达格列净联合胺碘酮治疗2型糖尿病合并阵发性房颤的疗效及对左心房功能及左心耳容积的影响

摘要
图/表
参考文献
相关文章 (2)

全文: PDF (2192 KB) HTML (0 KB)
输出: BibTeX | EndNote (RIS)

摘要 目的: 观察达格列净联合胺碘酮治疗2型糖尿病（T2DM）合并阵发性心房颤动（PAF）患者的疗效及对左心房功能及左心耳容积的影响。方法: 选取2020年8月―2021年11月邢台市第三医院心内科收治的T2DM合并PAF患者94例为研究对象,随机分为对照组及观察组,各47例,对照组在患者基础疾病治疗后给予胺碘酮口服治疗,观察组在对照组治疗基础上给予达格列净口服治疗,两组均治疗6个月。观察两组患者治疗前、治疗3个月及治疗6个月后PAF发作次数、持续时间及平均心率变化情况;采用多普勒超声检查患者左心房前后径（LAD）、左心房舒张末期面积（LAEDA）、心房容量（AV）、左心房射血分数（LAEF）及左心耳舒张末期容积（LAAEDV）变化情况。结果: 经重复测量方差结果显示,观察组与对照组治疗前、治疗3个月、6个月,PAF发作次数、持续时间、平均心率、FPG、2hPG、HbA1c、LAD、LAEDA、AV、LAEF及LAAEDV组别与时间点的交互作用差异有统计学意义;与对照组比较,观察组患者治疗后PAF发作次数减少,PAF持续时间缩短,平均心率、FPG、2hPG、HbA1c水平降低,LAD缩短,LAEDA减少,AV及LAAEDV降低,LAEF升高;观察组临床疗效优于对照组,两组不良反应发生率无明显差异。结论: 达格列净联合胺碘酮治疗T2DM合并PAF具有良好的临床效果,其机制可能与进一步改善糖代谢,改善左心房结构与功能有关。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	孙旭杜
	董梅
	张姗

关键词 ： 2型糖尿病, 阵发性房颤, 达格列净, 胺碘酮, 左房功能呢, 左心耳容积

Abstract：Objective To observe the efficacy of Dapagliflozin combined with amiodarone in the treatment of patients with type 2 diabetes mellitus (T2DM) complicated with paroxysmal atrial fibrillation (PAF) and its effect on left atrial function and left atrial appendage volume. Methods 94 patients with T2DM complicated with PAF admitted to the Department of Cardiology of the third Xingtai hospital from August 2020 to November 2021 were selected as the research objects. They were randomly divided into control group and observation group, 47 cases in each group. The patients in the control group were treated with amiodarone orally after the treatment of basic diseases, and the patients in the observation group were treated with Dapagliflozin orally on the basis of the treatment of the control group. Both groups were treated for 6 months. The frequency of PAF, duration and average heart rate were observed before treatment, 3 months after treatment and 6 months after treatment; Doppler ultrasound was used to examine the changes of left atrial anteroposterior diameter (LAD), left atrial end diastolic area (LAEDA), atrial volume (AV), left atrial ejection fraction (LAEF) and left atrial appendage end diastolic volume (LAAEDV). Results The results of repeated measurement of variance showed that there were significant differences between the observation group and the control group in PAF attack frequency, duration, mean heart rate, FPG, 2hPG, HbA1c, LAD, LAEDA, AV, LAEF and LAAEDV at groups and time points before treatment, 3 months after treatment and 6 months after treatment; Compared with the control group, the number of PAF episodes, PAF duration, mean heart rate, FPG, 2hPG, HbA1c, LAD, LAEDA, AV and LAAEDV decreased, and LAEF increased in the observation group after treatment; The clinical efficacy of the observation group was better than that of the control group, and there was no significant difference in the incidence of adverse reactions between the two groups. Conclusion Dapagliflozin combined with amiodarone has a good clinical effect in the treatment of T2DM complicated with PAF. The mechanism may be related to the further improvement of glucose metabolism and the improvement of left atrial structure and function.

Key words： type 2 diabetes paroxysmal atrial fibrillation dapagliflozin amiodarone left atrial function left atrial appendage volume

收稿日期: 2022-06-13

中图分类号:

R587.1

基金资助:邢台市重点研发计划自筹项目（NO.2021ZC109）

通讯作者: 孙旭杜,E-mail：sxudu@126.com

引用本文:

孙旭杜, 董梅, 张姗. 达格列净联合胺碘酮治疗2型糖尿病合并阵发性房颤的疗效及对左心房功能及左心耳容积的影响[J]. 金宝搏官方188学报(医学版), 2023, 20(1): 72-75. SUN Xudu, DONG Mei, ZHANG Shan. Effect of dagglitazone combined with amiodarone in the treatment of type 2 diabetes mellitus complicated with paroxysmal atrial fibrillation and its effect on left atrial function and left atrial appendage volume. HuNan ShiFan DaXue XueBao(YiXueBan), 2023, 20(1): 72-75.

链接本文:

http://yxb.hunnu.edu.cn/CN/ 或 http://yxb.hunnu.edu.cn/CN/Y2023/V20/I1/72

[1] Cho NH, Shaw JE, Karuranga S, et al.IDF diabetes atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045[J]. Diabetes Res Clin Pract, 2018, 138(4): 271-281.
[2] 中国老年2型糖尿病防治临床指南编写组, 中国老年医学学会老年内分泌代谢分会, 中国老年保健医学研究会老年内分泌与代谢分会, 等. 中国老年2型糖尿病防治临床指南 (2022年版)[J]. 中华内科杂志, 2022, 61(1): 12-50.
[3] 曲晓燕, 万春霞, 刘秀云, 等.230例糖尿病患者心电图分析[J]. 现代电生理学杂志, 2015, 22(4): 208-210.
[4] 杜薇, 邱清艳, 戴闽, 等. 左心耳容积与心房颤动射频消融术后复发的关系[J]. 中国心血管杂志, 2020, 25(5): 425-431.
[5] 屈文涛, 康亚宁, 许磊, 等. 高血压并发阵发性心房颤动患者的左房形变功能与血清NT-proBNP的相关性[J]. 临床心血管病杂志, 2021, 37(2): 156-160
[6] 王明杰, 厉菁. 胺碘酮治疗阵发性房颤的效果评价[J]. 上海医学, 2022, 43(5): 28-31.
[7] WivioTT SD, Raz I, Bonaca MP, et al. Dapagliflozin and cardiovascular out comes in type 2 diabetes[J]. N Engl J Med, 2019, 380(4): 347-357.
[8] 杨光全, 展庆垒, 吴付轩. 达格列净对慢性心力衰竭合并2型糖尿病患者左心室舒张功能的影响[J]. 中国循证心血管医学杂志, 2019, 11(9): 1118-1124.
[9] Thomas A, Marc P, Mosenzon O, et al.Effect of dapagliflozin on atrial fibrillation in patients with type 2 diabetes mellitus[J]. Circulation, 2020, 141(14): 1227-1234.
[10] 中华医学会糖尿病学分会. 中国2型糖尿病防治指南 (2017年版)[J]. 中国实用内科杂志, 2018, 38(4): 292-344.
[11] 黄从新, 张澍, 黄德嘉, 等. 心房颤动:目前的认识和诊疗建议-2015[J]. 中国心脏起搏与心电生理杂志, 2015, 29(5): 377-434.
[12] 张丽娜, 潘琦, 黄薇, 等. 北京地区2型糖尿病患者糖尿病心脏自主神经病变现况调查[J]. 中华糖尿病杂志, 2021, 13(6): 570-577.
[13] Huxley RR, Alonso A, Lopez FL, et al.Type 2 diabetes, glucose homeostasis and incident atrial fibrillation: the atherosclerosis risk in communities study[J]. Heart, 2012, 98(2): 133-138.
[14] Huxley RR, Filion KB, Konety S, et al.Meta-analysis of cohort and case-control studies of type 2 diabetes mellitus and risk of atrial fibrillation[J]. Am J Cardiol, 2011, 108(1): 56-62.
[15] Perkovic V, Jardine MJ, Neal B, et al.Canagliflozin and renal outcomes in type 2 diabetes and nephropathy[J]. N Engl J Med, 2019, 380(24): 2295-2306.
[16] 赵玉清, 刘恒, 杨亚楠, 等. 沙库巴曲缬沙坦联合胺碘酮治疗合并阵发性房颤的老年性心力衰竭的疗效观察[J]. 河北医药, 2019, 41(3): 404-410.
[17] 刘颖, 董京京, 江涛, 等. 芪苈强心胶囊和胺碘酮治疗老年心力衰竭合并阵发性房颤的价值研究[J]. 辽宁中医杂志, 2021, 48(6): 136-139.
[18] 陈宇宁, 严萍, 刘如松, 等. 达格列净治疗糖尿病合并高血压的临床效果[J]. 临床合理用药杂志, 2021, 14(31): 50-53.
[19] 梁万添, 陈姣, 庞军刚, 等. 达格列净对糖尿病合并高血压患者左心室重构的影响分析[J]. 中华老年心血管病杂志, 2022, 24(6): 591-594.
[20] Hugh C, Gerhard H, Riccardo C, et al.2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: Executive summary[J]. Europace, 2018, 20(1): 157-208.
[21] 黄洁, 彭艳铃, 刘英, 等. 房颤患者左心房、左心耳收缩期应变率与射频消融治疗预后关系的探讨[J]. 中华灾害救援医学, 2018, 6(2): 74-77.
[22] 闫艳, 李新立. 二维斑点追踪显像及实时三维成像评价阵发性房颤患者射频消融术后左心房结构和功能变化[J]. 四川大学学报 (医学版), 2019, 50(3): 390-395.
[23] Tanaka K, Koga M, Sato K, et al.Three-dimensional analysis of the left atrial appendage for detecting[J]. Inter J Stroke, 2014, 9(8): 1045-1051.
[24] 陈静, 顾崇怀, 项学军, 等. 达格列净对冠心病合并2型糖尿病伴高血压患者的临床疗效观察[J]. 实用药物与临床, 2022, 25(7): 595-600.