摘要
目的探讨二甲双胍联合达格列净在2型糖尿病(T2DM)合并射血分数中间值心力衰竭(HFmrEF)患者治疗中的临床效果。方法根据治疗方案将2019年7月至2020年7月郑州市第七人民医院收治的115例T2DM合并HFmrEF患者分为常规组(n=57例)和试验组(n=58例)。常规组接受二甲双胍治疗,试验组接受达格列净治疗,两组均治疗6个月。比较两组治疗前及治疗6个月后血糖[空腹血糖(FPG)、糖化血红蛋白(HbAlc)、餐后2 h血糖(2 h PG)]、血生化指标[超敏C反应蛋白(hs-CRP)、氨基末端脑钠尿肽(NT-proBNP)、可溶性ST2(sST2)]、心功能指标[左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室收缩末期内径(LVESD)、二尖瓣环舒张期早期峰值速度(Ea)与舒张晚期峰值速度(Aa)、6分钟步行试验距离]、明尼苏达生活量表(MLHFQ)评分及不良反应发生率。结果治疗6个月后两组FPG、2 h PG、HbAlc较治疗前均降低,且试验组低于常规组(P<0.05);治疗6个月后两组NT-proBNP、hs-CRP、sST2均有改善,且试验组优于常规组(P<0.05);治疗6个月后两组6分钟步行试验距离均有提高,且试验组高于常规组(P<0.05);两组治疗6个月后LVESD较治疗前下降,且试验组低于常规组(P<0.05);治疗前及治疗6个月后LVEDD、LVEF对比,差异无统计学意义(P>0.05);两组治疗6个月后MLHFQ评分较治疗前下降,且试验组低于常规组(P<0.05);两组不良反应发生率差异无统计学意义(P>0.05)。结论二甲双胍与达格列净联合治疗T2DM合并HFmrEF患者中能有效降低血糖水平,改善心功能,进而抑制病情进展,提高生活质量。
Objective To study the clinical efficacy of dapagliflozin combined with metformin in the treatment of type 2 diabetes mellitus(T2DM)patients with heart failure with median ejection fraction(HFmrEF).Methods A total of 115 patients with T2DM and HFmrEF admitted to Zhengzhou Seventh People’s Hospital from July 2019 to July 2020 were selected,and they were divided into a reference group(n=57)and a tset group(n=58)according to treatment plans.The reference group was treated with metformin,the tset group was treated with dapagliflozin,and both groups were treated for 6 months.The blood glucose[fasting blood glucose(FPG),glycosylated hemoglobin(HbAlc),2 hours postprandial blood glucose(2 h PG)],blood biochemical indexes[high-sensitivity C-reactive protein(hs-CRP),N-terminal pro-brain natriuretic peptide(NT-proBNP),soluble ST2(sST2)],cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic dimension(LVESD),early diastolic peak velocity(Ea)and late diastolic peak velocity(Aa),6-min walking distance],the Minnesota living with heart failure questionnaire(MLHFQ)score and incidence of adverse reactions were compared between the two groups before and after treatment for 6 months.Results After 6 months of treatment,FPG,2 h PG and HbAlc in the two groups were lower than those before treatment,and those in the tset group were greater than those in the reference group(P<0.05).After 6 months of treatment,FPG,2 h PG and HbAlc in both groups were lower than those before treatment,and those in the test group were better than those in the reference group(P<0.05).After 6 months of treatment,the 6-minute walking distance of the two groups was improved,and that of the tset group was higher than that of the reference group(P<0.05).After 6 months of treatment,the LVESD of the two groups were decreased,and that of the tset group was lower than that in the reference group(P<0.05).There was no significant difference between the LVEDD and LVEF before and after 6 months of treatment(P>0.05).After 6 months of treatment,MLHFQ scores in the two groups were decreased,and the scores in the tset group were lower than those in the reference group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during the treatment period(P>0.05).Conclusion Metformin combined with dapagliflozin in the treatment of T2DM patients with HFmrEF can effectively reduce blood glucose levels,improve cardiac function,and then inhibit disease progression.
作者
朱占占
孙雯雯
张申伟
ZHU Zhanzhan;SUN Wenwen;ZHANG Shenwei(Department of Cardiology,Zhengzhou Seventh People’s Hospital,Zhengzhou 450000,China;Department of Intensive Care Medicine,Zhengzhou Seventh People’s Hospital,Zhengzhou 450000,China)
出处
《河南医学研究》
CAS
2022年第21期3980-3983,共4页
Henan Medical Research
关键词
达格列净
2型糖尿病
射血分数
心力衰竭
dapagliflozin
type 2 diabetes mellitus
ejection fraction
heart failure
