2018

150 руб.

Хроническая сердечная недостаточность и сахарный диабет: патогенез и возможности лечения

Обрезан А. Г.1, 2, Куликов Н. В.1
1 ФГБОУ ВО «Санкт-Петербургский государственный университет», Санкт-Петербург, Россия
2 ООО «Международный медицинский центр «СОГАЗ», Санкт-Петербург, Россия

Ключевые слова: сердечная недостаточность, сахарный диабет, патогенез, лечение

DOI: 10.18087/cardio.2018.7.10156

В статье приводятся данные научных исследований о распространенности сахарного диабета (СД) у больных хронической сердечной недостаточностью (ХСН), патогенетических механизмах развития сердечной недостаточности у больных СД, факторах риска развития ХСН (гипергликемия, повышенный индекс массы тела, возраст, ишемическая болезнь сердца, нефропатии, протеинурия, длительность течения СД и др.). Показаны результаты анализа смертности у пациентов с СД или без него в зависимости от фракции выброса. Приводится характеристика различных препаратов для лечения ХСН, в том числе у больных СД, выделены перспективные направления лечения этой группы пациентов. Для пациентов с СД и ХСН могут быть эффективными ингибиторы SGLT2, в первую очередь эмпаглифлозин, с доказанными положительными кардиальными эффектами. Показана эффективность лечения при изменении образа жизни: с помощью снижения массы тела, физических упражнений, диеты и т. д. у пациентов с ожирением при наличии СД и без него. Кроме того, есть данные о положительных эффектах метформина, который снижает доступность энергетического субстрата за счет уменьшения объема эндогенной глюкозы при ХСН у пациентов с СД.
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Обрезан А. Г., Куликов Н. В. Хроническая сердечная недостаточность и сахарный диабет: патогенез и возможности лечения. Кардиология. 2018;58(7):85–94.

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