Clinical Observation of Combination Therapy of Dapagliflozin and Liraglutide in Patients with Diabetes Mellitus Type 2 Complicated with Chronic Heart Failure with Poor Hypoglycemic Effect of Metformin
Objective:To explore the clinical value of combination therapy of Dapagliflozin and Liraglutide in patients with diabetes mellitus type 2(T2DM)complicated with chronic heart failure(CHF)with poor hypoglycemic effect of Metformin.Method:A total of 80 patients with T2DM complicated with CHF with poor hypoglycemic effect of Metformin admitted to the Department of Cardiovascular Medicine of Pingxiang No.2 People's Hospital from January 2020 to October 2022 were selected and divided into control group(n=40,given conventional treatment + Liraglutide treatment)and combination group(n=40,combined with Dapagliflozin treatment on the basis of the control group)according to random number table method.Blood glucose level,cardiac function,clinical efficacy,inflammatory factors indexes[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],cystatin C(Cys C),plasminogen activator inhibitor-1(PAI-1)and adverse reactions were compared between the two groups.Result:After treatment,fasting plasma glucose,2 h postprandial blood glucose and glycosylated hemoglobin in both groups were decreased,and those in the combination group were lower than those in the control group,the differences were statistically significant(P<0.05).After treatment,the left ventricular ejection fraction of both groups were increased,and that in the combination group was higher than that in the control group,the N-terminal pro-brain natriuretic peptide of both groups were decreased,and that in the combination group was lower than that in the control group,the differences were statistically significant(P<0.05).After treatment,the heart function of the combination group was better than that of the control group,the difference was statistically significant(P<0.05).The total effective rate of the combination group was 97.50%,which was higher than 80.00%of the control group,the difference was statistically significant(P<0.05).After treatment,TNF-α and IL-6 were decreased in both groups,and those in the combination group were lower than those in the control group,the differences were statistically significant(P<0.05).After treatment,PAI-1 was decreased in both groups,and PAI-1 in the combination group was lower than that in the control group,the differences were statistically significant(P<0.05).After treatment,there was no significant difference in Cys C between the two groups(P>0.05).The total incidence of adverse reactions was 17.50%in the combination group and 12.50%in the control group,there was no statistical significance between the two groups(P>0.05).Conclusion:Dapagliflozin combined with Liraglutide in the treatment of patients T2DM complicated with CHF with poor hypoglycemic effect of Metformin can improve blood glucose control effect,improve cardiac function,improve clinical efficacy,reduce inflammatory reaction,and have a high safety.
Diabetes mellitus type 2Chronic heart failureLiraglutideDapagliflozin
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