达格列净对2型糖尿病合并射血分数保留型心衰病人心功能作用的影响

杨菲; 黄丽; 李娟; 王春

doi:10.13898/j.cnki.issn.1000-2200.2023.07.007

达格列净对2型糖尿病合并射血分数保留型心衰病人心功能作用的影响

Effects of dapagliflozin on cardiac function in patients with type 2 diabetes mellitus complicated with heart failure with preserved ejection fraction

摘要

摘要:
目的研究达格列净对2型糖尿病(T2DM)合并射血分数保留型心力衰竭(HFpEF)病人左心室射血功能及生活质量的影响。
方法选取应用胰岛素降糖的T2DM合并HFpEF病人70例，随机分为观察组(n=38)和对照组(n=32)，观察组病人加用达格列净控制血糖，对照组病人加用阿卡波糖控制血糖。采用6分钟步行实验(6MWT)评价病人心功能，采用KCCQ问卷评估病人生存质量。比较2组病人治疗前后6MWT评分、KCCQ评分、左心室射血分数(LVEF)、室间隔厚度、单核细胞/高密度脂蛋白胆固醇比率(MHR)及N末端B型利钠肽(NT-proBNP)、C反应蛋白(CRP)水平。
结果治疗后2个月，观察组6MWT评分、MHR均低于对照组(P < 0.01和P < 0.05)，2组KCCQ评分、室间隔厚度、LVEF、NT-proBNP、CRP水平差异均无统计学意义(P>0.05)。治疗后4个月，观察组6MWT评分、MHR、CRP水平均低于对照组(P < 0.05~P < 0.01)，KCCQ评分高于对照组(P < 0.05)，2组室间隔厚度、LVEF、NT-proBNP水平差异均无统计学意义(P>0.05)。治疗后6个月，观察组KCCQ评分、LVEF水平均高于对照组(P < 0.05)，6MWT评分、MHR、CRP水平均低于对照组(P < 0.05~P < 0.01)，2组室间隔厚度、NT-proBNP水平差异均无统计学意义(P>0.05)。
结论达格列净可以改善T2DM合并HFpEF病人临床症状，提高病人生存质量。

Abstract:
ObjectiveTo study the effect of dapagliflozin on left ventricular ejection function and quality of life in patients with type 2 diabetes mellitus(T2DM) complicated with heart failure with preserved ejection fraction(HFpEF).
MethodsSeventy T2DM patients with HFpEF treated with insulin to reduce blood glucose were selected and randomly divided into observation group(n=38) and control group(n=32).The patients in the observation group were additionally treated with dapagliflozin to control the blood glucose, and patients in the control group were additionally treated with acarbose to control the blood glucose.The 6-minute walk test(6MWT) was used to evaluate the cardiac function of the patients, and the KCCQ questionnaire was applied to evaluate the quality of life of the patients.The 6MWT score, KCCQ score, left ventricular ejection fraction(LVEF), ventricular septal thickness, monocyte/high-density lipoprotein cholesterol ratio(MHR), N-terminal pro-B-type natriuretic peptide(NT-proBNP) and C-reactive protein(CRP) level were compared between the two groups before and after treatment.
ResultsAfter two months of treatment, the 6MWT score and MHR in the observation group were lower than those in the control group(P < 0.01 and P < 0.05), and there were no significant differences in the KCCQ score, ventricular septal thickness, LVEF, NT-proBNP and CRP levels between the two groups(P>0.05).After four months of treatment, the 6MWT score, MHR and CRP level in the observation group were lower than those in the control group(P < 0.05 to P < 0.01), the KCCQ score was higher than that in the control group(P < 0.05), and there were no significant differences in the ventricular septal thickness, LVEF and NT-proBNP level between the two groups(P>0.05).After six months of treatment, the KCCQ score and LVEF level in the observation group were higher than those in the control group(P < 0.05), the 6MWT score, MHR and CRP level were lower than those in the control group(P < 0.05 to P < 0.01), and there were no significant differences in the ventricular septal thickness and NT-proBNP level between the two groups(P>0.05).
ConclusionsDapagliflozin can improve the clinical symptoms and quality of life of T2DM patients with HFpEF.

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