达格列净治疗2型糖尿病伴心功能不全效果及对患者心脏功能血小板淋巴细胞比值及血浆hcy水平的影响

The Effect of Dapagliflozin on Type 2 Diabetes Mellitus with Cardiac Insufficiency and Its Influence on Cardiac Function Platelet Lymphocyte Ratio and Plasma Hcy Level

目的:探究达格列净治疗2型糖尿病伴心功能不全效果及对患者心脏功能、血小板淋巴细胞比值(PLR)及血浆同型半胱氨酸(hcy)水平的影响。方法:选取2019年1月至2020年1月于本院住院及门诊就诊的171例2型糖尿病伴心功能不全患者,按简单随机法分为对照组(n=85)和观察组(n=86),对照组给予常规治疗,观察组在以上基础给予达格列净。比较两组临床疗效、血糖水平[糖化血红蛋白(HbA1c)、空腹血糖(FPG)及餐后2h血糖(2hPG)]、心脏功能[左室射血分数(LVEF)、左室舒张末期内径(LVEDD)及6min步行试验(6MWT)]、PLR和血浆hcy水平及不良反应发生情况。结果:观察组总有效率为94.19%,明显高于对照组的84.71%(P<0.05);治疗后,与对照组相比,观察组HbA1c、FPG、2hPG水平明显较低(P<0.05),LVEF、6MWT水平明显较高(P<0.05),LVEDD、PLR和血浆hcy水平明显较低(P<0.05);观察组不良反应发生率为10.47%,略高于对照组的5.88%,(P>0.05)。结论:针对2型糖尿病伴心功能不全患者给予达格列净,具有较好的临床疗效,可明显改善患者的血糖水平和心脏功能,调节PLR和血浆hcy水平,安全性较好。

Objective:To explore the effect of Dapagliflozin on heart function,platelet lymphocyte ratio(PLR)and plasma homocysteine(hcy)in patients with type 2 diabetes mellitus.Methods:171 patients with type 2 diabetes mellitus complicated with cardiac insufficiency in our hospital from January 2019 to January 2020 were randomly divided into comparison group(n=85)and observation group(n=86).Clinical efficacy,blood glucose level[glycosylated hemoglobin(HbA1c),fasting blood glucose(FPG)and 2h postprandial blood glucose(2hPG)],cardiac function[left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD)and 6 min walking test(6MWT)],PLR,plasma hcy level and adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 94.19%,which was significantly higher than that of the control group(84.71%)(P<0.05);after treatment,compared with the control group,the observation group had significantly lower levels of HbA1c,FPG and 2hPG(P<0.05),LVEF,6MWT levels were significantly higher(P<0.05),LVEDD,PLR,and plasma hcy levels were significantly lower(P<0.05);the incidence of adverse reactions in the observation group was 10.47%,slightly higher than 5.88%in the control group.(P>0.05).Conclusion:Dapagliflozin for patients with type 2 diabetes complicated with cardiac insufficiency has a good clinical effect,which can obviously improve the blood glucose level and cardiac function of patients,regulate PLR and plasma hcy levels,and has good safety.