达格列净对糖尿病合并心力衰竭患者临床疗效与血糖控制情况及心功能的影响

Effect of Dagliflozin on Clinical Efficacy,Glycemic Control and Cardiac Function in Patients with Diabetes Mellitus combined with Heart Failure

目的探讨达格列净对糖尿病合并心力衰竭患者临床疗效、血糖控制情况、心功能的影响。方法选取2022年1月至2023年2月江门市中心医院接诊的74例糖尿病合并心力衰竭患者作为研究对象,按随机数字表法分为对照组和观察组,各37例。入组后视患者心力衰竭情况给予血管紧张素抑制剂、利尿剂、β受体阻滞剂等进行对症治疗,对照组在此基础上给予盐酸二甲双胍片,观察组则采用达格列净治疗。比较两组患者临床疗效、血糖控制情况、心功能、血管内皮生长因子(VEGF)及不良反应。结果观察组治疗有效率为97.30%,高于对照组的81.08%(P<0.05)。治疗后两组空腹血糖、餐后2 h血糖及糖化血红蛋白低于治疗前(P<0.05),但两组组间比较差异无统计学意义(P>0.05)。治疗后,两组每搏输出量(SV)、左室射血分数(LVEF)高于治疗前,且观察组高于对照组,两组左室舒张末期内径(LVEDD)低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组VEGF水平低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论达格列净可有效提高糖尿病合并心力衰竭患者的临床疗效,改善心功能,其作用机制可能与降低VEGF水平有关。

Objective To explore the effect of daglizin on clinical efficacy,blood glucose control and cardiac function in patients with diabetes mellitus complicated with heart failure.Methods A total of 74 patients with diabetes mellitus and heart failure admitted to Jiangmen Central Hospital from January 2022 to February 2023 were selected as the study objects,and were divided into control group and observation group according to random number table method,with 37 cases in each group.Patients with heart failure were given symptomatic treatment with angiotensin inhibitors,diuretics andβ-blockers,the control group was given metformin hydrochloride tablets on the basis of this,and the observation group was treated with dagliaglozin.The clinical efficacy,blood glucose control,cardiac function,vascular endothelial growth factor(VEGF)and adverse reactions were compared between the two groups.Results The effective rate of observation group was 97.30%,which was higher than that of control group(81.08%)(P<0.05).Fasting blood glucose,2 h postprandial blood glucose and glycated hemoglobin in the two groups after treatment were lower than before treatment(P<0.05),but there was no statistical significance between the two groups(P>0.05).After treatment,stroke output(SV)and left ventricular ejection fraction(LVEF)in 2 groups were higher than before treatment,and observation group was higher than control group,and left ventricular end-diastolic diameter(LVEDD)in 2 groups was lower than before treatment,and observation group was lower than control group,the difference was statistically significant(P<0.05).After treatment,VEGF levels in the two groups were lower than before treatment,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Daglipzin can effectively improve the clinical efficacy and cardiac function in patients with diabetes mellitus complicated with heart failure,and its mechanism may be related to the reduction of VEGF levels.