SGLT-2i对高血压病合并糖尿病患者左心室肥厚的逆转作用  

Reverse effect of SGLT-2i on left ventricular hypertrophy in hypertensive patients with diabetes

作　　者：宋思凡 童嘉毅 魏芹 于复超 谢亮 李润乾 SONG Sifan;TONG Jiayi;WEI Qin;YU Fuchao;XIE Liang;LI Runqian(School of Medicine,Southeast University,Nanjing 210000,China;Department of Cardiology,Zhongda Hospital of Southeast University,Nanjing 210009,China;Department of Cardiology,General Hospital of the Eastern Theater of the Chinese People's Liberation Army,Nanjing 210018,China)

机构地区：[1]东南大学医学院,江苏南京210000 [2]东南大学附属中大医院心血管内科,江苏南京210009 [3]中国人民解放军东部战区总医院心内科,江苏南京210018

出　　处：《现代医学》2024年第6期836-844,共9页Modern Medical Journal

摘　　要：目的:探讨SGLT-2i对高血压病合并糖尿病患者有左心室肥厚(LVH)的逆转作用。方法:本研究纳入2018年1月至2022年12月于江苏省南京市东南大学附属中大医院住院的204例高血压病合并2型糖尿病的LVH患者,根据是否使用SGLT-2i分为SGLT-2i组与对照组,两组各102例。收集了所有纳入患者的基线时及再次至来院复查时资料,包括年龄、性别、身体质量指数(BMI)、血压、肌酐、空腹血糖、糖化血红蛋白、用药情况、左心室结构指标[左心室质量指数(LVMI)、左心室质量(LVM)、左心室射血分数(LVEF)、左心室舒张末期内径(LVDd)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)]等。并比较两组间的基线和复诊的相关指标。结果:对基线资料的分析发现,年龄、糖化血红蛋白、IVST组间差异存在统计学意义(P<0.05)。与基线时相比,对照组LVMI、LVM、LVDd、LVPWT、舒张压前后差异存在统计学意义(P<0.05);SGLT-2i组LVMI、LVM、LVDd、IVST、LVPWT、空腹血糖、肌酐前后差异存在统计学意义(P<0.05)。采用1∶1倾向性评分匹配平衡混杂因素后,SGLT-2i组与对照组进行比较,结果显示LVMI差值、LVM差值组间差异存在统计学意义(P<0.05),其余指标差值组间差异无统计学意义(P>0.05)。构建多因素线性回归模型显示,SGLT-2i治疗与LVMI及LVM降低有关(LVMI:β=-0.303,P=0.002;LVM:β=-0.303,P=0.002)。但SGLT-2i对LVEF没有影响(P>0.05)。结论:SGLT-2i对高血压病合并糖尿病患者的LVH具有逆转作用。Objective:To investigate the reverse effect of SGLT-2i on left ventricular hypertrophy(LVH)in patients with hypertension and diabetes.Methods:This study included 204 LVH patients with hypertension and type 2 diabetes who were hospitalized in Zhongda Hospital affiliated to Southeast University in Nanjing,Jiangsu Province from January 2018 to December 2022.According to whether they used SGLT-2i or not,they were divided into SGLT-2i group and control group,with 102 cases in each group.We collected baseline and follow-up data from all enrolled patients,including age,gender,body mass index(BMI),blood pressure,creatinine,fasting blood glucose,glycated hemoglobin,medication use,and left ventricular structural indicators[left ventricular mass index(LVMI),left ventricular mass(LVM),left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVDd),interventricular septal thickness(IVST),and left ventricular posterior wall thickness(LVPWT)].The baseline and follow-up related indicators were compared between the two groups.Results:The analysis of baseline data found that there were statistically significant differences in age,glycosylated hemoglobin,and IVST between groups(P<0.05).Compared with baseline,there were statistically significant differences in LVMI,LVM,LVDd,LVPWT,diastolic blood pressure,and fasting blood glucose before and after treatment in the control group(P<0.05).There were statistically significant differences in LVMI,LVM,LVDd,IVST,LVPWT,fasting blood glucose,and creatinine before and after treatment in the SGLT-2i group(P<0.05).After using 1∶1 propensity score to match the balanced confounding factors,the comparison between the SGLT-2i group and the control group showed that there were statistically significant differences in LVMI and LVM between the groups(P<0.05),while the differences in other indicators were not statistically significant(P>0.05).A multivariable linear regression model showed that SGLT-2i treatment was associated with the decreased LVMI and LVM(LVMI:β=-0.303,P=0.00

关 键 词：SGLT-2i 左心室肥厚 高血压病 2型糖尿病 

分 类 号：R541.3[医药卫生—心血管疾病]