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·论著·

达格列净对 2 型糖尿病患者急性心肌梗死后

住院期间新发心房颤动发生风险的影响研究

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郑汝杰，王越，江耀辉，张金盈 * 查看原文

【摘要】 背景 新发心房颤动是急性心肌梗死的常见并发症，其发生率为 5%~20%。急性心肌梗死后新发心
房颤动患者死亡风险和卒中风险显著增加。糖尿病是急性心肌梗死也是心房颤动的危险因素，在疾病进程中起着重要
作用。达格列净作为一种新型降糖药物，其降糖效果确切，然而鲜有研究报道其对糖尿病患者急性心肌梗死后心房颤
动发生风险的影响。目的 探讨达格列净对 2 型糖尿病患者急性心肌梗死后新发心房颤动发生风险的影响。方法 收
集 2018 年 12 月至 2020 年 6 月因急性心肌梗死于郑州大学第一附属医院心内科住院的 2 型糖尿病患者 764 例，根据
是否存在新发心房颤动将研究对象分为新发心房颤动组 188 例和无心房颤动组 576 例。收集研究对象的人口统计学资
料、超声心动图检查指标和实验室检验指标。采用多因素 Logistic 回归分析探讨达格列净对 2 型糖尿病患者急性心肌
梗死后新发心房颤动发生风险的影响。结果 新发心房颤动组年龄、男性比例、吸烟比例、糖化血红蛋白、左心房内
径、N 末端 B 型钠尿肽前体（NT-proBNP）、C 反应蛋白（CRP）水平高于无心房颤动组，而收缩压、胰岛素比例、
达格列净比例、高密度脂蛋白水平低于无心房颤动组（P<0.05）。多因素 Logistic 回归分析结果显示，达格列净与急
性心肌梗死后新发心房颤动风险降低相关，达格列净降低了 2 型糖尿病患者急性心肌梗死后 34% 的新发心房颤动风险
（OR=0.66，P=0.008）。结论 达格列净的使用与 2 型糖尿病患者急性心肌梗死后新发心房颤动的低风险相关。
【关键词】 糖尿病，2 型；达格列净；心肌梗死；心房颤动；住院；降低风险行为；影响因素分析
【中图分类号】 R 587.1 【文献标识码】 A DOI：10.12114/j.issn.1007-9572.2021.01.024
郑汝杰，王越，江耀辉，等 . 达格列净对 2 型糖尿病患者急性心肌梗死后住院期间新发心房颤动发生风险的影响
研究［J］. 中国全科医学，2022，25（5）：542-546. ［www.chinagp.net］
ZHENG R J，WANG Y，JIANG Y H，et al. Effect of Dapagliflozin on the risk of new-onset atrial fibrillation during
hospitalization for acute myocardial infarction in patients with type 2 diabetes［J］. Chinese General Practice，2022，25（5）：
542-546.

Effect of Dapagliflozin on the Risk of New-onset Atrial Fibrillation during Hospitalization for Acute Myocardial
Infarction in Patients with Type 2 Diabetes ZHENG Rujie，WANG Yue，JIANG Yaohui，ZHANG Jinying *
Cardiovascular Department，the First Affiliated Hospital of Zhengzhou University，Zhengzhou 450000，China
*
Corresponding author：ZHANG Jinying，Chief physician；E-mail：jyzhang@zzu.edu.cn
【Abstract】 Background Atrial fibrillation is a common complication of acute myocardial infarction with an incidence
varying from 5% to 20%. New-onset atrial fibrillation developing after acute myocardial fibrillation indicates a significantly
increased risk of death and stroke. Diabetes mellitus，as a shared risk factor in both acute myocardial infarction and atrial
fibrillation，plays an important role in the development of acute myocardial infarction and atrial fibrillation. It has been reported
that dapagliflozin，a new hypoglycemic agent，has a positive effect on lowering glucose. However，there are few data regarding
its impact on the risk of atrial fibrillation after acute myocardial infarction in patients with diabetes. Objective To investigate
the effect of dapagliflozin on the risk of new-onset atrial fibrillation after acute myocardial infarction in patients with type 2
diabetes mellitus. Methods Total 764 patients with type 2 diabetes mellitus admitted during December 2018 to June 2020 in
Cardiovascular Department，the First Affiliated Hospital of Zhengzhou University for acute myocardial infarction were selected.
The demographic data，echocardiographic indices and laboratory data were collected，and compared between participants
with new-onset atrial fibrillation（n=188）and those without（n=576）. Multivariate Logistic regression analysis was used to
assess the impact of dapagliflozin on the risk of new-onset atrial fibrillation after acute myocardial infarction. Results Patients

基金项目：国家自然科学基金资助项目（81870328）
450000 河南省郑州市，郑州大学第一附属医院心血管内科
*
通信作者：张金盈，主任医师；E-mail：jyzhang@zzu.edu.cn
本文数字出版日期：2021-08-27