摘要
目的探讨达格列净联合替罗非班对2型糖尿病合并冠心病患者的疗效。方法前瞻性选取2022年1—8月于阜阳市人民医院治疗的2型糖尿病合并冠心病患者120例为研究对象,根据治疗方法不同分为对照组和试验组,对照组采用替罗非班治疗,试验组采用达格列净联合替罗非班治疗,对比两组疗效和安全性。结果治疗3个月后,两组患者空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、D-二聚体(D-D)、纤维蛋白原(FIB)水平均较治疗前降低[试验组:(7.33±1.77)mmol/L比(9.45±2.05)mmol/L、(10.33±2.07)mmol/L比(13.57±2.88)mmol/L、(7.22±1.28)%比(9.25±1.78)%、(1.98±0.29)mmol/L比(6.05±1.24)mmol/L、(2.95±0.37)mmol/L比(4.35±0.76)mmol/L、(0.78±0.23)mg/L比(1.85±0.79)mg/L、(2.57±0.37)g/L比(7.15±1.36)g/L;对照组:(8.21±1.85)mmol/L比(9.68±2.17)mmol/L、(11.78±2.26)mmol/L比(13.89±3.02)mmol/L、(8.25±1.36)%比(9.37±1.86)%、(2.77±0.42)mmol/L比(6.08±1.22)mmol/L、(3.84±0.44)mmol/L比(4.27±0.72)mmol/L、(1.34±0.52)mg/L比(1.81±0.72)mg/L、(5.25±0.84)g/L比(7.11±1.28)g/L],差异有统计学意义(P<0.05);且两组间FPG、2 h PG、HbA1c、TC、LDL-C、D-D及FIB水平比较,差异有统计学意义(P<0.05)。高密度脂蛋白胆固醇(HDL-C)水平、左心室射血分数(LVEF)、心输血量(CO)、每搏输出量(SV)、凝血酶时间(TT)、部分活化凝血酶原时间(APTT)均升高[试验组:(1.76±0.30)mmol/L比(1.07±0.28)mmol/L、(68.64±12.91)%比(45.05±12.24)%、(4.88±0.91)L/min比(3.95±1.12)L/min、(53.66±5.43)ml/min比(43.27±4.88)ml/min、(31.83±4.39)s比(23.25±3.44)s、(13.85±2.17)s比(10.75±1.56)s;对照组:(1.43±0.26)mmol/L比(1.06±0.24)mmol/L、(60.37±11.86)%比(45.42±12.41)%、(4.37±0.84)L/min比(4.17±1.16)L/min、(47.86±5.27)ml/min比(43.36±4.94)ml/min、(27.24±3.91)s比(23.78±3.62)s、(12.74±1.94)s比(10.89±1.78)s],差异有统计学意义(P<0.05);且两组间HDL-C、LVEF、CO、SV、TT及APTT比较差异有统计学意义(P<0.05);两组患者治疗期间试验组不良反应发生率较对照组低[5.00%(3/60)比16.67%(10/60)],差异有统计学意义(P<0.05)。结论采用达格列净联合替罗非班对2型糖尿病合并冠心病患者进行治疗,具有显著的疗效,能够改善患者血糖、血脂水平、凝血功能和心功能,且安全性高。
Objective To investigate the efficacy of dapagliflozin combined with tirofiban in patients with type 2 diabetes mellitus complicated with coronary heart disease.Methods A total of 120 patients with type 2 diabetes mellitus and coronary heart disease treated in Fuyang People′s Hospital from January to August 2022 were prospectively selected as subjects.According to different treatment methods,they were divided into control group and experimental group.The control group was treated with tirofiban,and the experimental group was treated with dapagliflozin combined with tirofiban.The efficacy and safety of treatments between the two groups were compared.Results After 3 months of treatment,fasting plasma glucose(FPG),2 h postprandional blood glucose(2 h PG),glycated hemoglobin(HbA1c),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),D-dimer(D-D)and fibrinogen(FIB)levels in 2 groups were decreased compared with before treatment:experimental group:(7.33±1.77)mmol/L vs.(9.45±2.05)mmol/L,(10.33±2.07)mmol/L vs.(13.57±2.88)mmol/L,(7.22±1.28)%vs.(9.25±1.78)%,(1.98±0.29)mmol/L vs.(6.05±1.24)mmol/L,(2.95±0.37)mmol/L vs.(4.35±0.76)mmol/L,(0.78±0.23)mg/L vs.(1.85±0.79)mg/L,(2.57±0.37)g/L vs.(7.15±1.36)g/L,control group:(8.21±1.85)mmol/L vs.(9.68±2.17)mmol/L,(11.78±2.26)mmol/L vs.(13.89±3.02)mmol/L,(8.25±1.36)%vs.(9.37±1.86)%,(2.77±0.42)mmol/L vs.(6.08±1.22)mmol/L,(3.84±0.44)mmol/L vs.(4.27±0.72)mmol/L,(1.34±0.52)mg/L vs.(1.81±0.72)mg/L,(5.25±0.84)g/L vs.(7.11±1.28)g/L,the differences were statistically significant(P<0.05).The levels of FPG,2 h PG,HbA1c,TC,LDL-C,D-D and FIB between the two groups were statistically significant(P<0.05).High density lipoprotein cholesterol(HDL-C)level,left ventricular ejection fraction(LVEF),cardiac blood transfusion volume(CO),stroke output(SV),thrombin time(TT)and partially activated prothrombin time(APTT)were all increased:experimental group:(1.76±0.30)mmol/L vs.(1.07±0.28)mmol/L,(68.64±12.91)%vs.(45.05±12.24)%,(4.88±0.91)L/min vs.(3.95±1.12)L/min,(53.66±5.43)ml/min vs.(43.27±4.88)ml/min,(31.83±4.39)s vs.(23.25±3.44)s,(13.85±2.17)s vs.(10.75±1.56)s,control group:(1.43±0.26)mmol/L vs.(1.06±0.24)mmol/L,(60.37±11.86)%vs.(45.42±12.41)%,(4.37±0.84)L/min vs.(4.17±1.16)L/min,(47.86±5.27)ml/min vs.(43.36±4.94)ml/min,(27.24±3.91)s vs.(23.78±3.62)s,(12.74±1.94)s vs.(10.89±1.78)s,the differences were statistically significant(P<0.05).There were significant differences in HDL-C,LVEF,CO,SV,TT and APTT between the two groups(P<0.05).The incidence of adverse reactions in experimental group was lower than that in control group during treatment:5.00%(3/60)vs.16.67%(10/60),and the difference was statistically significant(P<0.05).Conclusions Dapagliflozin combined with tirofiban in the treatment of patients with type 2 diabetes mellitus complicated with coronary heart disease has obvious curative effect,and can improve blood glucose and blood lipid levels,coagulation function and cardiac function,with high safety.
作者
范奎龙
胡春阳
汝鹏
宁彬
Fan Kuilong;Hu Chunyang;Ru Peng;Ning Bin(Department of Cardiovascular Medicine,Fuyang People′s Hospital,Fuyang 236000,China)
出处
《中国医师进修杂志》
2023年第10期871-876,共6页
Chinese Journal of Postgraduates of Medicine
基金
安徽省卫生健康委科研项目(AHWJ2021b070)。
关键词
糖尿病
2型
替罗非班
达格列净
经皮冠状动脉介入术
疗效
安全性
Diabetes mellitus,type 2
Tirofiban
Dapagliflozin
Percutaneous coronary intervention
Efficacy
Safety
