目的 探讨达格列净对2型糖尿病合并高血压患者血压和心脏功能的影响。方法 选取2020年10月至2022年4月90例2型糖尿病合并高血压患者，随机分为达格列净组和常规组，每组45例。达格列净组在常规降糖、降压药物基础上加用达格列净(10mg，1片/d，口服)。常规组使用常规降糖、降压药物。对比两组患者治疗前和治疗24周后收缩压、舒张压、心率、左心室射血分数、室间隔厚度等血压和心脏功能指标。结果 治疗前，两组收缩压、舒张压、心率、左心室射血分数、室间隔厚度等血压和心脏功能指标差异无统计学意义，具有可比性(P＞0。05)。治疗后，达格列净组收缩压[(125。42±11。41)mmHg vs(131。20±14。73)mmHg)]、舒张压[(75。67±9。72)mmHg vs 80。11±9。87)mmHg]、心率[(70。28±11。94)次/min vs(75。76±12。35)次/min]和室间隔厚度[(1。06±0。11)cm vs(1。12±0。12)cm]显著低于常规组，左心室射血分数[(65。73±3。01％vs(62。42±2。93)％]显著高于常规组，差异具有统计学意义(P＜0。05)。与常规组比较，达格列净组收缩压降低幅度(5。78±3。39)mmHg，舒张压降低幅度(4。44±2。88)mmHg;其中达格列净组Ⅰ级、Ⅱ级、Ⅲ级高血压患者收缩压降低幅度分别为(5。95±3。72)mmHg、(5。38±3。25)mmHg和(5。91±3。14)mmHg，舒张压降低幅度分别为(5。33±2。37)mmHg、(4。00±3。65)mmHg和(3。27±2。41)mmHg。结论 达格列净对2型糖尿病合并高血压患者具有明确的降压和改善心脏功能作用，而且对不同级别高血压患者均有效果。
Effect of dapagliflozin on blood pressure and cardiac function in patients with type 2 diabetes and hypertension
Objective To investigate the effect of dapagliflozin on blood pressure and cardiac function in patients with type 2 diabetes and hypertension.Methods A total of 90 patients with type 2 diabetes and hypertension who were treated from October 2020 to April 2022 were randomly divided into dapagliflozin group and conventional group,with 45 patients in each group.The patients in the dapagliflozin group were given oral administration of 10 mg dapagliflozin once a day in addition to conventional hypoglycemic and antihypertensive drugs,and those in the control group were given conventional hypoglycemic and antihypertensive drugs alone.The two groups were compared in terms of related blood pressure and cardiac function parameters,such as systolic pressure,diastolic pressure,heart rate,left ventricular ejection fraction,and interventricular septal thickness,before treatment and after 24 weeks of treatment.Results Before treatment,there were no significant differences between the two groups in the blood pressure and cardiac function parameters such as systolic pressure,diastolic pressure,heart rate,left ventricular ejection fraction,and interventricular septal thickness(P＞0.05).After treatment,compared with the conventional group,the dapagliflozin group had significantly lower systolic pressure(125.42±11.41mmHg vs 131.20±14.73 mmHg,P＜0.05),diastolic pressure(75.67±9.72mmHg vs 80.11±9.87 mmHg,P＜0.05),heart rate(70.28±11.94beats/min vs 75.76±12.35beats/min,P＜0.05),and interventricular septal thickness(1.06±0.11cm vs1.12±0.12 cm,P＜0.05)and a significantly higher left ventricular ejection fraction(65.73％±3.01％vs 62.42％±2.93％,P＜0.05).Compared with the conventional group,the dapagliflozin group had a systolic pressurereduced by 5.78±3.39mmHg and a diastolic pressure reduced by 4.44±2.88mmHg;for the patients with grade Ⅰ,Ⅱ,and Ⅲ hypertension in the dapagliflozin group,systolic pressure was reduced by 5.95±3.72 mmHg,5.38±3.25 mmHg,and 5.91±3.14 mmHg,respectively,and diastolic pressure was reduced by 5.33±2.37mmHg,4.00±3.65mmHg,and 3.27±2.41 mmHg,respectively.Conclusion Dapagliflozin can reduce blood pressure and improve cardiac function in patients with type 2 diabetes and hypertension and exerts a therapeutic effect on patients with different grades of hypertension.
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