摘要
目的 探究血塞通滴丸联合达格列净治疗2 型糖尿病(T2DM)合并慢性心力衰竭(CHF)的效果及其对血糖代谢、心功能、血栓前状态(PTS)的影响.方法 选取2022 年7 月—2023 年7 月收治的90 例T2DM合并CHF,据随机数字表法分为研究组和对照组各45 例.2 组均予强心、利尿等抗心力衰竭治疗,在此基础上,对照组予达格列净治疗,研究组予血塞通滴丸联合达格列净治疗,治疗3 个月后对比2 组治疗效果、不良反应.比较2 组治疗前后血糖指标、心功能指标、PTS指标、心力衰竭症状(Lee氏心力衰竭评分)、生活质量[明尼苏达心力衰竭生活质量量表(MLHFQ)评分]、血清Nexilin、可溶性致癌抑制因子2(sST2)水平.结果 研究组总有效率为88.89%(40/45)明显高于对照组的71.11%(32/45)(P＜0.05),而不良反应发生率比较无明显差异(P＞0.05).与治疗前比较,2 组治疗1 个月、3 个月后外周血空腹血糖、糖化血红蛋白、餐后2h血糖水平均降低(P＜0.05).与对照组比较,研究组治疗1 个月、3 个月后左心室射血分数升高,左心室舒张末期内径、左心室收缩末期内径及血清氨基末端脑钠肽前体水平降低(P＜0.01);与对照组比较,研究组治疗1 个月、3 个月后血清组织型纤溶酶原激活物、纤溶酶原激活物抑制物-1 水平升高,纤维蛋白原、血栓素B2、Nexilin、sST2 水平降低(P＜0.01);与对照组比较,研究组治疗1 个月、3 个月后Lee氏心力衰竭评分、MLHFQ评分降低(P＜0.01).结论 在抗心力衰竭治疗基础上血塞通滴丸联合达格列净治疗T2DM合并CHF效果确切,可改善心功能、血糖代谢、PTS,并可提高生活质量,缓解心力衰竭病情进展,具一定安全性,可能与调节Nexilin、sST2 表达有关.
Abstract
Objective To explore the effect of Xuesaitong dropping pills combined with Dapagliflozin in the treatment of type 2 diabetes mellitus(T2DM)combined with chronic heart failure(CHF)and its effects on blood glucose metabolism,cardiac function and prethrombotic state(PTS).Methods A total of 90 patients with T2DM and CHF treated from July 2022 to July 2023 were selected,and divided into the research group and the control group,with 45 patients in each group.Both groups were treated with anti-heart failure therapies such as cardiotonic and diuretic therapy.On this basis,the control group was treated with Dapagliflozin and the research group was treated with Xuesaitong dropping pills combined with Dapagliflozin.At 3 months after treatment,the therapeutic effects and adverse reactions of the two groups were compared.The blood glucose index,cardiac function index,PTS index,heart failure symptoms(Lee's heart failure score),quality of life[Minnesota Liv-ing with Heart Failure Questionnaire(MLHFQ)score],serum Nexilin,soluble suppression of tumorigenesis-2(sST2)lev-els,and adverse reactions before and after treatment were compared between the two groups.Results The total effective rate of the research group was 88.89%(40/45),which was significantly higher than that of the control group(71.11%,32/45)(P＜0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Compared with those before treatment,the fasting blood glucose,glycosylated hemoglobin,and postprandial 2-hour blood glucose levels in peripheral blood of both groups decreased at 1 month and 3 months after treatment(P＜0.05).Com-pared with the control group,the left ventricular ejection fraction increased at 1 month and 3 months after treatment in the re-search group,while the left ventricular end-diastolic diameter,left ventricular end-systolic diameter,and serum amino-termi-nal pro-brain natriuretic peptide level decreased(P＜0.01).Compared with the control group,the serum tissue-type plas-minogen activator and plasminogen activator inhibitor-1 levels increased,while fibrinogen,thromboxane B2,Nexilin,and sST2 levels decreased at 1 month and 3 months after treatment in the research group(P＜0.01).Compared with the control group,the Lee's heart failure score and MLHFQ score decreased at 1 month and 3 months after treatment in the research group(P＜0.01).Conclusion On the basis of anti-heart failure therapies,Xuesaitong dropping pills combined with Dapagliflozin is effective in the treatment of T2DM with CHF,which can improve cardiac function,glycemic metabolism,and PTS status,enhance quality of life,alleviate the progression of heart failure,and has certain safety.This may be related to the regulation of Nexilin and sST2 expression.
基金项目
河北省医学科学研究课题(2022)(20221915)
维普
万方数据