达格列净对非糖尿病病人他汀类药所致血糖异常影响

EFFECT OF DAPAGLIFLOZIN ON PATHOGLYCEMIA CAUSED BY STATIN IN NON-DIABETIC PATIENTS

目的探究小剂量达格列净干预对非糖尿病病人使用他汀类降脂药所致血糖异常的影响。方法纳入2017年9月—2020年6月在青岛大学附属医院行经皮冠状动脉介入治疗(PCI)或冠状动脉造影(CAG)的非糖尿病病人294例,采用随机数字表法分为对照组(173例)和达格列净组(121例)。对照组采用常规治疗,达格列净组在常规治疗基础上加用达格列净(5 mg)。随访12个月,比较两组治疗前后血糖、肝功能、肾功能、心功能等指标的差异。结果治疗前,两组一般临床资料比较,差异均无统计学意义(P>0.05)。治疗后,对照组血糖异常发生率(6.36%)明显高于达格列净组(0.83%),差异具有统计学意义(χ^(2)=4.24,P<0.05)。与对照组相比,达格列净组血糖异常的相对危险度(RR)为0.13(95%CI=0.017~0.994)。两组治疗前后肝功能、肾功能、心功能指标的变化及不良反应比较差异均无统计学意义(P>0.05)。结论小剂量达格列净干预可明显降低他汀类降脂药所致血糖异常发生的风险,且不会加重心脏、肝脏、肾脏负担及增加其他不良反应。

Objective To investigate the effect of low-dose dapagliflozin on pathoglycemia caused by statins for antihyperlipidemic treatment in non-diabetic patients.Methods A total of 294 non-diabetic patients who underwent percutaneous coronary intervention or coronary arteriography in The Affiliated Hospital of Qingdao University from September 2017 to June 2020 were included and divided into control group with 173 patients and dapagliflozin group with 121 patients using a random number table.The patients in the control group were given conventional treatment,and those in the dapagliflozin group were given dapagliflozin(5 mg)in addition to the treatment in the control group.The patients were followed up for 12 months,and the two groups were compared in terms of the changes in the indicators including blood glucose,liver function,renal function,and cardiac function after treatment.Results There were no significant differences in general clinical data between the two groups before treatment(P>0.05).After treatment,the control group had a significantly higher incidence rate of pathoglycemia than the dapagliflozin group(6.36%vs 0.83%;χ^(2)=4.24,P<0.05).Compared with the control group,the dapagliflozin group had a relative risk of pathoglycemia of 0.13(95%CI=0.017-0.994).There were no significant differences between the two groups in the changes in liver function,renal function,and cardiac function parameters and the incidence rate of adverse reactions after treatment(P>0.05).Conclusion Low-dose dapagliflozin can significantly reduce the risk of pathoglycemia caused by statins for antihyperlipidemic treatment,without increasing the burden of the heart,kidney,and liver and adverse reactions.