达格列净在合并2型糖尿病的射血分数中间值心力衰竭患者中的研究  

Effects of Dapagliflozin on mid-range ejection fraction heart failure patients with type 2 diabetes

作　　者：戴日新[1] 刘露佳 杨锡恒[1] 苏强 钱宗杰[1] DAI Rix-in;LIU Lujia;YANG Xiheng;SU Qiang;QIAN Zongjie(Affiliated Hospital of Guilin Medical University,Guilin 541001,China)

机构地区：[1]桂林医学院附属医院,广西桂林541001

出　　处：《实用医学杂志》2020年第18期2505-2509,共5页The Journal of Practical Medicine

摘　　要：目的观察达格列净在合并2型糖尿病的射血分数中间值心力衰竭(heart failure with mid-range ejection fraction,HFmrEF)患者中对生化指标、步行距离、心功能的影响及其关系。方法入组合并2型糖尿病HFmrEF患者共50例,随机分为观察组24例,对照组26例。两组均采用常规降糖药物及抗心衰药物治疗,观察组加用达格列净药物5 mg/d,观察6个月。采用荧光素免疫化学发光法测定amino terminal pro brain natriuretic peptide(NT-proBNP)、免疫比浊法测定超敏C反应蛋白(high sensitivity C reactive protein,Hs-CRP)、酶联免疫吸附法测定可溶性ST2(soluble suppression of tumorigenicity 2,sST2)。记录患者6 min步行距离,改良Simpson法检测记录左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)及左室射血分数(left ventricular ejection fraction,LVEF)。结果与对照组相比,观察组患者血生化指标NT-proBNP、Hs-CRP、可溶性ST2明显下降(P<0.05);观察组的6 min步行距离[(432±121)m]较对照组[(360±118)m]明显提高(P<0.05);而左室舒张末径及左室射血分数[(54.3±6.3)mm vs.(55.7±6.0)mm,(46.7±5.1)%vs.(45.8±4.6)%,均P>0.05]差异无统计学意义。观察组6 min步行距离与NT-proBNP(r=-0.574,P=0.002)、Hs-CRP(r=-0.191,P=0.047)、sST2(r=-0.284,P=0.031)均呈负相关关系。结论在合并2型糖尿病HFmrEF患者当中,达格列净联合治疗能改善患者6 min步行距离,降低血清NT-proB-NP、sST2、Hs-CRP等指标水平,而对短期LVEDD、LVEF无显著影响。Objective To investigate the effects of Dapagliflozin on blood amino terminal pro brain natri-uretic peptide(NT-proBNP),high sensitivity C reactive protein(Hs-CRP),soluble suppression of tumorigenicity 2(sST2)levels and heart functional capacity in the mid-range ejection fraction heart failure(HFmrEF)patients with type 2 diabetes mellitus.Methods 50 HFmrEF patients with type 2 diabetes were randomly divided into two groups(drug group n=24 and control group n=26).The all patients were received conventional medical treatment according to the blood glucose level and the NYHA classification.The drug group was combined with Dapagliflozin(5 mg/day).The six minute walk test(6MWT)were evaluated in all patients,left ventricular end diastolic diame-ter(LVEDD),left ventricular ejection fraction(LVEF)were detected by the modified Simpson method,and serum NT-proBNP,Hs-CRP,sST2 levels were recorded at the day of the 6MWT after 6 months treatment.Results As compared with the control group,the drug group of patients had an significant decreased serum NT-proBNP,Hs-CRP,sST2 levels(P<0.05);6MWT were significantly improved in the drug group[(432±121)m vs.(360±118)m,P<0.05];Among HFmrEF patients treated with Dapagliflozin,the serum NT-proBNP,Hs-CRP,sST2 levels were inversely correlated with the 6MWT distance(r=-0.574,P=0.002;r=-0.191,P=0.047;r=-0.284,P=0.031 respectively).whereas,the LVEDD and the LVEF had no significant differences between two groups(P>0.05).Conclusions Dapagliflozin therapy can improve 6MWT,and decrease serum NT-proBNP,Hs-CRP,sST2 levels,however,the therapy has no beneficial effect on LVEDD and LVEF in short-term.

关 键 词：心力衰竭 糖尿病 射血分数 

分 类 号：R541.6[医药卫生—心血管疾病]