中国当代医药2025，Vol.32Issue(4)：27-35,9.DOI:10.3969/j.issn.1674-4721.2025.04.06
葡萄糖钠协同转运体-2抑制剂对2型糖尿病合并急性心肌梗死直接经皮冠状动脉介入治疗心力衰竭预后的效果
Effect of sodium-glucose cotransporter-2 inhibitors on the prognosis of direct percutaneous coronary intervention in heart failure in type 2 dia-betes mellitus complicated with acute myocardial infarction
摘要
Abstract
Objective To investigate the efficacy and safety of sodium-glucose cotransporter-2 inhibitors(SGLT-2i)com-bined with"golden triangle"drugs(angiotensin converting enzyme inhibitors[ACEI]/angiotensin receptor blocker[ARB]/angiotensin receptor-neprilysin inhibitor[ARNI]+β-blockers+aldosterone receptor antagonists)in the prognosis of heart failure after direct percutaneous coronary intervention(PCI)for type 2 diabetes mellitus complicated with acute myocardial infarction.Methods A total of 80 patients with type 2 diabetes mellitus complicated with acute ST-segment elevation my-ocardial infarction admitted to the Department of Cardiovascular Medicine of the Third Affiliated Hospital of Nanchang Uni-versity from January to December 2022 who underwent direct PCI within 12 hours of admission were selected as the re-search objects,and they were divided into experimental group and control group according to random number table method,with 40 cases in each group.The experimental group was treated with Empagliflozin combined with"golden triangle"drug,and the control group was treated with Metformin Hydrochloride Tablets combined with"golden triangle"drug.During 1-year follow-up,various observation indexes of the two groups were compared,including blood pressure,heart rate,color Doppler ultrasonography(ventricular remodeling,ejection fraction,myocardial strain rate,etc.),glucose metabolism,body mass index,lipid metabolism,kidney function,and the occurrence of complications during treatment.Results During 1 year follow-up,the mean blood pressure and heart rate of both groups were controlled in the normal range.Left ventricular end diastolic diameter(LVEDD)and left ventricular end systolic diameter(LVESD)of experimental group were lower than those of control group at 6 months and 1 year,and left ventricular posterior wall(LVPW)of experimental group were lower than those of control group at 1,3,6 month.The interventricular septal thickness(IVST)and N terminal pro B type natriuretic peptide(NT-proBNP)were lower than those of control group,and the ratio of left ventricular ejection fraction(LVEF),myocardial strain rate,the ratio of mitral valve maximum velocity during early diastole to maximum velocity during atrial contraction(E/A)were higher than those of control group,with statistical significances(P＜0.05).After 3 months of treat-ment,the glycated hemoglobin(HbA1c)and total cholesterol(TC)of experimental group were higher than those of control group,after 1 month and 1 year of treatment,the TC of experimental group was lower than that of control group,after 1,3 and 6 months of treatment,the total glyceride(TG)and blood creatinine of experimental group were lower than those of control group,the glomerular filtration rate(eGFR)of experimental group was higher than that of control group,with statistical significances(P＜0.05).Conclusion Compared with other non-SGLT-2i inhibitors,SGLT-2i can improve ventricular re-modeling,lipid metabolism and renal function in long-term patients.The use of SGLT-2i combined with"golden triangle"drug has good safety for the prognosis of heart failure in patients with type 2 diabetes mellitus complicated with acute myocardial infarction after PCI.关键词
葡萄糖钠协同转运体-2抑制剂/2型糖尿病/急性心肌梗死/心力衰竭Key words
Sodium-glucose cotransporter-2 inhibitors/Type 2 diabetes mellitus/Acute myocardial infarction/Heart failure分类
临床医学引用本文复制引用
李军华,高鸿,江小杰..葡萄糖钠协同转运体-2抑制剂对2型糖尿病合并急性心肌梗死直接经皮冠状动脉介入治疗心力衰竭预后的效果[J].中国当代医药,2025,32(4):27-35,9.基金项目
江西省卫生健康委科技计划项目(202311204). （202311204）
