达格列净对2型糖尿病心肌病患者心功能及外周血TGF-β/Smad3表达的影响  

Effect of Dagliflozin on cardiac function and peripheral blood TGF-β/Smad3 expression in patients with type 2 diabetic cardiomyopathy

作　　者：刘建军 王艳川 刘军 张茹星 LIU Jianjun;WANG Yanchuan;LIU Jun;ZHANG Ruxing(Department of Pharmacy,Shenmu City Hospital,Shenmu,Shaanxi 719300,China;Department of Pharmacy,Baoji Hospital Affiliated to Xi′an Medical College,Xi′an,Shaanxi 710021,China)

机构地区：[1]神木市医院药学部,陕西神木719300 [2]西安医学院附属宝鸡医院药学部,陕西西安710021

出　　处：《检验医学与临床》2025年第7期920-924,共5页Laboratory Medicine and Clinic

基　　金：陕西省重点研发计划项目(2023-ERCY-214)。

摘　　要：目的探讨达格列净对2型糖尿病心肌病(DCM)患者心功能及外周血转化生长因子-β(TGF-β)/Smad3表达的影响。方法选取2021年4月至2023年8月神木市医院收治的128例DCM患者为研究对象,采用随机数字表法分为对照组与研究组,每组64例。对照组在常规降糖方案基础上调整或联用胰岛素,心肌病采用常规治疗;研究组在对照组的基础上服用达格列净治疗,连续服用3个月。比较2组患者临床疗效,检测并比较2组患者治疗前后的空腹血糖(FPG)和餐后2 h血糖水平(2 hPG)、心功能指标[左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、心输出量(CO)]及血清TGF-βmRNA、Smad3 mRNA表达水平,并分析2组不良反应发生情况。结果对照组与研究组总有效率分别为82.81%、95.31%,研究组总有效率高于对照组,差异有统计学意义(P<0.05)。治疗前,对照组与研究组FPG、2 hPG水平,LVESD、LVEDD、LVEF、CO,以及血清TGF-βmRNA、Smad3 mRNA表达水平比较,差异均无统计学意义(P>0.05)。治疗后,与对照组比较,研究组的FPG、2 hPG水平更小,LVESD、LVEDD更低,LVEF、CO更高,血清TGF-βmRNA、Smad3 mRNA表达水平更低,差异均有统计学意义(P<0.05)。2组DCM患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论达格列净可以提高DCM患者临床治疗效果,降低血糖水平、改善心功能,其机制可能与抑制血清TGF-β/Smad3信号通路有关,具有较高的安全性。Objective To investigate the effects of Dagliflozin on cardiac function and peripheral blood transforming growth factor-β(TGF-β)/Smad3 expression in patients with type 2 diabetic cardiomyopathy(DCM).Methods A total 128 DCM patients admitted to Shenmu City Hospital from April 2021 to August 2023 were selected as the research subjects,and were randomly divided into a control group and a study group using a random number table method,with 64 patients in each group.The control group adjusted or combined insulin on the conventional hypoglycemic regimen treatment was used for cardiomyopathy.The research group received treatment with Dagliflozin on the basis of the control group for three consecutive months.Compare the clinical efficacy of two groups of patients,measure and compare the fasting blood glucose(FPG)and 2-hour postprandial blood glucose levels(2 hPG),cardiac function indicators[left ventricular end systolic diameter(LVES),left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),cardiac output(CO)],serum TGF-βmRNA and Smad3 mRNA expression levels before and after treatment,and analyze the occurrence of adverse reactions in the two groups.Results The total effective rates of the control group and the research group were 82.81%and 95.31%respectively.The total effective rate of the research group was higher than that of the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in the expression levels of the FPG and 2 hPG levels,LVESD,LVEDD,LVEF,CO,serum TGF-βmRNA and Smad3 mRNA(P>0.05).After treatment,compared with the control group,the study group had lower levels of FPG and 2 hPG,lower levels of LVESD and LVEDD,higher levels of LVEF and CO,and lower levels of serum TGF-βmRNA and Smad3 mRNA expression,with statistical significance(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups of DCM patients during treatment(P>0.05).Conc

关 键 词：达格列净 2型糖尿病心肌病 心功能 转化生长因子-Β SMAD3 

分 类 号：R587.2[医药卫生—内分泌] R917[医药卫生—内科学]