摘要
目的 针对糖尿病性心肌病(DCM)患者行坎地沙坦酯联合二甲双胍治疗,总结临床疗效,分析其对心脏重构及预后的影响。方法 前瞻性选取2019年1月至2021年12月柳州市柳铁中心医院收治的80例DCM患者作为研究对象,按随机数字表法分为观察组与对照组,每组40例。观察组给予常规治疗+坎地沙坦酯联合二甲双胍治疗,对照组给予常规治疗。比较两组患者的血糖指标、心脏重构指标[左心室舒张末期内径(LVEDD)、左心室舒张末期容积(LVEDV)、左心室收缩末期内径(LVESD)、左心室收缩末期容积(LVESV)、左心室射血分数(LVEF)]、血脂指标治疗前后变化情况,评估治疗效果,随访不良反应发生率及再入院率。结果 治疗前,两组患者空腹血糖、餐后2 h血糖(2 h PG)、糖化血红蛋白(Hb A1c)指标比较,差异均无统计学意义(P> 0. 05);治疗3个月后,观察组患者的空腹血糖、2 h PG、Hb A1c为(5. 09±0. 33) mmol/L、(5. 97±0. 23) mmol/L、(6. 81±0. 27)%,均明显低于对照组[(6. 12±0. 20) mmol/L、(6. 63±0. 47) mmol/L、(7. 41±0. 21)%],差异均有统计学意义(P<0.05)。治疗前,两组患者的各项心脏重构指标相比,差异均无统计学意义(P>0.05);治疗3个月后,观察组患者的LVEDD、LVEDV、LVESD、LVESV为(50. 48±6. 03)mm、(95. 76±10. 25) mL、(34. 20±4. 37) mm、(65. 74±10. 23) mL,均低于对照组[(56. 28±5. 61) mm、(112. 59±11. 20)mL、(38. 45±4. 20) mm、(72. 59±12. 58) mL],LVEF为(61. 23±6. 72)%,高于对照组[(53. 49±5. 56)%],差异均有统计学意义(P<0.05)。治疗前,两组患者各项血脂指标比较,差异均无统计学意义(P> 0. 05);治疗3个月后,观察组患者甘油三酯、总胆固醇、LDL-C水平为(0. 75±0. 32)、(2. 36±0. 19)、(1. 72±0. 14) mmol/L,均明显低于对照组[(1. 65±0. 52)、(4. 26±0. 36)、(2. 93±0. 22) mmol/L],HDL-C为(1. 88±0. 13) mmol/L,高于对照组[(1. 51±0. 42)mmol/L],差异均有统计学意义(P<0.05)。两组总有效率对比观�
Objective For patients with diabetic cardiomyopathy(DCM),candesartan medoxomil combined with metformin was used to summarize the clinical efficacy and analyze its impact on cardiac remodeling and prognosis.Methods A total of 80 patients with DCM who were admitted to Liuzhou Liutie Central Hospital from January 2019 to December 2021 were prospectively selected as the research subjects.They were divided into an observation group and a control group according to the random number table method,with 40 cases in each group.The observation group was given conventional treatment+candesartan cilexetil combined with metformin,and the control group was given conventional treatment.Blood glucose indexes and cardiac remodeling indexes[left ventricular end-diastolic diameter(LVEDD),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic diameter(LVESD),left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),The changes of ejection fraction(LVEF)]and blood lipid indexes before and after treatment were compared,the treatment effect was evaluated,and the incidence of adverse reactions and readmission rates were followed up.Resluts Before treatment,there was no significant difference in fasting blood glucose(FPG),2 h postprandial blood glucose(2 h PG)and hemoglobin A1c(HbA1c)between the two groups(P>0.05);after 3 months of treatment,the fasting blood glucose,2 h PG and HbA1c of the observation group were[(5.09±0.33)mmol/L,(5.97±0.23)mmol/L,(6.81±0.27)%],which were significantly lower than those of the control group[(6.12±0.20)mmol/L,(6.63±0.47)mmol/L,(7.41±0.21)%],the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in cardiac remodeling indexes between the two groups(P>0.05);after 3 months of treatment,the levels of LVEDD,LVEDV,LVESD and LVESV of the observation group were(50.48±6.03)mm,(95.76±10.25)mL,(34.20±4.37)mm,(65.74±10.23)mL,which were lower than tho
作者
梁晓
熊小奇
肖丽红
LIANG Xiao;XIONG Xiao-qi;XIAO Li-hong(Department of General Practice,Liuzhou Liutie Central Hospital,Liuzhou Guangxi 545007,China;Department of Cardiovascular,Liuzhou Liutie Central Hospital,Liuzhou Guangxi 545007,China;Department of General Medicine,Liuzhou people's Hospital,Liuzhou Guangxi 545006,China)
出处
《临床和实验医学杂志》
2022年第16期1712-1716,共5页
Journal of Clinical and Experimental Medicine
基金
广西卫健委科研课题项目(编号:Z20200850)。
关键词
糖尿病性心肌病
坎地沙坦酯
二甲双胍
心脏重构
预后
Diabetic cardiomyopathy
Candesartan cilexetil
Metformin
Cardiac remodeling
Prognosis
