达格列净治疗老年射血分数保留心力衰竭合并2型糖尿病患者的效果

Efficacy of dapagliflozin in the elderly patients with HF preserved ejection fraction and type 2 diabetes

目的探讨达格列净治疗老年射血分数保留心力衰竭合并2型糖尿病患者的临床效果。方法回顾性分析2020年9月至2021年3月中国科学技术大学附属第一医院(安徽省立医院)全科医学科住院的82例老年射血分数保留的心力衰竭合并2型糖尿病患者病历资料,根据用药方案分为对照组41例,达格列净组41例。2组均采用常规降糖药物及抗心力衰竭药物治疗,达格列净组加用达格列净10 mg/d,观察3个月。随访患者治疗前、治疗3个月后心功能指标血浆N末端B型利钠肽原(NT-proBNP)、患者6 min步行距离及再入院率。超声心动图参数包括:左心室舒张早期左房室瓣血流最大速度(E)/舒张早期左房室瓣环峰值速度(e′)、左心房容积指数(LAVI)、左心室射血分数(LVEF)等。结果与对照组比较,达格列净组治疗3个月后LAVI、E/e′、C反应蛋白、NT-proBNP水平明显降低(P<0.05)。达格列净组的6 min步行距离及LVEF较对照组明显提高(P<0.05)。达格列净组和对照组随访3个月因心力衰竭再次住院患者分别为6例(14.6%)、14例(34.1%),差异有统计学意义(P=0.04)。结论达格列净在老年射血分数保留心力衰竭合并2型糖尿病患者的治疗中能够改善患者的心力衰竭症状,降低再入院率。

Objective To analyze the clinical efficicy of dapagliflozin in elderly HFpEF patients with type 2 diabetes.Methods Eighty-two elderly HFpEF patients with type 2 diabetes were divided into control group(n=41)and dapagliflozin treatment group(n=41),The all patients were received conventional medical treatment according to the blood glucose level and the NYHA classification.The drug group was combined with Dapag(10 mg/d),The echocardiography parameters(E/e′,LAVI,and LVEF),NT-proBNPand readmission rate were recorded before treatment and after 3 months of treatment.Results As compared with the control group,the patients in the dapagliflozin group had a significant decreased serum NT-proBNP,CRP,LAVI,E/e′(P<0.05),6MWT and LVEF were significantly improved in the dapagliflozin group.The patients in two groups were followed up for 3 months,during which 6 patients(14.6%)in dagliflozin treatment group and 14 patients(34.1%)in control group were readmitted due to HF.Conclusions Dapagliflozin can improve the cardiac function in elderly HFpEF patients with type 2DM and reduce readmission rate.