2024 年第 2 期 第 19 卷

钠-葡萄糖协同转运蛋白2抑制剂对急性心肌梗死合并2型糖尿病患者临床指标及预后的影响

Effect of sodium-glucose cotransporter 2 inhibitor on clinical parameters and prognosis of patients with acute myocardial infarction complicated with type 2 diabetes mellitus

作者：王凯汪麟胡广全范婷婷何非程诚

英文作者：Wang Kai Wang Lin Hu Guangquan Fan Tingting He Fei Cheng Cheng

单位：安徽医科大学第二附属医院心血管内科，合肥230601

英文单位：Department of Cardiovascular Medicine the Second Hospital of Anhui Medical University Hefei 230601 China

关键词：急性心肌梗死；2型糖尿病；钠-葡萄糖协同转运蛋白2抑制剂；主要不良心血管事件

英文关键词：Acutemyocardialinfarction;Type2diabetesmellitus;Sodium-glucosecotransporter2inhibitor;Majoradversecardiovascularevents

• 摘要：

• 目的  观察钠-葡萄糖协同转运蛋白2抑制剂（SGLT-2i）对急性心肌梗死（AMI）合并2型糖尿病(T2DM)患者临床指标及预后的影响。方法  回顾性选取2020年1月至2022年6月于安徽医科大学第二附属医院胸痛中心就诊后确诊AMI合并T2DM患者180例，根据入院后降糖方案分为对照组（79例，给予磺脲类、α-糖苷酶抑制剂、二甲双胍等药物）和观察组（101例，给予达格列净或恩格列净）。患者出院后定期随访，比较2组患者临床指标及主要不良心血管事件（MACE）发生情况。结果  所有患者随访6～12个月，结果显示观察组白细胞计数小于对照组［（7.4±1.6）×109/L比（8.7±1.6）×109/L］，左心室舒张末期内径改善优于对照组［（-0.527±1.462）mm比（1.359±2.111）mm］（均P＜0.05）。观察组MACE发生率低于对照组［5.4%(2/37)比25.0%(8/32)］，差异有统计学意义（P=0.020）。结论  SGLT-2i较其他降糖药物12个月内能改善AMI合并T2DM患者的心脏功能及预后，且能减轻该类患者的全身炎症反应。

• Objective  To observe the effect of sodium-glucose cotransporter 2 inhibitor (SGLT-2i) on clinical parameters and prognosis of patients with acute myocardial infarction (AMI) and type 2 diabetes mellitus(T2DM). Methods  Retrospective selection of 180 patients with AMI and T2DM diagnosed at Chest Pain Center, the Second Hospital of Anhui Medical University from January 2020 to June 2022 were enrolled. According to the selection of hypoglycemic regimens after admission, patients were divided into control group (79 cases, treated with sulfonylureas, α-glycossidase inhibitors, metformin etc.) and observation group (101 cases, administered with dapagliflozin  or empagliflozin). All patients were followed-up regularly after discharge, and the clinical indicators and major adverse cardiovascular events (MACE) were compared between the two groups. Results  All patients were followed-up for 6-12 months, the white blood cell count in the observation group was lower than that in the control group［(7.4±1.6)×109/L vs (8.7±1.6)×109/L］, and the improvement of left ventricular end diastolic diameter was better than that in the control group ［(-0.527±1.462)mm vs (1.359±2.111)mm］(all P＜0.05). The incidence of MACE in the observation group was lower than that in the control group ［5.4%(2/37) vs 25.0%(8/32)］(P=0.020). Conclusion  Compared with other hypoglycemic agents, SGLT-2i can improve cardiac function and prognosis in patients with AMI and T2DM within 12 months, while it can reduce the systemic inflammatory reaction in such patients.