达格列净治疗2型糖尿病合并心力衰竭患者的效果及对氨基末端脑利钠肽前体的影响  

Effect of Dapagliflozin in the Treatment of Type 2 Diabetes Mellitus Complicated with Heart Failure and its Effect on N-terminal Pro Brain Natriuretic Peptide

作　　者：庞宁 黄红芳 赵晓芳 郑祖斌 陈小华 张紫君 PANG Ning;HUANG Hongfang;ZHAO Xiaofang;ZHENG Zubin;CHEN Xiaohua;ZHANG Zijun(Department of Integrated Traditional Chinese and Western Medicine,Dongsheng Hospital of Guangzhou,Guangzhou 510663,China;Department of Neurological Rehabilitation,Dongsheng Hospital of Guangzhou,Guangzhou 510663,China;Department of Internal Medicine,Dongsheng Hospital of Guangzhou,Guangzhou 510663,China)

机构地区：[1]广州市东升医院中西医结合科,广州510663 [2]广州市东升医院神经康复科,广州510663 [3]广州市东升医院内科,广州510663

出　　处：《中国医药指南》2024年第32期57-60,共4页Guide of China Medicine

摘　　要：目的探讨达格列净治疗2型糖尿病合并心力衰竭患者的效果及对氨基末端脑利钠肽前体(NT-proBNP)的影响。方法选取2022年1月到2023年12月收治的糖尿病合并心力衰竭患者100例,使用随机数表法将50例纳入观察组,50例纳入对照组。对照组患者接受降血糖和抗心力衰竭的常规治疗方案,观察组在常规治疗方案的基础上加用达格列净。疗程均为4周,结束后,收集两组患者的心功能指标、血糖水平等数据,并记录不良反应发生情况,进行对比分析。结果经过干预后,观察组患者的NT-proBNP、肌酸激酶同工酶MB(CK-MB)及心肌肌钙蛋白I(cTnI)水平相较于对照组均降低,而左室射血分数(LVEF)水平则升高(P<0.05)。与对照组相比,观察组患者的空腹血糖、胰岛素、C肽水平以及餐后2 h血糖、胰岛素、C肽水平均呈现明显降低的趋势(P<0.05)。治疗后,对照组患者出现不良事件的概率为8.00%,而观察组患者的不良事件发生率则为6.00%。经过统计分析,两组患者在不良事件发生率方面并未显示出统计学差异(P>0.05)。结论在常规降血糖和抗心力衰竭治疗的基础上加用达格列净,能够更加有效地改善糖尿病合并心力衰竭患者的心功能、血糖水平,且不会增加不良反应发生风险,具有较好的安全性。Objective To investigate the effect of dapagliflozin in the treatment of patients with type 2 diabetes mellitus complicated with heart failure and its effect on N-terminal pro brain natriuretic peptide(NT proBNP).Methods A total of 100 patients with diabetes mellitus combined with heart failure admitted from January 2022 to December 2023 were selected,and 50 cases were included in the observation group and 50 cases in the control group by random number table method.Patients in the control group received the conventional treatment regimen of hypoglycemia and anti-heart failure,while the observation group added dagliflozin on the basis of the conventional treatment regimen.The course of treatment was 4 weeks,then the data of cardiac function level and blood glucose level of the two groups of patients were collected,and the occurrence of adverse reactions was recorded for comparative analysis.Results After intervention,the NT proBNP,CK-MB,and cTnI levels in the observation group were significantly reduced compared to the control group,while LVEF levels were significantly increased(P<0.05).Compared with the control group,the observation group showed a significant decrease in fasting blood glucose,insulin,C-peptide levels,as well as 2 hour postprandial blood glucose,insulin,and C-peptide levels(P<0.05).After treatment,there was no statistically significant difference in the probability of adverse events among the control group patients(P>0.05).Conclusions The addition of daggligin can better improve the heart function and blood sugar level of patients with diabetes combined with heart failure.It has good safety and is worth popularizing.

关 键 词：糖尿病 心力衰竭 B型脑钠肽 达格列净 不良反应 

分 类 号：R587.1[医药卫生—内分泌] R541.6[医药卫生—内科学]