目的 探讨恩格列净治疗 2 型糖尿病(Diabetes Mellitus type 2，T2DM)合并射血分数保留的心力衰竭(heart failure with preserved ejection fraction，HFpEF)患者的有效性和安全性。方法 纳入 2020 年 1 月～2023 年 12 月武城县人民医院收治的T2DM合并HFpEF患者76 例，随机分成对照组(n=38)与试验组(n=38)，两组患者均接受抗心力衰竭药物治疗，对照组在基础治疗上常规降糖治疗，试验组在基础治疗上给予恩格列净，比较两组患者血糖指标[(空腹血糖(FBG)、餐后 2 h血糖(2 h PBG)]、空腹胰岛素水平(FINS)、糖化血红蛋白(HbA1c);治疗前后血清炎症因子水平[C反应蛋白(CRP)，肿瘤坏死因子-α(TNF-α)]、以及血浆B型利钠肽(BNP)水平，临床治疗有效率以及不良反应(口渴、恶心、皮疹)总发生率。结果 治疗后，试验组空腹血糖、餐后 2 h血糖更低(P＜0。05);且试验组患者炎症因子水平以及血糖水平、HbA1c和FINS水平均低于对照组(P＜0。05);治疗后，试验组BNP水平显著低于对照组(P＜0。05);与对照组比较，试验组总有效率更高(P＜0。05)，但不良反应发生率更低(P＜0。05)。结论 恩格列净治疗T2DM合并HFpEF患者，可以改善血糖、胰岛素、血浆BNP水平，同时降低血清炎症因子水平，提高治疗总有效率，用药安全有效。
Efficacy and safety of empagliflozin in the treatment of type 2 diabetes mellitus with preserved ejection fraction in patients with heart failure
Objective To investigate the efficacy and safety of empagliflozin in the treatment of patients with type 2 diabetes mellitus(T2DM)and heart failure with preserved ejection fraction(HFpEF).Methods A total of 76 T2DM patients with HFpEF in Wucheng County People's Hospital from January 2020 to December 2023 were included and randomly divided into control group and experimental group(n=38).Patients in both groups received anti-heart failure drug treatment,the control group received routine hypoglycemic treatment on basic treatment,and the experimental group received empagliflozin on basic treatment.The blood glucose indexes[fasting blood glucose(FBG),2h postpranational blood glucose(2 h PBG)],fasting insulin levels(FINS)and glycated blood glucose protein(HbA1c)were compared between the two groups.The levels of serum inflammatory factors[C-reactive protein(CRP),tumor necrosis factor(TNF-α)]and plasma brain natriuretic peptide(BNP)before and after treatment were observed,and the overall incidence of clinical treatment effectiveness and adverse reactions(thirst,nausea,rash)were observed.Results After treatment,the fasting blood glucose and 2 h postprandial blood glucose of experimental group were lower(P＜0.05);compared with control group,the levels of inflammatory factors,blood glucose,HbA1c and FINS in test group were lower than those in control group(P＜0.05).After treatment,the plasma brain natriuretic peptide(BNP)level of experimental group was significantly lower than that of control group(P＜0.05);compared with the control group,the total effective rate of experimental group was higher(P＜0.05),but the incidence of adverse reactions was lower(P＜0.05).Conclusion In the treatment of T2DM patients with HFpEF,empagliflozin can improve the levels of blood glucose,insulin,plasma brain natriuretic peptide and reduce the levels of serum inflammatory factors,improve the total effective rate,and the drug is safe and effective.
万方数据
维普
