达格列净治疗2型糖尿病合并心功能不全患者的效果观察  

Effect observation of dapagliflozin on type 2 diabetes mellitus patients with cardiac insufficiency

作　　者：唐敏 李丽燕 TANG Min;LI Li-yan(Department of Cardiovascular Medicine,Tongshan District People's Hospital,Xuzhou 221006,China)

机构地区：[1]徐州市铜山区人民医院心血管内科,221006 [2]徐州医科大学附属医院全科医学科,221006

出　　处：《中国实用医药》2023年第1期23-27,共5页China Practical Medicine

摘　　要：目的 分析达格列净在2型糖尿病合并心功能不全患者治疗中的应用价值。方法 选取102例2型糖尿病合并心功能不全患者作为研究对象,采用随机数字表法分为对照组和观察组,每组51例。两组均给予综合心内科治疗方案,对照组给予二甲双胍降糖治疗,观察组患者给予达格列净降糖治疗。比较两组患者治疗前后血糖[空腹血糖(FBG)、餐后2 h血糖(2 h PG)]水平、心功能指标[左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、舒张早期二尖瓣血流峰速度和舒张晚期二尖瓣血流峰速度的比值(E/A)]、实验室指标[血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、N末端B型脑钠肽前体(NT-proBNP)、可溶性生长激素表达基因2蛋白(sST2)和同型半胱氨酸(Hcy)]水平、6 min步行距离及不良反应发生情况。结果 治疗后,两组患者的FBG、2 h PG水平均明显低于本组治疗前,且观察组患者的FBG(6.46±0.54)mmol/L、2 h PG(9.54±0.79)mmol/L均低于对照组的(7.68±0.66)、(10.58±1.17)mmol/L,差异具有统计学意义(P<0.05)。治疗后,两组患者的LVEF、E/A均高于本组治疗前, LVEDD小于本组治疗前,且观察组患者的LVEF(50.3±2.0)%和E/A(0.92±0.15)均高于对照组的(47.1±1.8)%、(0.84±0.15), LVEDD(48.3±2.6)mm小于对照组的(51.2±2.8)mm,差异具有统计学意义(P<0.05)。治疗后,两组患者的血清IL-6、TNF-α、hs-CRP、NT-proBNP、sST2和Hcy水平均低于本组治疗前,且观察组患者的血清IL-6(9.5±1.0)ng/L、TNF-α(10.4±1.1)ng/L、hs-CRP(2.17±0.24)mg/L、NT-proBNP(1812±328)μg/L、sST2(0.42±0.06)μg/L、Hcy(9.87±0.78)μmol/L均低于对照组的(13.2±1.4)ng/L、(15.9±1.5)ng/L、(3.20±0.33)mg/L、(2794±457)μg/L、(0.54±0.10)μg/L、(11.37±1.02)μmol/L,差异具有统计学意义(P<0.05)。治疗后,两组患者的6 min步行距离均明显长于本组治疗前,且观察组患者的6 min步行距离(456.4±32.4)m长于对照组的(410.2±29.5)m,�Objective To analyze the application value of dapagliflozin on type 2 diabetes mellitus patients with cardiac insufficiency. Methods A total of 102 cases of type 2 diabetes mellitus patients with cardiac insufficiency were randomly divided into control group and observation group, with 51 cases in each group. Both groups were given comprehensive cardiology treatment regimen. The control group received metformin hypoglycemic treatment, and the observation group received dapagliflozin hypoglycemic treatment. Both groups were compared in terms of levels of blood glucose [fasting blood glucose(FBG) and 2 h postprandial glucose(2 h PG)], cardiac function indexes [left ventricular ejection fraction(LVEF), left ventricular end-diastolic diameter(LVEDD), early diastolic peak flow velocity of mitral valve/late diastolic peak flow velocity of mitral valve(E/A)], and laboratory indexes [interleukin-6(IL-6), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), high-sensitivity C-reactive protein(hs-CRP), N-terminal pro-brain natriuretic peptide(NT-proBNP), soluble growth stimulation expressed gene 2(sST2) and homocysteine(Hcy)] levels, 6 min walking distance before and after treatment, and the occurrence of adverse reactions. Results After treatment,the FBG and 2 h PG levels in both groups were significantly lower than those before treatment in this group,and the FBG(6.46±0.54) mmol/L and 2 h PG(9.54±0.79) mmol/L in the observation group were lower than(7.68±0.66) and(10.58±1.17) mmol/L in the control group;the differences were statistically significant(P<0.05).After treatment, the LVEF and E/A in both groups were higher than those before treatment in this group, and LVEDD was smaller than that before treatment in this group;the LVEF(50.3±2.0)% and E/A(0.92±0.15)in the observation group were higher than(47.1±1.8)% and(0.84±0.15) in the control group;the LVEDD(48.3±2.6) mm in the observation group was smaller than(51.2±2.8) mm in the control group;the differences were statistically significant(P<0.05). After treat

关 键 词：2型糖尿病 心功能不全 二甲双胍 达格列净 血糖 心功能 炎症因子 

分 类 号：R587.1[医药卫生—内分泌] R541.6[医药卫生—内科学]