达格列净与恩格列净用于2型糖尿病合并射血分数降低心力衰竭患者的疗效和安全性比较  

Comparison of Efficacy and Safety of Dapagliflozin and Empagliflozin in T2DM Patients with HFrEF

作　　者：陈安[1] 梁国泉 潘敏[1] 翟永新[3] 白建雄[3] 易燕桃 黄小瑜[2] CHEN An;LIANG Guo-quan;PAN Min;ZHAI Yong-xin;BAI Jian-xiong;YI Yan-tao;HUANG Xiao-yu(Department of Clinical pharmacy,Zhaoqing Second People′s Hospital,Zhaoqing 526060,China;Department of pharmacy,Zhaoqing Second People′s Hospital,Zhaoqing 526060,China;Department of Cardiology,Zhaoqing Second People′s Hospital,Zhaoqing 526060,China)

机构地区：[1]肇庆市第二人民医院临床药学科,广东肇庆526060 [2]肇庆市第二人民医院药剂科,广东肇庆526060 [3]肇庆市第二人民医院心血管内科,广东肇庆526060

出　　处：《海峡药学》2023年第8期72-76,共5页Strait Pharmaceutical Journal

基　　金：2021年度肇庆市科技创新指导类项目(项目编号2021040314055)。

摘　　要：目的 评价达格列净与恩格列净治疗2型糖尿病合并射血分数降低心力衰竭患者的临床疗效和安全性。方法 选取2021年8月至2022年10月我院心血管中心就诊的80例2型糖尿病合并射血分数降低心力衰竭患者作为研究对象,采取随机数字表法将其分为观察组和对照组各40例。两组患者均行标准心力衰竭治疗,在此基础上,观察组患者采用达格列净治疗,对照组患者采用恩格列净治疗。比较两组患者的心血管死亡发生率,心力衰竭住院(包括首次和再次住院)、因心力衰竭急诊发生率,全因死亡率,不良事件停药率,不良事件发生率,以及糖化血红蛋白、血肌酐、血红细胞压积、N-端脑利钠肽前体、体重、收缩压等指标情况。结果 治疗后,两组患者的心力衰竭恶化、心力衰竭住院(首次和再次住院)、因心力衰竭急诊发生率比较,差异无统计学意义(P>0.05)。观察组患者的心血管死亡发生率低于对照组,差异有统计学意义(P<0.05);两组患者的全因死亡率比较,差异无统计学意义(P>0.05)。两组患者的不良事件总发生率比较,差异无统计学意义(P>0.05)。两组患者的不良事件发生停药情况比较,差异无统计学意义(P>0.05)。两组患者治疗后的糖化血红蛋白、血肌酐、血红细胞压积、N-端脑利钠肽前体、体重和收缩压比较,差异均无统计学意义(P>0.05)。结论 达格列净和恩格列净用于2型糖尿病合并射血分数降低心力衰竭患者的疗效和安全性相似,但达格列净改善患者心血管预后较显著。OBJECTIVE To evaluate the clinical efficacy and safety of Dapagliflozin and Empagliflozin in the treatment of T2DM with HFrEF.METHODS A total of 80 patients with type 2 diabetes with reduced ejection fraction in Zhaoqing Second Cardiovascular Center from May 2021 to October 2022 were selected as the study subjects,followed by random numbers after matching stratification,which were divided into 40 cases of observation group and control group.Both groups were treated with standard heart failure,based on this,patients in the observation group were treated with Dapagliflozin and control patients were treated with Empagliflozin.The incidence of cardiovascular death,heart failure hospitalization(including first and rehospitalization),emergency treatment rate for heart failure,and all-cause mortality,discontinuation rate of adverse events,incidence of adverse events,and glycated hemoglobin,blood creatinine,hematocrit,N-telencephalic natriuretic peptide precursor,body weight,systolic blood pressure and other indicators were compared.RESULTS After treatment,heart failure occurred,heart failure occurred(P>0.05).The incidence of cardiovascular death in the observation group was lower than that in the control group(P<0.05);the difference of all-cause mortality in the two groups was not significant(P>0.05).The overall incidence of adverse events between the two groups was not significant(P>0.05).In the two groups,there was no significant difference(P>0.05).There was no significant difference between the treated hemoglobin A1 c,blood creatinine,hematocrit,N-telencephalic natriuretic peptide precursor,body weight and systolic blood pressure between the two groups(P>0.05).CONCLUSION The efficacy and safety of Dapagliflozin andEmpagliflozin in T2DM patients with HFrEF are similar,but Dapagliflozin improves the cardiovascular prognosis of patients more significantly.

关 键 词：达格列净 恩格列净 2型糖尿病 射血分数降低心力衰竭 疗效 安全性 

分 类 号：R969.4[医药卫生—药理学]