卡格列净对2型糖尿病合并慢性心力衰竭患者心功能的影响分析  

Effect Analysis of Canagliflozin on Heart Function in Patients with Type 2 Diabetes Mellitus Complicated with Chronic Heart Failure

作　　者：张晓飞 杨光[1] 夏忠华 ZHANG Xiaofei;YANG Guang;XIA Zhonghua(Department of Geriatrics,731 Hospital of China Aerospace Science and Industry Group,Beijing 100074,China)

机构地区：[1]中国航天科工集团七三一医院老年医学科,北京100074

出　　处：《中国实用乡村医生杂志》2022年第5期47-51,59,共6页Chinese Practical Journal of Rural Doctor

摘　　要：目的探讨卡格列净治疗2型糖尿病合并慢性心力衰竭患者对其心功能的影响。方法将2019年3月—2020年8月中国航天科工集团七三一医院心内科收治的62例2型糖尿病合并慢性心力衰竭患者,随机分为卡格列净组和格列美脲组各31例。卡格列净组在常规治疗基础上给予卡格列净治疗,格列美脲组在常规治疗基础上给予格列美脲治疗,两组均连续治疗24周。比较两组患者治疗前后氨基末端B型钠尿肽、血糖、超声心动图、心功能分级及生活质量改变情况。结果治疗24周后,两组氨基末端B型钠尿肽水平均较治疗前下降,差异均具有统计学意义(P<0.05);但两组治疗后氨基末端B型钠尿肽水平及其改变百分比差异均无统计学意义(P>0.05)。治疗24周后,格列美脲组糖化血红蛋白下降程度大于卡格列净组,卡格列净组体质量下降程度大于格列美脲组,卡格列净组血红蛋白和红细胞压积增高程度大于格列美脲组,上述差异均具有统计学意义(P<0.05)。两组治疗前后心功能分级及超声心动图各项指标变化情况,差异均无统计学意义(P>0.05)。结论卡格列净治疗2型糖尿病合并慢性心力衰竭患者24周,与格列美脲相比,对患者氨基末端B型钠尿肽水平及心功能的影响未见差异,两种药物都具有较好的降血糖作用,且格列美脲对患者糖化血红蛋白的影响程度大于卡格列净,而卡格列净对患者体质量、血红蛋白和红细胞压积的影响程度大于格列美脲。Objective To explore the effect of canagliflozin on heart function in patients with type 2 diabetes mellitus(T2DM)complicated with chronic heart failure(CHF).Methods A total of 62 patients with type 2diabetes mellitus complicated with chronic heart failure admitted to department of cardiology,the 731 Hospital of China Aerospace Science and Industry Group from March 2019 to August 2020,were randomly divided into the canagliflozin group and glimepiride group with 31 cases in each group.Canagliflozin group was treated with canagliflozin on the basis of routine treatment,and glimepiride group was treated with glimepiride on the basis of routine treatment.Both groups were treated for 24 weeks.The changes of N-terminal pro-B type natriuretic peptide(NT-pro BNP),blood glucose,echocardiography,heart function grade and quality of life were compared between the two groups before and after treatment.Results After 24 weeks of treatment,the level of NT-pro BNP in both groups significantly decreased compared with that before treatment(P<0.05).However,there was no significant difference in the level of NT-pro BNP and its change percentage between the two groups after treatment(P>0.05).After 24 weeks of treatment,the decrease of glycosylated hemoglobin in glimepiride group was significantly greater than that in canagliflozin group,the decrease of body mass in canagliflozin group was significantly greater than that in glimepiride group,and the increase of hemoglobin and hematocrit in canagliflozin group was significantly greater than that in glimepiride group(all P<0.05).There was no significant difference in heart function grade and echocardiographic indexes between the two groups before and after treatment(P>0.05).Conclusion Compared with glimepiride,canagliflozin treatment in T2DM complicated with CHF patients for 24 weeks had the same effect on,the NT-pro BNP levels and heart function,both drugs can play a good role in lowering blood glucose,and the effect of glimepiride on glycosylated hemoglobin was greater than that of can

关 键 词：2型糖尿病 合并症 心力衰竭 药物治疗 卡格列净 氨基末端B型钠尿肽 心功能 

分 类 号：R58[医药卫生—内分泌]