达格列净对大量白蛋白尿的2型糖尿病合并心衰患者预后的影响
| 作 者：周国艳, 李青 |
| 单 位：湖南师范大学附属湘东医院 |
| 基金项目：湖南省教育厅科学研究项目 |
| 摘 要： |
| 目的：探讨达格列净对大量白蛋白尿的2型糖尿病合并心衰患者预后的影响。方法：选取我院住院的大量白蛋白尿的2型糖尿病合并心衰患者90例，分成观察组和对照组，各45例。观察组在原降糖基础上加用达格列净，对照组在原降糖基础上根据目标血糖调整药物剂量，治疗12周，比较两组治疗前后24小时尿白蛋白定量（24h-Alb）、血肌酐（Cr）、估算肾小球滤过率（eGFR）、N末端B型尿钠肽前体（NT-proBNP）、左心室舒张末期内径（LVEDD）、左心室射血分数（LVEF）、明尼苏达心力衰竭生活质量调查表评分（MLHFQs）、血管性血友病因子(vWF)变化。结果：治疗后两组空腹血糖（FBG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbA1c）均降低，两组间比较无明显差异（P0.05）；两组24h-Alb、Cr、vWF、NT-proBNP、LVEDD、MLHFQs均降低，达格列净组降低更明显（P0.05）；两组eGFR、LVEF较治疗前升高，达格列净组升高更明显（P0.05）。结论：对大量白蛋白尿的2型糖尿病合并心衰患者，达格列净在降糖之外，可以减少尿蛋白排泄，保护心血管，改善心力衰竭。 |
| 关键词：达格列净，2型糖尿病，大量白蛋白尿，心力衰竭，血管性血友病因子 |
Effect of dapagliflozin on type 2 diabetic mellitus with massive Albuminuria and heart failu
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| Abstract: |
| Objective: To investigate the effects of dapagliflozin on type 2 diabetes mellitus with massive albuminuria and heart failure.Methods: 90 patients with type 2 diabetes mellitus combined with massive albuminuria and heart failure were selected and divided into 2 groups: the observation group and the control group,45 cases per group。The observation group was added with dapagliflozin on the basis of the control group. After 12 weeks of treatment, the changes of 24h-Alb, Cr, eGFR, NT-proBNP, LVEDD, LVEF, MLHFQs were compared between the two groups.Result:1.Compared with those before treatment: FBG，2hPG，HbA1c decreased in both groups, There was no significant difference in the reduction of FBG, 2hPG and HbA1c between the two groups (P0.05)。2.Compared with those before treatment: 24h-Alb, Cr, vWF, NT-proBNP, LVEDD and MLHFQs decreased in both groups, and the decrease was more obvious in the observation group, the difference was statistically significant (P0.05); the levels of eGFR and LVEF of the two groups were increased, but the increase was more obvious in the observation group, the difference was statistically significant (P0.05).Conclusion:For patients with type 2 diabetes mellitus with massive albuminuria, Independent of hypoglycemia, dapagliflozin can reduce the excretion of albuminuria ,improve vascular endothelial injury，ameliorate the prognosis of patients with heart failure. |
| Keywords: dapagliflozin,type 2 diabetes mellitus , massive albuminuria, heart failure, vWF |
| 投稿时间：2023-08-15 |
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