摘要目的 分析钠依赖型葡萄糖转运蛋白-2（SGLT-2）抑制剂治疗2型糖尿病合并心力衰竭效果。方法 选取2020年1月至2021年1月新余市人民医院收治的80例2型糖尿病合并心力衰竭患者为研究对象，按照随机数字表法分为对照组（40例）与观察组（40例），两组患者均采用常规抗心力衰竭治疗，对照组常规降糖治疗，观察组采用SGLT-2抑制剂降糖方案治疗，比较两组患者血糖、炎症因子、氧化应激的情况及不良反应发生率。结果 两组患者治疗前空腹血糖（FPG）、餐后2 h血糖（2 h PG）水平比较，差异无统计学意义（P＞0.05）；治疗后两组FPG、2 h PG水平均低于治疗前，且观察组治疗后FPG、2 h PG水平高于对照组，差异有统计学意义（P＜0.05）。两组患者治疗前左室射血分数（LVEF）、每搏输出量（SV）、二尖瓣流入比值（E/A）比较，差异无统计学意义（P＞0.05）；治疗后两组LVEF、SV、E/A均高于治疗前，且观察组治疗后LVEF、SV、E/A高于对照组，差异有统计学意义（P＜0.05）。两组患者治疗前C-反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、丙二醛（MDA）、超氧化物歧化酶（SOD）水平比较，差异无统计学意义（P＞0.05）；治疗后两组CRP、TNF-α、MDA水平低于治疗前，SOD高于治疗前，差异有统计学意义（P<0.05）；观察组治疗后CRP、TNF-α、MDA水平低于对照组，SOD水平高于对照组，差异有统计学意义（P＜0.05）。两组患者治疗前6 min步行距离比较，差异无统计学意义（P＞0.05）；治疗后两组6 min步行距离长于治疗前，且观察组治疗后6 min步行距离长于对照组，差异有统计学意义（P＜0.05）。观察组治疗后心力衰竭再住院率低于对照组，差异有统计学意义（P＜0.05），两组的心血管死亡率比较，差异无统计学意义（P＞0.05）。观察组不良反应总发生率低于对照组，差异有统计学意义（P＜0.05）。结论 将SGLT-2抑制剂用于2型糖尿病合并心力衰竭患者中疗效显著，如促进心功能改善、控制血糖水平方面均具有显著优势。
Abstract：Objective To analyze the effect of sodium-dependent glucose transporter-2 (SGLT-2) inhibitor in the treatment of type 2 diabetes mellitus complicated with heart failure. Methods A total of 80 patients with type 2 diabetes complicated with heart failure admitted to Xinyu People′s Hospital from January 2020 to January 2021 were selected as the research objects, they were divided into control group (40 cases) and observation group (40 cases) according to random number table method. Both groups were treated with conventional anti-heart failure therapy, the control group treated with conventional hypoglycemic treatment, and the observation group treated with SGLT-2 inhibitor hypoglycemic treatment. The incidence of blood glucose, inflammatory factors, oxidative stress and adverse reactions were compared between the two groups. Results There were no significant differences in fasting blood glucose (FPG) and 2 h postprandial blood glucose (2 h PG) levels between two groups before treatment (P>0.05). After treatment, the levels of FPG and 2 h PG in the two groups were lower than before treatment, and the levels of FPG and 2 h PG in the observation group were higher than those in the control group, the differences were statistically significant (P<0.05). Before treatment, there were no significant differences in left ventricular ejection fraction (LVEF), output per wave (SV) and mitral valve inflow ratio (E/A) between two groups (P>0.05). After treatment, LVEF, SV and E/A in the two groups were higher than those before treatment, and LVEF, SV and E/A in the observation group were higher than those in the control group, the differences were statistically significant (P<0.05). There were no significant differences in the levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), malondialdehyde (MDA) and superoxide dismutase (SOD) between two groups before treatment (P>0.05). After treatment, the levels of CRP, TNF-α and MDA in the two groups were lower than those before treatment, while SOD was higher than that before treatment, with statistical significances (P<0.05). After treatment, the levels of CRP, TNF-α and MDA in the observation group were lower than those in the control group, while the level of SOD was higher than that in the control group, with statistical significances (P<0.05). There was no significant difference in 6 min walking distance before treatment between two groups (P>0.05). The 6 min walking distance of the two groups after treatment was longer than that before treatment, and the distance of the observation group was longer than that of the control group, the differences were statistically significant (P<0.05). The rehospitalization rate of heart failure in the observation group was lower than that in the control group, and the difference was statistically significant (P<0.05), while there was no significant difference in cardiovascular mortality between the two groups (P>0.05). The total incidence of adverse reactions in the observation group was lower than that in the control group, and the difference was statistically significant (P<0.05). Conclusion SGLT-2 inhibitor has significant efficacy in patients with type 2 diabetes mellitus complicated with heart failure, such as promoting the improvement of heart function and controlling blood glucose level.
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