达格列净治疗2型糖尿病合并HFrEF患者心功能变化的评价分析  

Evaluation and Analysis of Cardiac Function Changes in Type 2 Diabetes Patients with HFrEF Treated with Dapagliflozin

作　　者：雷煌平 蓝胜峰 LEI Huangping;LAN Shengfeng(Jingdezhen Second People's Hospital,Jingdezhen Jiangxi 333000,China)

机构地区：[1]景德镇市第二人民医院,江西景德镇333000

出　　处：《药品评价》2023年第6期729-732,共4页Drug Evaluation

基　　金：景德镇市科技计划项目(20221SFZC055)。

摘　　要：目的探讨达格列净治疗2型糖尿病(T2DM)合并射血分数下降的心力衰竭(HFrEF)患者的临床效果及对心功能的影响。方法选取2020年8月至2022年8月景德镇市第二人民医院收治的60例T2DM合并HFrEF患者,按随机数字表法分为两组,各30例。两组均予以常规抗心衰治疗,对照组予以二甲双胍治疗,观察组予以达格列净治疗,持续治疗6个月。比较两组临床疗效,心功能指标[左室射血分数(LVEF)、左室舒张末内径(LVEDd)、左室收缩末内径(LVESd)],血糖水平[糖化血红蛋白(HbA1c)、空腹血糖(FPG)水平、餐后2 h血糖(2 hPG)],N末端B型利钠肽原(NT-proBNP),炎症水平[C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)],6 min步行距离,生活质量[世卫组织生活简易量表(WHOQOL-BREF)]及不良反应。结果观察组总有效率较对照组高。治疗后,LVEF高于对照组,LVEDd、LVESd低于对照组,差异有统计学意义(P<0.05);观察组HbA1c、FPG、2hPG低于对照组,差异有统计学意义(P<0.05);观察组NT-proBNP、CRP、IL-6、TNF-α水平低于对照组,6 min步行距离长于对照组,差异有统计学意义(P<0.05);观察组WHOQOL-BREF评分高于对照组,差异有统计学意义(P<0.05);两组不良反应差异无统计学意义(P>0.05)。结论达格列净可提高T2DM合并HFrEF治疗效果,降低血糖水平,减轻心功能损害,改善生活质量,安全可靠。Objective To investigate the clinical effect of dapagliflozin in the treatment of type 2 diabetes and heart failure with reduced ejection fraction(HFrEF)and its influence on cardiac function.Methods 60 patients with T2DM and HFrEF admitted to Jingdezhen Second People's Hospital from August 2020 to August 2022 were randomly divided into two groups,30 patients in each group.Both groups were treated with conventional anti-heart failure therapy,the control group was treated with metformin,and the observation group was treated with dapagliflozin,all treated for 6 months.The clinical efficacy,cardiac function index(LVEF、LVEDd、LVESd),blood glucose level(HbA1c、FPG、2 hPG),N-terminal B-type natriuretic peptide(NT-proBNP),inflammation level(CRP、IL-6、TNF-α),6-minute walking distance,quality of life(WHOQOL-BREF)and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group.After treatment,LVEF in observation group was higher than that of the control group,LVEDd and LVESd in observation group were lower than that of the control group,with statistical difference(P<0.05);HbA1c,FPG and 2hPG in the observation group were lower than those in the control group,with statistical difference(P<0.05);NT-proBNP,CRP,IL-6,TNF-αlevel were lower than thoes in the control group,and the 6-minute walking distance was longer than the control group,with a statistically significant difference(P<0.05);the WHOQOL-BREF score in the observation group was higher than that in the control group,with a statistically significant difference(P<0.05);there was no statistically significant difference in adverse reactions between the two groups(P>0.05).Conclusion Dapagliflozin can improve the therapeutic effect of T2DM combined with HFrEF,reduce blood glucose level,reduce cardiac function damage,improve quality of life,and is safe and reliable.

关 键 词：达格列净 糖尿病 2型 射血分数下降的心力衰竭 心功能 血糖水平 

分 类 号：R587.1[医药卫生—内分泌] R969[医药卫生—内科学]