中国合理用药探索2026，Vol.23Issue(3)：56-62,7.DOI:10.3969/j.issn.2096-3327.2026.03.007
达格列净联合利尿剂对2型糖尿病合并慢性心力衰竭患者尿酸水平与预后的影响
Effects of Dapagliflozin Combined with Diuretics on Uric Acid and Prognosis in Patients with Type 2 Diabetes Mellitus and Chronic Heart Failure
摘要
Abstract
Objective:To dapagliflozin combined with diuretics on serum uric acid(UA)levels and prognosis in patients with type 2 diabetes mellitus(T2DM)complicated by chronic heart failure(CHF).Methods:In this prospective study,104 patients with T2DM complicated by CHF who were treated at a hospital between June 2019 and June 2024 were selected and randomly assigned by a random number table method to a control group(diuretics alone)and a study group(dapagliflozin combined with diuretics),with 52 cases in each group.Blood glucose,cardiac function,renal function,clinical efficacy,adverse reactions,and prognosis were compared between the two groups.Results:After 3 months of treatment,fasting blood glucose(FBG),2-h postprandial blood glucose(2hPG),glycated hemoglobin(HbA1c),mean amplitude of glycemic excursions(MAGE),largest amplitude of glycemic excursions(LAGE),glucose coefficient of variation(GlucV),left ventricular mass index(LVMI),left ventricular remodeling index(LVRI),N-terminal pro-B-type natriuretic peptide(NT-proBNP),brain natriuretic peptide(BNP),UA,blood urea nitrogen(BUN),and serum creatinine(SCr)decreased in both groups(P<0.05),and these indices were lower in the study group than in the control group(P<0.05).Cardiac index(CI),left ventricular ejection fraction(LVEF),and glomerular filtration rate(GFR)increased in both groups(P<0.05)and were higher in the study group than in the control group(P<0.05).The overall response rate was higher in the study group than in the control group(94.23%vs.80.77%,P<0.05).No significant difference was observed in the overall incidence of adverse reactions between the two groups(P>0.05).The incidences of major adverse cardiovascular events(MACE)and readmission due to CHF were lower in the study group than in the control group(3.85%vs.17.31%and 1.92%vs.13.46%,P<0.05).Conclusion:Dapagliflozin combined with diuretics are effective in patients with T2DM complicated by CHF.This regimen can more effectively control glycemic fluctuation,improve cardiac function,reduce UA levels,protect renal function,and improve prognosis without increasing the overall risk of adverse reactions.关键词
达格列净/利尿剂/2型糖尿病/慢性心力衰竭/尿酸/预后Key words
dapagliflozin/diuretics/type 2 diabetes mellitus/chronic heart failure/uric acid/prognosis分类
医药卫生引用本文复制引用
王朝旭,刘明明,沈亚非,谢亚争,吴丹,王丹萍..达格列净联合利尿剂对2型糖尿病合并慢性心力衰竭患者尿酸水平与预后的影响[J].中国合理用药探索,2026,23(3):56-62,7.基金项目
河南省二〇二一年科技发展计划(212102310798) （212102310798）
