达格列净对老年射血分数保留型心力衰竭合并2型糖尿病患者的影响

Effect of Dapagliflozin on Elderly Patients with Heart Failure with Preserved Ejection Fraction Combined with Type 2 Diabetes Mellitus

目的:探讨达格列净对老年射血分数保留型心力衰竭(heart failure with preserved ejection fraction,HFpEF)合并2型糖尿病患者的影响。方法:选取2021年6—12月恩施市中心医院收治的80例老年HFpEF合并2型糖尿病患者。根据随机数表法将其分为对照组(n=40)和试验组(n=40)。对照组接受常规治疗,试验组在对照组基础上给予达格列净治疗。比较两组治疗前及治疗1年后心功能指标、炎症因子,主要心血管不良事件及并发症。结果:治疗1年后,两组N末端B型利钠肽原(N-terminal pro-B-type natriuretic peptide,NT-proBNP)、血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)水平均低于治疗前,左心室射血分数高于治疗前;试验组NT-proBNP、AngⅡ水平均低于对照组,左心室射血分数高于对照组,差异有统计学意义(P<0.05)。治疗1年后,两组C反应蛋白、肿瘤坏死因子-α水平及单核细胞/高密度脂蛋白胆固醇比值均低于治疗前,试验组C反应蛋白、肿瘤坏死因子-α水平及单核细胞/高密度脂蛋白胆固醇比值均低于对照组,差异有统计学意义(P<0.05)。试验组主要不良心血管事件发生率低于对照组,差异有统计学意义(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:达格列净可增强老年HFpEF合并2型糖尿病患者的心功能,降低NT-proBNP、AngⅡ及炎症因子水平,减少主要心血管不良事件的发生。

Objective:To investigate the effect of Dapagliflozin on elderly patients with heart failure with preserved ejection fraction(HFpEF)combined with type 2 diabetes mellitus.Method:A total of 80 elderly patients with HFpEF combined with type 2 diabetes admitted to Enshi Central Hospital from June to December 2021 were selected.They were divided into control group(n=40)and experimental group(n=40)according to random number table method.The control group received conventional treatment,and the experimental group received Dapagliflozin on the basis of the control group.Cardiac function indexes,inflammatory factors before and after 1 year of treatment,major cardiovascular adverse events and complications were compared between the two groups.Result:After 1 year of treatment,the levels of N-terminal pro-B-type natriuretic peptide(NT-proBNP)and angiotensinⅡ(AngⅡ)in both groups were lower than those before treatment,the left ventricular ejection fraction was higher than that before treatment;the levels of NT-proBNP and AngⅡin the experimental group were lower than those in the control group,and left ventricular ejection fraction was higher than that in control group,the differences were statistically significant(P<0.05).After 1 year of treatment,the levels of C-reactive protein,tumor necrosis factor-αand the ratio of monocyte/high-density lipoprotein cholesterol in the two groups were lower than those before treatment,and the levels of C-reactive protein,tumor necrosis factor-αand the ratio of monocyte/high-density lipoprotein cholesterol in the experimental group were lower than those in the control group,the differences were statistically significant(P<0.05).The incidence of major adverse cardiovascular events in the experimental group was lower than that in control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Dapagliflozin can enhance the cardiac function of elderly HFpEF patients combined with type 2 diabetes,reduce the levels of NT-proBNP,AngⅡand inflammatory factors,and reduce the occurrence of major cardiovascular adverse events.