【摘要】 目的：观察达格列净对2型糖尿病合并慢性心衰患者左室舒张功能的影响，探讨达格列净的心脏保护作用机制。方法：选取于2019年6月-2020年6月在湛江中心人民医院就诊的100例T2DM合并HF患者(心功能Ⅰ、Ⅱ、Ⅲ级)，将其采用随机对照方法分为对照组(n=50)和观察组(n=50)。两组患者均进行HF标准化药物治疗，对照组予以胰岛素治疗，观察组在对照组基础上予以达格列净治疗。收集两组患者治疗前及治疗6个月时的临床资料，比较两组患者治疗前后B型钠尿肽(BNP)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、左室舒张末期容积(LVEDV)、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、心房收缩期左心室充盈峰速度(A)、舒张早期左室充盈峰速度(E)、E/A变化。结果：治疗6个月后，两组LVEF、E、E/A较治疗前均有所上升，BNP、TNF-α、hs-CRP、LVEDD、LVEDV、A较治疗前均有所降低，差异均有统计学意义(P<0.05)。治疗6个月后，观察组LVEF、E、E/A均明显高于对照组，BNP、TNF-α、hs-CRP、LVEDD、LVEDV、A均明显低于对照组，差异均有统计学意义(P<0.05)。两组不良反应事件发生率比较，差异无统计学意义(P>0.05)。结论：达格列净可通过降低TNF-α和hs-CRP水平减轻2型糖尿病合并心衰患者炎症反应，改善患者左心室舒张功能。更多还原

【Abstract】 Objective:To observe the effect of Dapagliflozin on left ventricular diastolic function (LVDF) in patients with type 2 diabetes mellitus (T2DM) and chronic heart failure (HF),and to explore the mechanism of cardiac protection of Dapagliflozin.Method:A total of 100 T2DM patients with HF (cardiac functionⅠ,Ⅱ,Ⅲ) admitted to Zhanjiang Central People’s Hospital from June 2019 to June 2020 were selected and divided into control group (n=50) and observation group (n=50) by randomized control method.Both groups were given HF standardized drug therapy,the control group was given Insulin treatment,and the observation group was given Dapagliflozin treatment on the basis of the control group.Clinical data of two groups were collected before treatment and 6 months after treatment,B-type natriuretic peptide (BNP),tumor necrosis factor-α (TNF-α),high-sensitive C-reactive protein (hs-CRP),left ventricular end-diastolic volume (LVEDV),left ventricular ejection fraction (LVEF),left ventricular end-diastolic diameter (LVEDD),left ventricular filling peak velocity (A) in atrial systole,left ventricular filling peak velocity (E) in early diastole and the E/A ratio were compared before and after treatment.Result:After 6 months of treatment,LVEF,E and E/A in both groups were increased,BNP,TNF-α,hs-CRP,LVEDD,LVEDV and A were decreased,the differences were statistically significant (P<0.05).After 6 months of treatment,LVEF,E and E/A in the observation group were significantly higher than those in the control group,BNP,TNF-α,hs-CRP,LVEDD,LVEDV and A were significantly lower than those in the control group,the differences were statistically significant (P<0.05).There was no significant difference in the incidence of adverse events between the two groups (P>0.05).Conclusion:Dapagliflozin can reduce the inflammatory reaction and improve the left ventricular diastolic function in patients with T2DM complicated with heart failure by reducing the level of TNF-αand hs-CRP.更多还原