2型糖尿病合并心力衰竭患者行二甲双胍联合达格列净治疗的临床效果及安全性分析

Clinical Efficacy and Safety Analysis of Metformin Combined with Dapagliflozin in Patients with Type 2 Diabetes Mellitus Complicated with Heart Failure

目的分析2型糖尿病(Type 2 Diabetes Mellitus,T2DM)合并心力衰竭(Heart Failure,HF)患者选择二甲双胍联合达格列净治疗的效果及用药安全性。方法选取2022年11月-2023年11月东平县中医院收治的96例T2DM合并HF患者为研究对象,以随机信封法分为对照组(n=48)和观察组(n=48)。两组均接受抗心力衰竭治疗,对照组选择二甲双胍治疗,观察组选择二甲双胍联合达格列净治疗,对比两组血糖指标、心功能指标及不良反应发生情况。结果治疗3个月后,和对照组相比,观察组空腹血糖、餐后2 h血糖、糖化血红蛋白水平及N端脑钠肽前体水平较低,左室射血分数较高,差异有统计学意义(P均<0.05)。观察组药物不良反应总发生率为6.25%,略高于对照组的4.17%,但差异无统计学意义(χ^(2)=0.211,P>0.05)。结论针对T2DM合并HF患者选择二甲双胍联合达格列净用药方案,不但能够确保血糖良好控制,同时还能够促进心功能改善,药物安全性表现优异。

Objective To analyze the efficacy and safety of metformin combined with dapagliflozin in patients with type 2 diabetes mellitus(T2DM)and heart failure(HF).Methods A total of ninety-six patients with T2DM combined with HF admitted to Dongping County Hospital of Traditional Chinese Medicine from November 2022 to November 2023 were selected as the study objects.They were divided into control group(n=48)and observation group(n=48)by random envelope method.Both groups received anti-heart failure treatment,the control group was selected metformin treatment,the observation group was selected metformin combined with dapagliflozin treatment.Blood glucose index,cardiac function index and occurrence of adverse reactions were compared between the two groups.Results After 3 months of treatment,compared with control group,fasting blood glucose,2-hour postprandial blood glucose,glycosyl-ated hemoglobin A1c level and N-terminal probrain natriuretic peptide level in observation group were lower,and left ventricular ejection fraction was higher,and the differences were statistically significant(all P<0.05).The total inci-dence of drug adverse reactions in the observation group was 6.25%,slightly higher than that in the control group(4.17%),but there was no statistically significant difference between groups(χ^(2)=0.211,P>0.05).Conclusion For T2DM patients with HF,the combination of metformin and dapagliflozin can not only ensure good blood glucose con-trol,but also promote the improvement of cardiac function,and the drug safety performance is excellent.