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JAMA :二甲双胍对肾功能减退的糖尿病患者安全性良好

2019-09-24 MedSci MedSci原创

研究发现,在坚持单药治疗的糖尿病伴肾功能下降患者中,二甲双胍治疗与磺脲类药物相比,MACE风险更低

安全问题是限制二甲双胍在肾脏疾病患者中应用的最主要原因,近日研究人员比较糖尿病和肾功能减退患者继续使用二甲双胍或磺酰脲治疗的主要不良心血管事件(MACE)差异。

174882名二甲双胍和磺脲类药物的持续使用者参与研究,患者肾功能降低--肾小球滤过率<60 ml/min/1.73 m2 或肌酐≥1.4mg/dl(女性)或≥1.5mg/dl(男性) 。并在肾功能降低后继续接受降糖药物治疗。研究的主要终点为MACE,包括急性心肌梗死卒中、短暂性脑缺血发作或心血管死亡住院。

共有67749名二甲双胍和28976名磺酰脲持续单药治疗使用者;加权队列包括24679名二甲双胍和24799名磺酰脲使用者(平均年龄70岁,48497名男性,平均肾小球滤过率为55.8毫升/分钟/1.73平方米,血红蛋白A1c水平为6.6%。在随访期间(二甲双胍组1.0年,磺脲类药物组1.2年),二甲双胍组有1048例(23.0/1000人-年)发生MACE,磺脲类药物组有1394例(29.2/1000人-年)发生MACE。与磺脲类药物相比,二甲双胍的MACE原因特异性校正危险比为0.80。与磺脲类药物相比,二甲双胍每1000人-年的调整率差为5.8。

研究发现,在坚持单药治疗的糖尿病伴肾功能下降患者中,二甲双胍治疗与磺脲类药物相比,MACE风险更低。

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    2020-01-09 yese
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    2019-09-24 misszhang

    二甲双胍,神药!

    0

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    2019-09-24 misszhang

    谢谢MedSci提供最新的资讯

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