达格列净片联合磷酸肌酸钠治疗T2DM合并心力衰竭的效果观察

Clinical effect of dapagliflozin tablets combined with creatine phosphate sodium on T2DM complicated by heart failure

目的分析达格列净片联合磷酸肌酸钠治疗2型糖尿病(T2DM)合并心力衰竭的临床效果。方法采取便利抽样的方法,抽取2021年1月至2023年1月驻马店市第一人民医院收治的120例T2DM合并心力衰竭患者,根据随机数字表法分为对照组与观察组,每组60例。对照组予以常规治疗,观察组在对照组的基础上予以达格列净片联合磷酸肌酸钠治疗。比较两组的临床疗效、血糖控制水平、心功能状态及血清心肌损伤标志物水平。结果治疗后,观察组总有效率(93.33%,56/60)高于对照组(78.33%,47/60),P<0.05。治疗后,观察组糖化血红蛋白、餐后2 h血糖与空腹血糖值低于对照组(P<0.05)。治疗后,观察组舒张早期二尖瓣血流速度(E峰)/舒张晚期二尖瓣血流速度(A峰)、左室射血分数高于对照组,左室舒张末期内径与左室收缩末期内径均短于对照组(P均<0.05)。治疗后,观察组N末端脑钠肽前体、肌钙蛋白I与血管紧张素水平均低于对照组(P均<0.05)。结论达格列净片联合磷酸肌酸钠应用于T2DM合并心力衰竭患者可提高其临床效果,增强血糖控制水平,同时改善心功能状态,降低心肌损伤。

Objective To analyze the effect of dapagliflozin tablets combined with creatine phosphate sodium on type 2 diabetes mellitus(T2DM)complicated by heart failure.Methods A total of 120 T2DM patients with heart failure admitted to Zhumadian First People’s Hospital from January 2021 to January 2023 were selected by convenience sampling method,and they were divided into two groups according to the random number table method,with 60 cases in each group.The control group was treated by conventional treatment,and the observation group was treated with dapagliflozin tablets combined with creatine phosphate sodium based on the treatment of the control group.The clinical efficacy,blood glucose control level,cardiac function and levels of serum markers of myocardial injury were compared between the two groups.Results After treatment,the total effective rate in the observation group(93.33%,56/60)was higher than that in the control group(78.33%,47/60),P<0.05.The levels of glycosylated hemoglobin,2-hour postprandial blood glucose and fasting blood glucose in the observation group were significantly lower than the control group after treatment(P<0.05).After treatment,the early to late diastolic transmitral flow velocity(E/A)ratio and left ventricular ejection fraction in the observation group were significantly higher than those in the control group,moreover,left ventricular end-diastolic diameter left ventricular and end-systolic diameter in the observation group were shorter than those in the control group(all P<0.05).The levels of N-terminal pro-brain natriuretic peptide,troponin I and angiotensin in the observation group were lower than those in the control group(all P<0.05).Conclusions Dapagliflozin tablets combined with creatine phosphate sodium in patients with T2DM complicated by heart failure can improve clinical efficacy,enhance blood glucose control,improve cardiac function,and reduce myocardial injury.