达格列净对急性心肌梗死合并2型糖尿病患者心功能及心室重构的影响

Effect of dapagliflozin on cardiac function and ventricular remodeling in patients with acute myocardial infarction complicated with type 2 diabetes mellitus

目的观察达格列净治疗心肌梗死和2型糖尿病的心血管益处和安全性。方法选择2021年1月至2022年1月期间于徐州医科大学第二附属医院心内科住院治疗的急性心肌梗死合并2型糖尿病患者122例,随机将分为实验组和对照组,每组各61例。对照组给予常规治疗,实验组在对照组的治疗基础上加用达格列净进行治疗,比较两组患者6个月后心血管危险因素、心功能及心室重构指标的差异,并监测治疗期间不良反应发生情况。结果治疗前两组患者基线资料比较,差异无统计学意义(P>0.05)。两组患者治疗后心功能指标变化量比较结果显示,两组患者ΔLVEF差异无统计学意义(P>0.05);实验组ΔLVM、ΔLVMI、ΔNT-proBNP与对照组相比,差异均有统计学意义(P<0.05)。两组患者治疗后心血管危险因素指标比较结果显示,两组患者治疗后ΔCr、ΔUA、ΔeGFR、ΔLDL、ΔHDL、ΔTC、ΔTG差异无统计学意义(P>0.05);实验组ΔBMI、ΔSBP、ΔDBP、ΔFPG、ΔHbA1c与对照组相比,差异均有统计学意义(P<0.05)。两组患者在药物相关的不良反应发生率比较,差异均无统计学差异(P>0.05)。结论2型糖尿病患者急性心肌梗死后早期应用达格列净,可改善患者心功能、逆转心室重塑,并取得较好的血糖、血压、体质量控制效果,安全性较好。

Objective To observe the cardiovascular benefits and safety of dapagliflozin in the treatment of acute myocardial infarction and type 2 diabetes mellitus.Methods A total of 122 patients with acute myocardial infarction combined with type 2 diabetes mellitus who were hospitalized in the Department of Cardiology of the Second Affiliated Hospital of Xuzhou Medical University from January 2021 to January 2022 were admitted.Patients were randomly divided into an experimental group and a control group,with 61 cases in each group,the control group was given basic treatment,and the experimental group added dapagliflozin to the basic treatment regimen.The differences in cardiovascular risk factors,cardiac function,and ventricular remodeling indexes between the two groups after 6 months were compared,and the occurrence of adverse reactions during treatment was monitored.Results There was no significant difference in baseline data between the two groups before treatment(P>0.05).The comparison of changes in cardiac function indicators after treatment between the two groups showed that there was no significant difference inΔLVEF between the two groups(P>0.05);compared with the control group,the differences inΔLVM,ΔLVMI,andΔNT-proBNP in the experimental group were statistically significant(P<0.05).The comparison of cardiovascular risk factors after treatment between the two groups showed that there were no significant differences inΔCr,ΔUA,ΔeGFR,ΔLDL,ΔHDL,ΔTC,andΔTG between the two groups(P>0.05);compared with the control group,the differences inΔBMI,ΔSBP,ΔDBP,ΔFPG,andΔHbA1c in the experimental group were statistically significant(P<0.05).There was no significant difference in the incidence of drug-related adverse reactions between the two groups(P>0.05).Conclusion The early application of dapagliflozin in patients with type 2 diabetes mellitus after acute myocardial infarction can improve cardiac function,reverse ventricular remodeling,and achieve better blood glucose,blood pressure,and body quality control effects,and good safety.