达格列净对不稳定型心绞痛合并T2DM患者PCI后临床结局的影响

Effect of dapagliflozin on clinical outcomes after PCI in patients with unstable angina pectoris and T2DM

目的探究达格列净对不稳定型心绞痛(UA)合并2型糖尿病(T2DM)患者经皮冠状动脉介入治疗(PCI)后糖代谢、心功能及再入院率的影响。方法选取2019年1月至2022年1月于阜阳市人民医院心血管内科行PCI治疗的114例UA合并T2DM患者为研究对象。采用随机数表法分为达格列净组(在对照组基础上联合达格列净治疗,n=57)和对照组(PCI后接受常规治疗,n=57)。比较两组糖代谢水平、心功能;记录主要心血管不良事件发生情况、再入院率及不良反应发生情况。结果达格列净组FPG、2hPG、HbA1c治疗前后的差值高于对照组(P<0.05),治疗后FPG、2hPG、HbA1c水平低于对照组(P<0.05)。达格列净组治疗前后LVEF、LVEDd、NT-proBNP的差值高于对照组(P<0.05),治疗后LVEF水平高于对照组(P<0.05),LVEDd、NT-proBNP水平低于对照组(P<0.05)。达格列净组再入院率低于对照组(P<0.05)。结论UA合并T2DM患者于PCI术后接受达格列净治疗,能更好地改善糖代谢水平与心功能,降低再入院率,且安全性较好。

Objective As patients with unstable angina(UA)and type 2 diabetes mellitus(T2DM)have a higher risk of poor prognosis after percutaneous coronary intervention(PCI),the effect of dapagliflozin on glucose metabolism,cardiac function and readmission rate in patients with unstable angina pectoris(UA)and type 2 diabetes mellitus(T2DM)after percutaneous coronary intervention(PCI)was discussed.Methods A total of114 patients with UA and T2DM who underwent PCI in the Department of Cardiovascular Medicine,Fuyang People's Hospital,from January 2019 to January 2022,were selected as the research subjects,and assigned to the dapagliflozin group(n=57)and the control group(n=57)by random number table method.Glucose metabolism levels and cardiac function in the two groups were comparatively analyzed.the occurrence of major cardiovascular adverse events,readmission rate and adverse reactions were recorded.Results The differences between FPG,2hPG,and HbA1c in the dapagliflozin group before and after treatment were higher than those in the control group(P<0.05),and the levels of FPG,2hPG,and HbA1c after treatment were lower than those in the control group(P<0.05).The differences between LVEF,LVEDd and NT proBNP in the dapagliflozin group before and after treatment were higher than those in the control group(P<0.05),and the LVEF level after treatment was higher than that in the control group(P<0.05),while the levels of LVEDd and NT proBNP were lower than the control group(P<0.05).The readmission rate in the dapagliflozin group was lower than that in the control group(P<0.05).Conclusion Dapagliflozin treatment can better improve glucose metabolism and cardiac function in patients with UAcombined with T2DM after PCI,and reduce the readmission rate,with good safety.