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OA

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.