沙库巴曲缬沙坦联合达格列净治疗糖尿病心肌病的疗效评价  

Evaluation of the Efficacy of Sacubitril Valsartan Combined with Dapagliflozin in the Treatment of Diabetic Cardiomyopathy

作　　者：刘玲[1] 李乃光[1] 管文娟[1] LIU Ling;LI Nai-guang;GUAN Wen-juan(Department of Pharmacy,Puyang People's Hospital,Puyang 457001,China)

机构地区：[1]濮阳市人民医院药剂科,濮阳457001

出　　处：《中国合理用药探索》2023年第6期71-76,共6页Chinese Journal of Rational Drug Use

基　　金：河南省医学科技攻关计划项目(LHGJ20200914)。

摘　　要：目的:探究沙库巴曲缬沙坦联合达格列净对糖尿病心肌病(DCM)患者心功能及糖脂代谢的影响。方法:选取2020年12月~2021年12月期间本院收治的104例DCM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52例。对照组口服盐酸贝那普利和达格列净,观察组口服沙库巴曲缬沙坦和达格列净,两组均连续治疗3个月。比较两组临床疗效、心功能指标[脑钠肽(BNP)、左室射血分数(LVEF)]、6分钟步行试验(6MWT)和糖脂代谢指标[空腹血糖(FBG)、餐后2h血糖(2h PG)、甘油三酯(TG)与总胆固醇(TC)],观察并记录两组治疗期间不良反应的发生情况。结果:治疗3个月后,观察组总有效率(94.23%)高于对照组(80.77%,P<0.05);两组BNP水平较治疗前均降低(P<0.05),且观察组BNP水平低于对照组(P<0.05);两组LVEF和6MWT较治疗前均升高(P<0.05),且观察组LVEF和6MWT均高于对照组(P<0.05);两组FBG、2h PG、TG和TC较治疗前均有所下降(P<0.05),且观察组各指标水平略低于对照组,但两组比较无统计学差异(P>0.05);两组治疗期间不良反应发生率比较无统计学差异(P>0.05)。结论:沙库巴曲缬沙坦联用达格列净治疗DCM疗效显著,可有效改善患者的心功能和糖脂代谢,且安全性较高。Objective:To investigate the effects of sacubitril valsartan combined with dapagliflozin on cardiac function and glycolipid metabolism in patients with diabetic cardiomyopathy(DCM).Methods:A total of 104 patients with DCM admitted to our hospital from December 2020 to December 2021 were divided into the control group and observation group by random number table method,with 52 patients in each group.The control group was treated with benazepril hydrochloride and dapagliflozin,and the observation group was treated with sacubitril valsartan and dapagliflozin,both groups were treated continuously for 3 months.The clinical efficacy,cardiac function indicators[brain natriuretic peptide(BNP),left ventricular ejection fraction(LVEF)],six-minute walking test(6MWT)and glycolipid metabolism indicators[fasting blood glucose(FBG),2-hour postprandial blood glucose(2h PG),triglyceride(TG)and total cholesterol(TC)]were compared between the two groups.The occurrence of adverse reactions during treatment was observed and recorded in both groups.Results:After 3 months of treatment,the total effective rate in the observation group(94.23%)was higher than that in the control group(80.77%,P<0.05).The levels of BNP in the two groups were lower than those before treatment(P<0.05),and the level of BNP in the observation group was lower than that in the control group(P<0.05).LVEF and 6MWT were higher than those before treatment(P<0.05),and LVEF and 6MWT in the observation group were higher than those in the control group(P<0.05).The levels of FBG,2h PG,TG and TC in the two groups were lower than those before treatment(P<0.05).The levels of indicators in the observation group were slightly lower than those in the control group,but there was no statistical difference between the two groups(P>0.05).There was no statistical significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Sacubitril valsartan combined with dapagliflozin can effectively improve the cardiac function and the glycolipid metabol

关 键 词：糖尿病心肌病 沙库巴曲缬沙坦 达格列净 心功能 糖脂代谢 

分 类 号：R587.1[医药卫生—内分泌]