达格列净对AMI合并T2DM患者血糖水平及MACE的影响  

Effect of dapagliflozin on blood glucose level and MACE in patients with AMI and T2DM

作　　者：阴艳萍[1] 卢先本[1] 张云燕[1] 江建军[1] 米亚非[1] YIN Yanping;LU Xianben;ZHANG Yunyan;JIANG Jianjun;MI Yafei(Department of Cardiology,Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University,Linhai 317000,China)

机构地区：[1]浙江省台州医院心血管内科,浙江临海317000

出　　处：《中国现代医生》2021年第36期49-52,共4页China Modern Doctor

基　　金：浙江省中医药科技计划项目(2020ZB294)。

摘　　要：目的探讨达格列净对急性心肌梗死(AMI)合并2型糖尿病(T2DM)患者血糖水平及主要心血管事件(MACE)的影响。方法选取2018年11月至2019年11月我院60例AMI合并T2DM患者临床资料进行回顾性研究,根据治疗方案分为两组,每组各30例。对照组给予二甲双胍,研究组给予二甲双胍+达格列净,连续治疗6个月。观察两组空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、体质量指数(BMI)、脂肪特异性丝氨酸蛋白酶抑制剂(vaspin)、脂联素(ADP)、不良反应,并于治疗后1个月随访MACE发生风险。结果治疗后研究组FPG(5.41±0.89)mmol/L、2hPG(7.34±1.13)mmol/L、HbA1c(6.03±0.35)%、HOMA-IR(1.95±0.46)%、FINS(8.12±0.31)mU/L、BMI(24.44±1.21)kg/m2,低于对照组的(6.82±1.03)mmol/L、(8.25±1.26)mmol/L、(7.57±0.42)%、(2.63±0.52)%、(8.69±0.33)mU/L、(25.81±1.34)kg/m^(2)(P<0.05);治疗后研究组ADP(17.91±5.83)μg/L、vaspin(218.86±15.57)ng/mL,低于对照组的(24.36±4.78)μg/L、(289.93±16.69)ng/mL(P<0.05);两组不良反应(23.33%vs.16.67%)比较,差异无统计学意义(P>0.05);研究组再发心肌梗死、血运重建、卒中等MACE发生率为6.67%,与对照组的13.33%比较,差异无统计学意义(P>0.05)。结论达格列净应用于AMI合并T2DM患者,有助于控制血糖,减轻体质量指数,且安全性较高。Objective To investigate the effect of dapagliflozin on blood glucose levels and major cardiovascular events(MACE)in patients with acute myocardial infarction(AMI)and type 2 diabetes(T2DM).Methods The clinical data of 60 patients with AMI and T2DM in our hospital from November 2018 to November 2019 were retrospectively analyzed.According to the treatment plan,the patients were divided into two groups,with 30 cases in each group.The control group was given metformin,and the study group was given metformin+dapagliflozin.They were treated continuously for six months.The fasting blood glucose(FPG),2h postprandial blood glucose(2 hPG),glycosylated hemoglobin(HbA1c),fasting insulin(FINS),insulin resistance index(HOMA-IR),body mass index(BMI),fat-specific serine protease inhibitors(vaspin),adiponectin(ADP),adverse reactions of two groups were observed.And the risk of MACE was followed up for one month after treatment.Results After treatment in the study group,FPG(5.41±0.89)mmol/L,2 hPG(7.34±1.13)mmol/L,HbA1c(6.03±0.35)%,HOMA-IR(1.95±0.46)%,FINS(8.12±0.31)mU/L,BMI(24.44±1.21)kg/m2,lower than the control group(6.82±1.03)mmol/L,(8.25±1.26)mmol/L,(7.57±0.42)%,(2.63±0.52)%,(8.69±0.33)mU/L,(25.81±1.34)kg/m2(P<0.05);after treatment,ADP(17.91±5.83)μg/L and vaspin(218.86±15.57)ng/mL in the study group were lower than those in the control group(24.36±4.78)μg/L,(289.93±16.69)ng/mL(P<0.05);the difference between the two groups of adverse reactions(23.33%vs.16.67%)was not statistically significant(P>0.05);study group The incidence of MACE such as recurrent myocardial infarction,revascularization,and stroke was 6.67%,which was not statistically different compared with 13.33%in the control group(P>0.05).Conclusion Dapagliflozin applied to patients with AMI and T2DM can help control blood sugar,reduce body weight index,and has high safety.

关 键 词：急性心肌梗死 2型糖尿病 达格列净 二甲双胍 HBA1C FPG 

分 类 号：R587.2[医药卫生—内分泌]