseline characteristics， comorbidities， and differences in drug treatment were compared between the two groups. Based on univariate analysis， multivariate Logistic regression analysis was performed to identify independent influencing factors of SGLT-2i use in patients with HFpEF， followed by further stratified analysis. RESULTS Among 358 HFpEF patients， the overall utilization rate of SGLT-2i was 33.5%. Combined with type 2 diabetes [OR＝9.063，95%CI（4.924-16.679） ] ， atrial fibrillation [OR＝3.135，95%CI（1.590-6.178） ] ， coronary artery heart disease [OR＝1.888，95%CI（1.072-3.327） ] and the use of loop diuretics [OR＝3.822， 95%CI （1.588-9.200） ] were all independent influencing factors for the use of SGLT-2i in patients with HFpEF （ P ＜0.05）. The results of the stratified descriptive analysis were consistent with those of the multivariate analysis， showing a higher utilization rate of SGLT-2i among patients with concomitant T2DM，atrial fibrillation， coronary artery heart disease， and those receiving loop diuretics （ P ＜0.05）； whereas the utilization rate of SGLT-2i was comparable across patients with different levels of renal function （ P ＞0.05）. CONCLUSIONS In the real-world clinical practice， the utilization of SGLT-2i in patients with HFpEF remains suboptimal， and treatment coverage still needs to be improved. Their use of SGLT-2i is primarily influenced by the presence of type 2 diabetes， atrial fibrillation， coronary artery heart disease， and the use of loop diuretics. |
| 期刊： | 2026年第37卷第08期 |
| 作者： | 蔡恬恬；陈俊龙；张艺航；何思意；刘健；肖若楠；罗尚健；高磊；张冬颖 |
| AUTHORS： | CAI Tiantian，CHEN Junlong， ZHANG Yihang，HE Siyi，LIU Jian，XIAO Ruonan，LUO Shangjian，GAO Lei，ZHANG Dongying |
| 关键字： | 钠-葡萄糖协同转运蛋白-2抑制剂；射血分数保留型心衰；糖尿病；真实世界研究；合理用药；影响因素 |
| KEYWORDS： | sodium-dependent glucose transporters 2 inhibitors； heart failure with preserved ejection fraction； diabetes |
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