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慢性射血分数降低性心力衰竭合并糖耐量受损患者服用恩格列净的有效性和安全性

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摘要:

目的 观察慢性射血分数降低性心力衰竭(HFrEF)合并糖耐量受损(IGT)患者服用恩格列净的有效性和安全性。方法 选择2020年12月至2021年2月于郑州大学第一附属医院就诊的慢性HFrEF合并IGT的患者,以1:1的比例随机分为恩格列净组(n=55)和对照组(n=55),记录其治疗前后的心功能指标和血糖情况和治疗期间的不良事件。结果 经12周的治疗,两组各剩余50例患者,两组患者的心功能指标、血糖情况均有改善,与对照组相比,恩格列净组的心功能指标、血糖情况改善更为显著[恩格列净组的增幅 vs. 对照组的增幅:左心室射血分数(LVEF):(6.77±4.21)% vs. (3.17±4.68)%;左心室舒张末期内径(LVEDD):[-(4.18±4.71)mm vs. -(2.15±4.35)mm];N末端脑钠肽前体(NTproBNP):[-(1645.34±892.36)pg/ml vs. -(1051.22±782.23)pg/ml];空腹血糖:[-(0.64±0.72)mmol/Lvs. -(0.35±0.61)mmol/L];糖负荷后2 h血糖:[-(0.92±0.65)mmol/L vs. -(0.63±0.74)mmol/L];糖化血红蛋白:[-(0.24±0.12)% vs. -(0.16±0.16)%],P均<0.05]。12周的治疗期间,两组患者中不良事件[低血压、肾功能异常、血钾水平异常(高血钾、低血钾)、泌尿生殖系统感染、再入院、死亡]的发生率差异无统计学意义(P>0.05)。结论 慢性HFrEF合并IGT患者服用恩格列净后心功能和血糖情况均有改善,不良事件并未明显增加。

Abstract:

Objective To observe the efficacy and safety of empagliflozin in patients with chronic heart failure with reduced ejection fraction (HFrEF) combined with impaired glucose tolerance (IGT). Methods 110 patients with chronic HFrEF combined with IGT were chosen from the First Affiliated Hospital of Zhengzhou University from Dec. 2020 to Feb. 2021, and then randomly divided, in a 1:1 ratio, into empagliflozin group and control group (each n=55). The indexes of heart function and blood sugar conditions before and after treatment, and adverse events during treatment were recorded. Results After treatment of 12 weeks, there were 50 patients remained in each group, and indexes of heart function and blood sugar conditions were improved in 2 groups. Compared with control group, the improvements of heart function indexes and blood sugar conditions were more significant in empagliflozin group [increase in empagliflozin group vs. increase in control group: left ventricular ejection fraction (LVEF): [(6.77 ±4.21)% vs. (3.17±4.68)%]; left ventricular end-diastolic diameter (LVEDD): [-(4.18±4.71) mm vs. -(2.15± 4.35) mm]; N-terminal pro-brain natriuretic peptide (NT-proBNP): [-(1645.34±892.36) pg/ml vs. -(1051.22± 782.23) pg/ml]; fasting plasma glucose (FPG): [-(0.64±0.72) mmol/L vs. -(0.35±0.61) mmol/L]; plasma glucose of 2-h post glucose-load: [-(0.92±0.65) mmol/L vs. -(0.63±0.74) mmol/L]; glycated hemoglobin: [-(0.24± 0.12)% vs. -(0.16±0.16)%, all P<0.05]. During 12-week treatment, the differences in incidence rates of adverse events [hypotension, abnormal kidney function, abnormal blood potassium levels (hyperkalemia and hypokalemia), genitourinary infection, readmission and death] had no statistical significances between 2 groups (P>0.05). Conclusion The heart function and blood sugar conditions are improved with no significant increases of adverse events after taking empagliflozin in patients with chronic HFrEF combined with IGT.

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