Page 83 - 北京京煤集团总医院第十届·2022学术年会论文集

北京京煤集团总医院 第十届·2022 学术年会论文集

canagliflozin group and dapagliflozin group. The control group received routine treatment.

Canagliflozin group and dapagliflozin group were added with canagliflozin and dapagliflozin

respectively on the basis of routine treatment. After discharge for 1 year, glycosylated hemoglobin
A1c, left ventricular ejection fraction, brain natriuretic peptide and heart failure rehospitalization

were compared among the three groups. Results: There was no significant difference in HbA1C
and heart failure rehospitalization among the three groups after treatment. After treatment, LVEF

of the canagliflozin group and dapagliflozin group was 53.47% and 53.13%, both of which were

higher than the control group (LVEF 45.53%). The difference in LVEF between the three groups

was statistically significant (P < 0.05), and there was no significant difference between the

canagliflozin group and dapagliflozin group. After treatment, The BNP of the canagliflozin group

and dapagliflozin group was 238.59 pg/ml and 379.78 pg/ml, both lower than the control group

(BNP 724.41 pg/ml). The difference between the three groups was statistically significant (P <

0.05), and there was no difference between the canagliflozin group and dapagliflozin group.

Conclusion: Both canagliflozin and dapagliflozin can improve the clinical prognosis of patients

with heart failure complicated with type 2 diabetes, and there was no statistical difference between

them.

Key words: Sodium-glucose cotransporter 2 inhibitors; Heart failure; Type 2 diabetes mellitus

2 型糖尿病（T2DM）是临床常见疾病，也是引起心力衰竭（心衰）的危险因素之一
[1] ，同时罹患心衰及糖尿病患者的 5 年生存率不足 25%。传统抗糖尿病药物在降糖方面效

果良好，但显著的心血管益处较少 [2,3] 。近年来，一系列临床研究证据促使 T2DM 的治疗模

式从单纯控制血糖转移至改善心血管临床结局。钠-葡萄糖协同转运蛋白 2（SGLT2）是分

布在肾脏近曲小管的钠-葡萄糖共转运蛋白，将 90%的尿糖进行重吸收。SGLT2 抑制剂能

够抑制 SGLT2，进而降低血糖。同时 SGLT2 抑制剂还具有降低体重、血压、尿白蛋白、

血尿酸及降低心衰发生风险等额外收益 [4,5] 。近期欧洲心脏病学会科学年会（ESC）及美国

心脏病学会科学年会（ACC）均将 SGLT2 抑制剂列为射血分数降低心衰患者减少心血管

死亡和心衰再住院的 I 类推荐 [6, 7] 。本文旨在探究不同类型 SGLT2 抑制剂对心力衰竭合并 2

型糖尿病患者的临床预后。

1 资料和方法

1.1 一般资料 选取 2020 年 6 月至 2020 年 12 月于北京京煤集团总医院心内科住院的心衰合

并 2 型糖尿病患者 50 例，随机分为三组：对照组（n=17）采用抗心衰、降糖等常规治

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