沙库巴曲缬沙坦联合达格列净治疗2型糖尿病合并心力衰竭临床疗效观察  

Clinical efficacy of sacubitril/valsartan combined with dapagliflozin in treatment of type 2 diabetes mellitus complicated with heart failure

作　　者：刘哲[1] 刘易婷 王晶[3] LIU Zhe;LIU Yiting;WANG Jing(Department of Cardiovascular Internal Medicine,Affiliated Hospital of Yan’an University,Yan’an 716000,China)

机构地区：[1]延安大学附属医院心血管内科,陕西延安716000 [2]延安大学附属医院肿瘤科,陕西西安716000 [3]延安大学附属医院内分泌代谢科,陕西西安716000

出　　处：《陕西医学杂志》2022年第3期355-358,共4页Shaanxi Medical Journal

基　　金：陕西省科技惠民计划项目(2016HM-04)。

摘　　要：目的:探讨沙库巴曲缬沙坦联合达格列净治疗2型糖尿病(T2DM)合并心力衰竭(HF)患者的临床疗效。方法:将T2DM合并HF患者180例随机分为对照组(85例)和观察组(95例)。对照组给予沙库巴曲缬沙坦治疗,观察组在对照组基础联合达格列净治疗,均连续治疗3个月。比较两组患者治疗前后空腹血糖(FPG)、餐后2 h血糖(2hPBG)、血浆脑钠肽(BNP)、C-反应蛋白(CRP)、糖化血红蛋白(HbA1c)水平变化以及心功能指标[左心室射血分数(LVEF)、左室舒张期内径(LVEDD)、二尖瓣血流频谱E峰/A峰(E/A)]改善情况。统计两组患者不良反应发生情况。结果:治疗前,两组患者FPG、2hPBG、血浆BNP、CRP、HbA1c、LVEF、LVEDD、E/A值比较差异无统计学意义(均P>0.05)。治疗3个月后,两组患者FPG、2hPBG、血浆BNP、CRP、HbA1c、LVEDD下降,LVEF、E/A值升高,且观察组优于照组(均P<0.05)。对照组不良反应总发生率(8.24%)略高于观察组(4.21%),但组间比较差异无统计学意义(P>0.05)。结论:沙库巴曲缬沙坦联合达格列净治疗T2DM合并HF患者,可有效控制血糖,促进血浆BNP、CRP、HbA1c水平下降,改善心功能,且安全性较高。Objective:To investigate the clinical efficacy of sacubitril/valsartan combined with dapagliflozin in the treatment of type 2 diabetes mellitus(T2DM)complicated with heart failure(HF).Methods:180 patients with T2DM and HF were randomly divided into control group(85 cases)and observation group(95 cases).Patients in the control group were treated with sacubitril/valsartan,while patients in the observation group were treated with sacubitril/valsartan combined with dapagliflozin.Both groups underwent 3 months of continuous treatment.The changes of fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPBG),plasma brain natriuretic peptide(BNP),C-reactive protein(CRP),glycosylated hemoglobin(HbA1c)and the improvement of cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular diastolic diameter(LVEDD),mitral valve flow spectrum E peak/A peak(E/A)]were compared between the two groups before and after treatment.The incidence rates of adverse reactions in the two groups were calculated.Results:Before treatment,there was no significant difference in FPG,2hPBG,plasma BNP,CRP,HbA1c,LVEF,LVEDD and E/A between the two groups(all P>0.05).After 3 months of treatment,FPG,2hPBG,plasma BNP,CRP,HbA1c and LVEDD decreased,LVEF and E/A increased,and the observation group was better than the control group(all P<0.05).The total incidence of adverse reactions in the control group(8.24%)was slightly higher than that(4.21%)in the observation group,but there was no significant difference between two groups(P>0.05).Conclusion:In the treatment of T2DM patients with HF,sacubitril/valsartan combined with dapagliflozin can effectively control blood glucose,reduce the levels of plasma BNP,CRP and HbA1c,improve cardiac function,and has high safety.

关 键 词：2型糖尿病 心力衰竭 沙库巴曲缬沙坦 达格列净 血糖控制 心功能 

分 类 号：R587.1[医药卫生—内分泌]