Clinical effect of sodium-glucose cotransporter 2 inhibitor combined with Lepidium seed on chronic heart failure complicated by pulmonary infection
10.3969/j.issn.1008-9691.2024.03.003
- VernacularTitle:钠-葡萄糖协同转运蛋白2抑制剂联合葶苈子治疗慢性心力衰竭合并肺部感染的临床疗效分析
- Author:
Yubing QIAO
1
;
Wei YANG
Author Information
1. 秭归县中医院心内科,湖北宜昌 443600
- Keywords:
Heart failure;
Pulmonary infection;
Lepidium seed;
Sodium-glucose cotransporter 2 inhibitor;
Ceftazidime;
Cardiac function;
Cardiovascular event
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2024;31(3):267-271
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effects of sodium-glucose cotransporter 2 inhibitor combined with Lepidium seed on cardiac,digestive,and pulmonary function in patients with heart failure complicated by pulmonary infection.Methods A total of 168 patients with heart failure and lung infection admitted to Zigui County Hospital of Traditional Chinese Medicine from August 2017 to March 2019 were selected as the research objects.They were divided into observation group and control group according to different treatment methods(84 patients per group).The control group received sodium-glucose cotransporter 2 inhibitor combined with ceftazidime,while the observation group was treated with Lepidium seed on the basis of control group for 30 days.Nutritional status[prealbumin(PA),albumin(ALB),red blood cell count(RBC),body mass index(BMI)],immune function[cytoplasmic domains(CD3,CD4,CD8),immunoglobulins(IgG,IgM)],inflammatory cytokines[interleukins(IL-8,IL-10,IL-17),tumor necrosis factor-α(TNF-α)],intestinal flora(Enterococcus,Escherichia coli,Lactobacillus,Bifidobacterium,Saccharomycetes,Digestion),and cardiopulmonary function[arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),heart rate(HR),maximum oxygen consumption(VO2max),maximum exercise load(Wmax),maximum oxygen pulse,anaerobic threshold(AT),forced expiratory volume in one second/forced lung volume ratio(FEV1/FVC),FEV1 and maximal voluntary ventilation(MVV)]were compared between the two groups before and after treatment.Results After treatment,PA,ALB,RBC,BMI,CD3,CD4,CD8,IgG and IgM,Lactobacillus,Bifidobacterium,PaO2,VO2max,Wmax,maximum oxygen pulse,AT,FEV1/FVC,FEV1,MVV all increased significantly compared to before treatment.IL-8,IL-17,TNF-α,Enterococcus,Escherichia coli,PaCO2,and heart rate were significantly reduced compared to before treatment.The levels of PA,ALB,RBC,BMI,CD3,IgG,IgM,IL-10,Bifidobacterium,Lactobacillus,PaO2,VO2max,Wmax,maximum oxygen pulse,AT,FEV1/FVC,FEV1,and MVV in the observation group were significantly higher than those in the control group after treatment[PA(mg/L):259.69±20.73 vs.217.69±20.73,ALB(g/L):41.46±4.58 vs.36.56±3.73,RBC(×1012/L):4.52±0.24 vs.4.21±0.31,BMI(kg/m2):22.37±2.73 vs.19.66±2.24,CD3:0.63±0.08 vs.0.56±0.08,IgG(g/L):21.85±3.68 vs.15.72±4.36,IgM(g/L):4.68±1.68 vs.3.73±1.67,IL-10(ng/L):65.28±7.23 vs.50.23±6.14,Bifidobacterium(CFU/kg):83.5±8.6 vs.78.5±8.3,Lactobacillus(CFU/kg):62.1±6.5 vs.53.5±6.0,PaO2(mmHg,1 mmHg≈0.133 kPa):98.36±1.75 vs.91.95±2.95,VO2max(L/min):1.71±0.35 vs.1.22±0.39,Wmax(W):127.49±19.54 vs.97.49±15.37,maximum oxygen pulse(L/time):11.27±2.42 vs.9.46±2.79,AT:(50.49±7.48)%vs.(41.35±6.67)%,FEV1/FVC:(75.68±5.86)%vs.(65.48±8.54)%,FEV1:(82.44±5.73)%vs.(73.57±7.75)%,MVV(L/min):74.86±10.64 vs.64.63±9.68,all P<0.05].CD4,CD8,IL-8,IL-17,TNF-α.Enterococcus,Escherichia coli,PaCO2,and heart rate levels were significantly lower than those in the control group[CD4:0.32±0.06 vs.0.39±0.05,CD8:0.28±0.06 vs.0.34±0.05,IL-8(ng/L):16.64±2.63 vs.26.35±4.13,IL-17(ng/L):112.38±30.16 vs.207.75±42.23,TNF-α(ng/L):45.27±10.23 vs.61.26±14.29,Enterococcus(CFU/kg):63.6±5.6 vs.69.5±6.8,Escherichia coli(CFU/kg):65.8±6.4 vs.70.5±7.0,PaCO2(mmHg):41.84±4.45 vs.56.18±5.37,heart rate(bpm):75.96±11.57 vs.91.57±12.68,all P<0.05].Conclusions Treatment with Lepidium seed combined with sodium-glucose cotransporter 2 inhibitor improved cardiopulmonary function,reduced inflammation,enhanced nutrition,and normalized gut flora in heart failure patients with lung infections.Our findings support integrating this combination into clinical guidelines for optimized management of these critically ill patients.
