SGLT2抑制剂对2型糖尿病患者血糖、血尿酸水平及心脏功能的影响

摘要 目的：研究SGLT2抑制剂对2型糖尿病患者血糖、血尿酸水平及心脏功能的影响。方法：选取我院2019年1月~2020年6月收治的2型糖尿病合并稳定性心功能不全患者106例为研究对象，采用随机数字表法将患者分为两组，所有患者均给予2型糖尿病饮食控制治疗方案，并给予心功能不全对症药物治疗。对照组患者在此基础上给予二甲双胍，观察组在对照组的基础上给予SGLT2抑制剂达格列净。比较两组患者的血糖、血尿酸（uric acid，UA）、血清脑钠肽(brainnatriureticpeptide，BNP)水平、心脏功能及生活质量。结果：治疗前两组的餐后2 h血糖（2- hour postprandial glucose，2 h PBG）、空腹血糖（fasting blood glucose，FBG）及糖化血红蛋白（glycosylated hemoglobin，HbAIc）水平比较无差异（P＞0.05），治疗后两组的上述指标均显著降低，且观察组显著低于对照组（P<0.05）；治疗前两组的UA和BNP水平比较无差异（P＞0.05），治疗后两组的上述指标均显著降低，且观察组显著低于对照组（P<0.05）；治疗前两组的左室射血分数（left ventricular ejection fraction，LVEF）和左室舒张末期内径（left ventricular end diastolic diameter，LVEDD）水平比较无差异（P＞0.05），治疗后观察组的LVEF水平显著升高，LVEDD水平显著降低（P<0.05），但对照组治疗前后比较无差异（P＞0.05）；治疗前两组的SF-36健康调查量表(the SF-36 Health Survey，SF-36)评分比较无差异（P＞0.05），治疗后两组的SF-36评分均显著上升，且观察组显著高于对照组（P<0.05），两组的不良反应发生率比较无统计学差异（P＞0.05）。结论：达格列净可显著改善2型糖尿病合并稳定性心功能不全患者的血糖、血尿酸水平，还能够改善患者的心脏功能，值得临床借鉴。

Effects of SGLT2 Inhibitors on Blood Glucose and Uric Acid Levels and Cardiac Function in Patients with Type 2 Diabetes Mellitus

ABSTRACT Objective: To study the effects of SGLT2 inhibitors on blood glucose, blood uric acid levels and heart function in patients with type 2 diabetes. Methods: A total of 106 patients with type 2 diabetes combined with stable cardiac insufficiency admitted to our hospital from January 2019 to June 2020 were selected as the research objects. The patients were divided into two groups by random number table method. All patients were given diet control and exercise therapy for type 2 diabetes, and symptomatic drug therapy for cardiac insufficiency. Control group was additively given metformin, and observation group was additively given the SGLT2 inhibitordagliazin. Blood glucose, blood uric acid, BNP level, heart function and quality of life in 2 groups were compared. Results: There were no significant differences in the levels of PBG, FBG and HBAIC in 2 groups before treatment (P>0.05). After treatment, the above indexes in 2 groups were significantly decreased, and the observation group was significantly lower than the control group(P<0.05). There was no significant difference in UA and BNP levels between 2 groups before treatment(P>0.05). After treatment, the above indexes in 2 groups were significantly decreased, and the observation group was significantly lower than the control group(P<0.05). Before treatment, there was no statistical difference in LVEF and LVEDD levels between the two groups(P>0.05). After treatment, LVEF level in the observation group was significantly increased while LVEDD level was significantly decreased, and there was a statistical difference between the two groups(P<0.05). However, there was no statistical difference between the control group before and after treatment(P>0.05). There was no statistical difference in the SF-36 score between the two groups before treatment (P>0.05), but after treatment, the SF-36 score of the two groups was significantly increased, and the observation group was significantly higher than the control group (P<0.05). There was no statistical difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Daglixin can significantly improve the levels of blood glucose and uric acid in patients with type 2 diabetes mellitus complicated with stable cardiac insufficiency, and can also improve the cardiac function of patients, which is worthy of clinical reference.