达格列净对急性心肌梗死合并糖尿病患者经皮冠状动脉介入治疗后糖代谢和心功能的影响  

Effects of dapagliflozin on glucose metabolism and cardiac function in patients with acute myocardial infarction complicated with diabetes mellitus after percutaneous coronary intervention

作　　者：刘凯 陈园园 陈海燕 项学军[1] 乔锐[1] 聂佩 LIU Kai;CHEN Yuanyuan;CHEN Haiyan;XIANG Xuejun;QIAO Rui;NIE Pei(Department of Cardiovascular Medicine,Anqing Municipal Hospital,Anqing 246001,China;Department of Critical Care Medicine,Anqing Municipal Hospital,Anqing 246001,China)

机构地区：[1]安庆市立医院心血管内科,安庆246001 [2]安庆市立医院重症医学科,安庆246001

出　　处：《西北药学杂志》2024年第3期189-193,共5页Northwest Pharmaceutical Journal

基　　金：安徽医科大学青年科学基金项目(编号:2021xkj115)。

摘　　要：目的探究达格列净对急性心肌梗死合并糖尿病患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)后糖代谢、心功能及再入院率的影响。方法将108例急性心肌梗死合并2型糖尿病患者作为研究对象,采用随机数字法将其分为观察组(55例)和对照组(53例)。对照组于PCI术后常规给予抗血小板药物及降糖药物治疗,观察组在对照组治疗的基础上给予达格列净治疗。于治疗3个月后,比较2组治疗疗效及再入院率、血管再狭窄率、心脏不良事件发生率;观察2组患者治疗前后心功能指标[N端B型脑钠肽前体(N-terminal pro-B-type natriuretic peptide,NT-proBNP)、左室射血分数(left ventricular ejection fraction,LVEF)、左室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)]、糖代谢指标[空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2-hours postprandial blood glucose,2 hPBG)和糖化血红蛋白(glycosylated hemoglobin,HbAlc)]和炎症因子[髓过氧化物酶(myeloperoxidase,MPO)、白细胞介素-6(interleukin-6,IL-6)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]。结果观察组、对照组的治疗总有效率分别为92.73%、81.13%,2组比较差异无统计学意义。治疗后,观察组NTproBNP水平低于对照组[(237.31±20.59)pg·mL^(-1) vs.(251.68±21.17)pg·mL^(-1)],LVEF值大于对照组[(58.04%±3.12%)vs.(56.97%±3.65%)],LVEDD值小于对照组[(52.70±5.09)mm vs.(55.05±4.37)mm,P<0.05];FBG、2 hPBG水平和HbAlc值均低于对照组[(5.14±0.69)mmol·L^(-1) vs.(5.68±0.71)mmol·L^(-1),(8.01±1.65)mmol·L^(-1) vs.(8.79±1.39)mmol·L^(-1),(6.45%±0.69%)vs(.7.04%±0.81%),P<0.05];MPO、IL-6和TNF-α水平均低于对照组(P<0.05);再入院率低于对照组(1.82%vs.11.32%,P<0.05);2组患者血管再狭窄率及心脏不良事件发生率比较差异无统计学意义(0 vs.7.55%,3.64%vs.13.21%,P>0.05)。结论达格列净可降低急性心肌梗死合并糖尿病患者PCI后血糖水平及再入院率,且可改善患�Objective To explore the effects of dapagliflozin on glucose metabolism,cardiac function and readmission rate in patients with acute myocardial infarction complicated with diabetes mellitus after percutaneous coronary intervention(PCI).Methods 108 patients with acute myocardial infarction complicated with type 2 diabetes mellitus were enrolled as the study subjects,and were divided into observation group(n=55)and control group(n=53)by the random number table method.The control group was treated with routine antiplatelet drugs and hypoglycemic drugs after PCI,while the observation group was given dapagliflozin on the basis of the control group.After 3 months of treatment,the treatment efficacy,readmission rate,vascular restenosis rate and the incidence rate of adverse cardiac events were compared between the 2 groups.Cardiac function indicators[N-terminal pro-B-type natriuretic peptide(NT-proBNP),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)],glucose metabolism indicators[fasting blood glucose(FBG),2-hour postprandial blood glucose(2 hPBG),glycosylated hemoglobin(HbAlc)]and inflammatory factors[myeloperoxidase(MPO),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)]in the 2 groups were observed before and after treatment.Results The total effective rates of treatment in observation group and control group were 92.73%and 81.13%.There was no statistically significant difference between the 2 groups.After treatment,the NTproBNP level in observation group was lower than that in control group[(237.31±20.59)pg·mL^(-1) vs.(251.68±21.17)pg·mL^(-1)],and the LVEF was higher than that in control group[(58.04%±3.12%)vs.(56.97%±3.65%)],while the LVEDD was lower than that in control group[(52.70±5.09)mm vs.(55.05±4.37)mm](P<0.05).The levels of FBG and 2 hPBG and HbAlc value in observation group were lower than those in control group[(5.14±0.69)mmol·L^(-1) vs.(5.68±0.71)mmol·L^(-1),(8.01±1.65)mmol·L^(-1) vs.(8.79±1.39)mmol·L^(-1),(6.45%±0.69%)vs.(7.04%±0.81%),P<0.

关 键 词：达格列净 急性心肌梗死 糖尿病 经皮冠状动脉介入治疗 糖代谢 心功能 再入院率 

分 类 号：R972[医药卫生—药品]