芪苈强心胶囊联合达格列净对心力衰竭合并2型糖尿病患者血糖水平、神经内分泌因子及心功能的影响  

Effect of Qili Qiangxin capsule combined with dapagliflozin on blood glucose level,neuroendocrine factors and cardiac function in patients with heart failure complicated with type 2 diabetes mellitus

作　　者：张玲娟 王西辉[1] 曹彪 王建榜 ZHANG Lingjuan;WANG Xihui;CAO Biao;WANG Jianbang(Cardiovascular Medicine Department,the Second Affiliated Hospital of Xi'an Medical University,Xi'an 710038,China)

机构地区：[1]西安医学院第二附属医院心血管内科,陕西西安710038

出　　处：《临床医学研究与实践》2022年第20期61-65,共5页Clinical Research and Practice

基　　金：陕西省重点研发计划项目(No.2018SF-114);西安医学院第四批校级重点学科[西医发〔2019〕96号]。

摘　　要：目的探讨芪苈强心胶囊联合达格列净对心力衰竭合并2型糖尿病患者血糖水平、神经内分泌因子及心功能的影响。方法选取2020年1月至2021年10月我院收治的189例心力衰竭合并2型糖尿病患者作为研究对象,根据治疗方案不同将其分为三组,各63例。A组行芪苈强心胶囊治疗,B组行达格列净治疗,C组行芪苈强心胶囊联合达格列净治疗。比较三组心功能指标[舒张期左心室后壁厚度(LVPWD)、左心室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左心室质量指数(LVMI)、左心室重构指数(LVRI)]、血糖水平[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]、神经内分泌因子[N端前体脑钠肽(NT-proBNP)、血管紧张素Ⅱ(AngⅡ)、肿瘤坏死因子-α(TNF-α)]、血管内皮功能指标[血管内皮素-1(ET-1)、一氧化氮(NO)、血栓素B2(TXB2)]、不良反应发生情况及治疗效果。结果治疗后,三组的LVPWD、LVEDD、LVMI低于治疗前,LVEF、LVRI高于治疗前,且C组优于A、B组(P<0.05)。治疗后,三组的FPG、2 h PG、HbA1c、NT-ProBNP、AngⅡ、TNF-α水平低于治疗前,且C组低于A、B组(P<0.05)。治疗后,三组的ET-1、TXB2水平低于治疗前,NO水平高于治疗前,且C组优于A、B组(P<0.05)。三组的不良反应总发生率比较,差异无统计学意义(P>0.05)。C组的治疗总有效率高于A、B组(P<0.05)。结论芪苈强心胶囊联合达格列净治疗心力衰竭合并2型糖尿病患者,有利于改善血糖水平及血管内皮功能,降低神经内分泌因子水平,提高心功能指标,且安全性较好。Objective To investigate the effect of Qili Qiangxin capsule combined with dapagliflozin on blood glucose level,neuroendocrine factors and cardiac function in patients with heart failure complicated with type 2 diabetes mellitus.Methods A total of 189 patients with heart failure complicated with type 2 diabetes admitted to our hospital from January 2020 to October 2021 were selected and divided into three groups according to different treatment regimens,with 63 cases in each group.Group A was treated with Qili Qiangxin capsule,group B was treated with dapagliflozin,and group C was treated with Qili Qiangxin capsule combined with dapagliflozin.The cardiac function indexes[diastolic left ventricular posterior wall thickness(LVPWD),left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),left ventricular mass index(LVMI),left ventricular reconstruction index(LVRI)],plasma glucose levels[fasting plasma glucose(FPG),2 h postprandial plasma glucose(2 h PG),glycosylated hemoglobin(HbA1c)],neuroendocrine factors[N-terminal pro-brain natriuretic peptide(NT-proBNP),angiotensinⅡ(AngⅡ),tumor necrosis factor-α(TNF-α)],vascular endothelial function indexes[endothelin-1(ET-1),nitric oxide(NO),thromboxane B2(TXB2)],incidence of adverse reactions and therapeutic effect were compared among the three groups.Results After treatment,LVPWD,LVEDD and LVMI in three groups were lower than those before treatment,LVEF and LVRI were higher than those before treatment,and those of the group C were better than the groups A and B(P<0.05).After treatment,the levels of FPG,2 h PG,HbA1c,NT-proBNP,AngⅡand TNF-αin three groups were lower than those before treatment,and those in the group C were lower the than groups A and B(P<0.05).After treatment,the levels of ET-1 and TXB2 in the three groups were lower than those before treatment,the level of NO was higher than that before treatment,and those of the group C were better than the groups A and B(P<0.05).There was no significant difference in the total inciden

关 键 词：芪苈强心胶囊 达格列净 心力衰竭 2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]