| Objective: To observe the changes of blood glucose,body weight,heart and kidney function on elderly patients with HFr EF and T2 DM after taking dapagliflozin,and to evaluate the clinical value of dapagliflozin in elderly patients with HFr EF and T2 DM.Methods: Fifty consecutive patients who met the inclusion criteria in the Department of Cardiology,the second hospital of Hebei Medical University from February 2020 to August 2020 were included.All patients did not take SGLT2 inhibitors and other hypoglycemic agents were used for at least half a year before inclusion All patients were randomly divided into the observation group and the control group,26 cases in the observation group and 24 cases in the control group.Both groups were given conventional anti heart failure and hypoglycemic treatment.The observation group was treated with dapagliflozin 10 mg for 3 months on the basis of conventional hypoglycemic treatment,while the control group continued the original hypoglycemic regimen.The baseline clinical data,Hb A1 c level and weight change,BNP level,cardiac function parameters(LVEF、LVEDD、E/e’),renal function related indexes(serum creatinine,serum uric acid),the occurrence of composite endpoint events(cardiac death and rehospitalization with worsening heart failure)during 3 months of treatment,and the occurrence of adverse events during 3 months of treatment.Results: there were no significant differences in gender,age,systolic pressure,diastolic pressure,average heart rate,BMI,fasting blood glucose,Hb A1 c,NYHA classification of heart failure,combined basic diseases,types of basic drugs for heart failure treatment and Application of hypoglycemic drugs between the two groups(P>0.05);Before treatment,the Hb A1 c levels were similar(P>0.05).After 3 months of treatment,the Hb A1 c were decreased compared with the baseline value,and the observation group decreased more significantly(7.3± 0.4 vs.8.0±0.6,P<0.05);Before treatment,the weight was similar(P>0.05).After 3 months of treatment,there was no significant difference in the average weight of the two groups(P>0.05),but the weight of the observation group was more lower(66.1±5.3 vs.67.0±5.1)The BNP level of the two groups was similar(P>0.05),after treatment,the BNP level was decreased compared with the baseline value,and the observation group decreased more significantly(432±164 vs.649±166,P<0.05);Before treatment,LVEF,LVEDD and E/e’ levels of the two groups were similar(P>0.05).After treatment,the LVEF levels was higher than the baseline values,and the observation group more increased(40.8±2.4 vs.37.7±1.7,P<0.05),LVEDD and E/e’ were lower than the baseline values,and the observation group more decreased(53.9±1.9 vs.56.8±2.4,P<0.05 and11.6±1.6 vs.13.3±1.5,P<0.05);Before treatment,the Scr levels were similar(P>0.05),and after treatment,there was no significant change(P>0.05);Before treatment,the SUA levels were similar(P>0.05).After treatment,the SUA level of the control group were not significantly changed compared with the baseline value(P>0.05),the SUA level of the observation group decreased more significantly(373.4±71.9 vs.452.1±65.9,P<0.05);while During the observation period,there was no significant difference in the incidence of composite endpoint events between two groups(P>0.05);There were no significant differences in the hypoglycemia events,urinary tract infection and gastrointestinal adverse reactions betweentwo groups(P>0.05).Conclusions: on the basis of effective hypoglycemic effect,dapagliflozin can not only significantly improve the cardiac function of elderly patients with HFr EF and T2 DM,but also reduce body weight,decrease the level of SUA and have better safety. |
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