达格列净联合常规治疗对2型糖尿病伴心力衰竭患者的心血管保护作用及对血清炎症因子和sST2水平的影响  

Cardiovascular protective effect of dapagliflozin combined with conventional therapy on diabetes mellitus type 2 patients with heart failure and its effect on serum inflammatory factors and sST2 levels

作　　者：赵志强 张梦遥 吕晓蕾 许浩军 李相权 叶斐 ZHAO Zhi-qiang;ZHANG Meng-yao;LYU Xiao-lei(Department of Cardiovascular,First People's Hospital of Kunshan,Kunshan Jiangsu 215300,China)

机构地区：[1]江苏省昆山市第一人民医院心血管内科,江苏昆山215300

出　　处：《临床和实验医学杂志》2024年第9期914-918,共5页Journal of Clinical and Experimental Medicine

基　　金：国自然科学基金项目(编号:81700737)。

摘　　要：目的探究达格列净联合常规治疗对2型糖尿病伴心力衰竭患者的心血管保护作用及对血清炎症因子和可溶性生长刺激表达基因2(sST2)水平的影响。方法前瞻性选取2020年9月至2022年8月江苏省昆山市第一人民医院收治的86例2型糖尿病伴心力衰竭患者为研究对象,按随机数字表法分为对照组和观察组,各43例。对照组予以常规治疗降糖及抗心力衰竭治疗,观察组在对照组基础上增加达格列净治疗。比较两组治疗前、治疗6个月后的血糖[糖化血红蛋白(HbA1c)、空腹血糖、餐后2 h血糖(2 h PG)]、血脂[总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)]、心功能[左心室射血分数(LVEF)、血浆N端脑钠肽前体(NT-proBNP)、6 min步行试验(6MWT)]、血清指标[白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、sST2]水平及心血管事件及不良反应发生率。结果治疗6个月后,观察组的HbA1c、空腹血糖、2 h PG、总胆固醇、甘油三酯、LDL-C水平分别为(6.65±0.73)%、(6.25±1.54)mmol/L、(7.88±1.35)mmol/L、(3.87±0.85)mmol/L、(1.52±0.46)mmol/L、(2.41±0.63)mmol/L,均明显低于对照组[(7.07±0.85)%、(7.16±1.49)mmol/L、(8.82±1.48)mmol/L、(4.24±0.82)mmol/L、(1.73±0.51)mmol/L、(2.69±0.61)mmol/L],差异均有统计学意义(P<0.05)。治疗6个月后,观察组的LVEF、6MWT水平分别为(52.28±3.43)%、(424.87±72.58)m,均明显高于对照组[(50.79±3.25)%、(367.52±74.43)m],血浆NT-proBNP水平为(1778.65±224.37)pg/mL,低于对照组[(2943.41±256.22)pg/mL],差异均有统计学意义(P<0.05)。治疗6个月后,观察组的血清IL-1β、TNF-α、sST2水平分别为(6.60±1.14)pg/mL、(22.15±4.30)ng/L、(0.42±0.13)g/L,均明显低于对照组[(7.19±1.39)pg/mL、(29.68±5.24)ng/L、(0.50±0.16)g/L],差异均有统计学意义(P<0.05)。观察组心血管事件总发生率为9.30%,低于对照组(25.58%),差异有统计学意义(P<0.05)。两组均无严重不良反应发生。结论在使用常规�Objective To investigate the cardiovascular protective effect of dapagliflozin combined with conventional therapy on patients with diabetes mellitus type 2 and heart failure and its effect on serum inflammatory factors and soluble growth stimulation expressed gene 2(sST2)levels.Methods A total of 86 patients with diabetes mellitus type 2 and heart failure admitted to First People's Hospital of Kunshan from September 2020 to August 2022 were selected as the research objects and divided into control group and observation group according to the random number table method,with 43 cases in each group.The control group was treated with conventional hypoglycemic and anti-heart failure treatment,and the observation group was treated with dapagliflozin on the basis of the control group.The levels of blood glucose[hemoglobin A1c(HbA1c),fasting blood glucose,2 h postprandial blood glucose(2 hPG)],blood lipids[total cholesterol,triglyceride,low density lipoprotein cholesterol(LDL-C)],cardiac function[left ventricular ejection fraction(LVEF),plasma N-terminal pro-brain natriuretic peptide(NT-proBNP),6 min walking test(6MWT)],serum indexes[interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),sST2]before treatment,after 6 months of treatment,and the incidence of cardiovascular events,adverse reactions were compared between the two groups.Results After 6 months of treatment,the HbA1c,fasting blood glucose,2 h PG,total cholesterol,triglycerides,and LDL-C levels in the observation group were(6.65±0.73)%,(6.25±1.54)mmol/L,(7.88±1.35)mmol/L,(3.87±0.85)mmol/L,(1.52±0.46)mmol/L,and(2.41±0.63)mmol/L,respectively,which were significantly lower than those in the control group[(7.07±0.85)%,(7.16±1.49)mmol/L,(8.82±1.48)mmol/L,(4.24±0.82)mmol/L,(1.73±0.51)mmol/L,(2.69±0.61)mmol/L],the differences were statistically significant(P<0.05).After 6 months of treatment,the LVEF and 6MWT levels in the observation group were(52.28±3.43)%and(424.87±72.58)m,respectively,which were significantly higher than those in the control group[

关 键 词：达格列净 糖尿病 2型 心力衰竭 心血管保护作用 炎症因子 可溶性生长刺激表达基因2 

分 类 号：R587.2[医药卫生—内分泌] R541.6[医药卫生—内科学]