达格列净对急性心肌梗死合并2型糖尿病PCI术后患者心功能的影响  

Effect of dapagliflozin on cardiac function in patients with acute myocardial infarction complicated with type 2 diabetes after PCI

作　　者：魏方勇[1] 陈静静[1] 王伟荣[1] WEI Fangyong;CHEN Jingjing;WANG Weirong(Department of Cardiovascular Medicine,Zhucheng People′s Hospital Affiliated to Weifang Medical College,Shandong Province,Zhucheng 262200,China)

机构地区：[1]潍坊医学院附属诸城市人民医院心血管内科,山东省诸城市262200

出　　处：《临床合理用药杂志》2023年第7期19-22,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的 观察达格列净对急性心肌梗死合并2型糖尿病经皮冠状动脉介入治疗(PCI)术后心功能的影响。方法 选取2021年1月—2022年5月于潍坊医学院附属诸城市人民医院进行治疗的急性心肌梗死合并2型糖尿病患者84例为研究对象,将所有研究对象依据随机分组原则分为达格列净组和常规组,每组42例。2组入院后均行PCI术,术后常规组在常规治疗基础上给予门冬胰岛素30注射液治疗,达格列净组在常规治疗基础上给予达格列净治疗,2组均治疗3个月。比较2组治疗前、治疗3个月后左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、脂联素、N末端脑钠肽前体(NT-proBNP)、白介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、主要心血管不良事件及药物不良反应。结果 治疗3个月后,2组LVEF均高于治疗前,LVEDD及LVESD均小于治疗前,且达格列净组升高/降低幅度大于常规组(P<0.05或P<0.01);2组脂联素水平均高于治疗前,NT-proBNP、IL-6及hs-CRP水平均低于治疗前,且达格列净组升高/降低幅度大于常规组(P<0.05或P<0.01);达格列净组主要心血管不良事件总发生率为4.76%,低于常规组的21.43%(χ^(2)=5.126,P=0.024);常规组与达格列净组药物不良反应总发生率比较差异无统计学意义(14.29%vs. 9.52%,χ^(2)=0.454,P=0.500)。结论 达格列净可改善急性心肌梗死合并2型糖尿病PCI术后患者心功能、左室重构和血清学指标,减轻炎性反应,降低主要心血管不良事件发生风险,具有较高的安全性。Objective To observe the effect of dapagliflozin on cardiac function in patients with acute myocardial infarction complicated with type 2 diabetes after percutaneous coronary intervention(PCI). Methods A total of 84 patients with acute myocardial infarction complicated with type 2 diabetes admitted to Zhucheng People′s Hospital Affiliated to Weifang Medical College from January 2021 to May 2022 were selected and divided into dapagliflozin group and conventional group by random number table method, with 42 cases in each group. All patients in 2 groups received PCI after admission, the conventional group was given insulin aspartate 30 injection on the basis of conventional treatment after surgery, and the dapagliflozin group was given dapagliflozin on the basis of conventional treatment, and all patients in 2 groups were treated for 3 months. Compared the LVEF, LVEDD, LVESD, adiponectin, NT-proBNP, interleukin-6(IL-6), hypersensitive C-reactive protein(hs-CRP), lord cardiovascular adverse events and adverse drug reactions between the two groups. Results After 3 months of treatment, LVEF of patients in both groups were higher than those before treatment, LVEDD and LVESD were lower than those before treatment, and the increase/decrease of the dapagliflozin group were greater than the conventional group(P<0.05 or P<0.01);The levels of adiponectin in the two groups were higher than those before treatment, and the levels of NT-proBNP, IL-6 and hs-CRP were lower than those before treatment, the increase/decrease of the dapagliflozin group were greater than the conventional group(P<0.05 or P<0.01);The total incidence of major adverse cardiovascular events in dapagliflozin group was 4.76%, lower than 21.43% in conventional group(χ ~2=5.126,P=0.024);There was no significant difference in the total incidence of adverse drug reactions between conventional group and dapagliflozin group(14.29% vs. 9.52%, χ^(2)=0.454,P=0.500). Conclusion Dapagliflozin can improve cardiac function, left ventricular remodeling and serological

关 键 词：急性心肌梗死 2型糖尿病 经皮冠状动脉介入治疗 达格列净 心功能 

分 类 号：R542.22[医药卫生—心血管疾病] R587.1[医药卫生—内科学]