达格列净对慢性心力衰竭合并2型糖尿病患者血糖、血脂及心功能的影响  

Effects of dapagliflozin on blood glucose, blood lipid and heart function in patients with chronic heart failure complicated with type 2 diabetes

作　　者：陈蕊 张伟[1] 龚军 CHEN Rui;ZHANG Wei;GONG Jun(Department of Cardiology,Nanjing Hospital of TCM/Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Jiangsu Province,Nanjing 210000,China)

机构地区：[1]南京市中医院/南京中医药大学附属南京中医院心内科,210000

出　　处：《临床合理用药杂志》2023年第7期12-15,共4页Chinese Journal of Clinical Rational Drug Use

基　　金：南京市中医药青年人才培养计划(ZYQ20009)。

摘　　要：目的 观察达格列净对慢性心力衰竭合并2型糖尿病患者血糖、血脂及心功能的影响。方法 选取2020年1月—2021年6月于南京市中医院/南京中医药大学附属南京中医院心内科门诊或住院治疗的慢性心力衰竭合并2型糖尿病患者72例,采用随机数字表法分为观察组和对照组各36例。对照组采用标准抗心力衰竭及降糖方案治疗,观察组在对照组基础上加用达格列净治疗,2组疗程均为6个月。比较2组患者治疗前后血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)]、血脂指标[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)]、心功能指标[左室射血分数(LVEF)、血浆N末端脑钠肽前体(NT-proBNP)]、血清生物标志物[超敏C反应蛋白(hs-CRP)、基质金属蛋白酶-9(MMP-9)、白介素-6(IL-6)]及不良反应。结果 治疗6个月后,2组FPG、2 hPG、HbA1c、TC、TG、LDL-C、NT-proBNP、hs-CRP、MMP-9、IL-6水平均较治疗前下降,LVEF较治疗前升高,且观察组FPG、2 hPG、HbA1c、NT-proBNP、hs-CRP、MMP-9及IL-6水平低于对照组,LVEF高于对照组(P<0.05或P<0.01);2组治疗期间均未出现心血管不良事件,复查血常规、血生化未见明显异常改变,观察组出现尿路感染1例,对症治疗后好转。结论 达格列净治疗慢性心力衰竭合并2型糖尿病的疗效确切,可降低血糖水平,改善心功能。Objective To observe the effect of dapagliflozin on blood glucose, blood lipid and heart function in patients with chronic heart failure complicated with type 2 diabetes.Methods From January 2020 to June 2021, 72 patients with chronic heart failure complicated with type 2 diabetes who were treated in the outpatient or inpatient department of cardiology of Nanjing Hospital of TCM/Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine were selected, and they were randomly divided into the observation group and the control group, 36 cases in each group. The control group was treated with standard anti heart failure and hypoglycemic regimen, and the observation group was treated with dapagliflozin on the basis of the control group, both groups were treated for 6 months. The blood glucose indexes[fasting blood glucose(FPG), postprandial blood glucose 2 hours after meal(2 hPG), glycosylated hemoglobin(HbA1c)], blood lipid index[total cholesterol(TC), triacylglycerol(TG), low-density lipoprotein cholesterol(LDL-C)], cardiac function index[left ventricular ejection fraction(LVEF), N-terminal pro-brain natriuretic peptide(NT-proBNP)], serum biomarkers[hypersensitive C reactive protein(hs-CRP), matrix metalloproteinase-9(MMP-9), interleukin-6(IL-6)] and adverse reactions. Results After 6 months of treatment, the levels of FPG, 2 hPG, HbA1c, TC, TG, LDL-C, NT-proBNP, hs-CRP, MMP-9, IL-6 in both groups decreased and LVEF increased compared with those before treatment, the levels of FPG, 2 hPG, HbA1c, NT-proBNP, hs-CRP, MMP-9 and IL-6 in the observation group were lower than those in the control group, and LVEF were higher than those in the control group(P<0.05 or P<0.01);During the treatment, no adverse cardiovascular events occurred in both groups, and no significant abnormal changes were found in blood routine examination and blood biochemistry, one case of urinary tract infection occurred in the observation group, which improved after symptomatic treatment. Conclusion Dapagliflozin is ef

关 键 词：心力衰竭 慢性 糖尿病 2型 达格列净 心功能 血清生物标志物 

分 类 号：R541.6[医药卫生—心血管疾病] R587.1[医药卫生—内科学]