摘要
目的:探讨恩格列净对老年射血分数轻度降低的心力衰竭(HFmrEF)合并2型糖尿病(T2DM)患者的临床疗效。方法:选择2020年1月至2023年10月就诊于潍坊市人民医院的HFmrEF合并T2DM患者370例,按照随机数字表法分为对照组(185例,给予生活方式干预及标准治疗)及恩格列净组(185例,在对照组治疗的基础上给予恩格列净10 mg qd口服),两组均连续治疗6个月。比较两组人体质量指数(BMI)、心率、血脂、空腹血糖、糖化血红蛋白(HbA1c)、肌酐、N末端B型利钠肽原(NT-proBNP)、左心室射血分数(LVEF)、6 min步行距离(6MWD)以及堪萨斯城心肌病调查问卷(KCCQ)-12评分,记录两组患者不良反应发生情况。结果:与对照组比较,恩格列净组患者治疗6个月后BMI、心率、NT-proBNP、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、肌酐、空腹血糖、HbA1c与治疗前差值显著降低(P均<0.01),LVEF、高密度脂蛋白胆固醇(HDL-C)、6MWD、KCCQ-12评分差值显著升高(P均<0.001)。两组患者各个不良反应发生率差异均无统计学意义(P均>0.05)。结论:恩格列净可有效改善老年HFmrEF合并T2DM患者的心功能、血脂、血糖、肾功能、运动耐量和生活质量,且无显著不良反应。
Objective:To investigate the clinical efficacy of empagliflozin in elderly patients with heart failure with mildly reduced ejection fraction(HFmrEF)and type 2 diabetes mellitus(T2DM).Methods:A total of 370 patients with HFmrEF and T2DM who were treated in Weifang People's Hospital between January 2020 and October 2023 were randomly divided into the control group(n=185,lifestyle intervention and standard therapy)and empagliflozin group(n=185,additional empagliflozin 10 mg qd oral).Both groups were continuously treated for 6 months.The body mass index(BMI),heart rate,blood lipids,fasting blood glucose,hemoglobin A1c(HbA1c),creatinine,N-terminal pro-B-type natriuretic peptide(NT-proBNP),left ventricular ejection fraction(LVEF),6-minute walking distance(6MWD)and Kansas City Cardiomyopathy Questionnaire(KCCQ)score were compared between the two groups.The occurrence of adverse reactions in both groups was recorded.Results:Compared to patients in control group,those in empagliflozin group had significantly lower difference of BMI,heart rate,NT-proBNP,low-density lipoprotein cholesterol(LDL-C),triglycerides(TG),creatinine,fasting blood glucose,HbA1c between before and after 6-month treatment(P<0.01 all),and significantly higher difference of LVEF,high-density lipoprotein cholesterol(HDL-C),6MWD and KCCQ score(P<0.001 all).There were no significant difference in the incidence of all adverse reactions between the two groups(P>0.05 all).Conclusion:Empagliflozin could effectively improve cardiac function,blood lipids,blood glucose,renal function,exercise tolerance and quality of life in elderly patients with HFmrEF and T2DM without significant adverse reactions.
作者
高香
韩晓真
唐姗
刘传亮
李志玲
孙东倩
刘方圆
GAO Xiang;HAN Xiao-zhen;TANG Shan;LIU Chuan-liang;LI Zhi-ling;SUN Dong-qian;LIU Fang-yuan(First Department of Geriatrics,Weifang People's Hospital,Weifang,Shandong,261041,China)
出处
《心血管康复医学杂志》
2026年第1期32-38,共7页
Chinese Journal of Cardiovascular Rehabilitation Medicine
基金
潍坊市卫生健康委员会中医药科研项目计划(WFZYY2022-4-002)
潍坊市科技发展计划项目(2022YX006)
山东省老年医学学会2021年度科技发展计划项目(LKJGG2021W124)。
关键词
心力衰竭
糖尿病
2型
恩格列净
Heart failure
Diabetes mellitus,type 2
Empagliflozin
