达格列净对糖尿病合并高血压患者左心室重构的影响分析

Eeffect of dapagliflozin on left ventricular emodeling in DM patients with hypertension

目的探讨达格列净是否能缓解糖尿病合并高血压患者的左心室重构进程。方法纳入2019年10月~2020年10月于汕头大学附属粤北人民医院住院的2型糖尿病合并高血压患者193例,根据治疗方式不同,将患者分为对照组98例和达格列净组(加服达格列净)95例,治疗6个月后随访,比较2组患者入院时、出院时和随访时血糖、血压和心室重构相关指标差异。结果与对照组比较,达格列净组随访时空腹血糖、糖化血红蛋白、收缩压和左心室收缩末期容积指数均明显降低(P<0.05),LVEF明显升高[(62.90±4.56)%vs(60.79±4.14)%,P<0.05],出院时和随访时血浆N末端B型钠尿肽前体明显降低[(238.01±14.61)ng/L vs(247.40±10.03)ng/L,(221.75±10.06)ng/L vs(236.31±9.64)ng/L,P<0.05]。结论在传统药物治疗的基础上,达格列净可以进一步改善糖尿病合并高血压患者血糖和血压及左心室功能情况,延缓左心室重构进程。

Objective To study the effect of dapagliflozin on left ventricular remodeling in DM patients with hypertension.Methods One hundred and ninety-sthree type 2 DM patients with hypertension admitted to our hospital from October 2019 to October 2020 were divided into control group(n=98)and dapagliflozin group(n=95).The patients were followed up for 6 months.The erum blood glucose level,blood pressure and left ventricular remodeling were compared between the two groups at discharge and during follow-up.Results The serum levels of fasing blod glucose,HbA1c,SBP,and the left ventricular systolic end volume were significantly lower(P<0.05),The LVEF(62.90±4.56%vs 60.79±4.14%,P<0.05)was significantly higher while the serum NT-proBNP level was significantly lower in dapagliflozin group than in control group during the follow up(238.01±14.61 ng/L vs 247.40±10.03 ng/L,221.75±10.06 ng/L vs 236.31±9.64 ng/L,P<0.05).Conclusion Dapagliflozin+traditional medication can reduce the serum blood glucose level and blood pressure,improve the left ventricular function and delay the left ventricular remodeling process in DM patient with hypertension.