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AIM:DPP-4抑制剂治疗T2DM心衰患者可将风险降到很低

2015-10-26 崔倩 译 MedSci原创

最近的一些研究表明,二肽基肽酶-4(DPP-4)抑制剂可进行血糖控制,但人们也因此提高了对2型糖尿病(T2DM)的心衰患者风险的关注。然而,大规模的关于在二甲双胍中添加DPP-4抑制剂与磺酰脲类药物对心血管结果的影响的研究仍然很少。该研究的目的是在T2DM患者使用二甲双胍治疗时,比较加入DPP-4抑制剂与磺脲类药物临床结果。该项全国性研究数据来源于台湾国家保险研究数据库,在台湾进行。该研究的参与者

最近的一些研究表明,二肽基肽酶-4(DPP-4)抑制剂可进行血糖控制,但人们也因此提高了对2型糖尿病(T2DM)的心衰患者风险的关注。然而,大规模的关于在二甲双胍中添加DPP-4抑制剂与磺酰脲类药物对心血管结果的影响的研究仍然很少。

该研究的目的是在T2DM患者使用二甲双胍治疗时,比较加入DPP-4抑制剂与磺脲类药物临床结果。

该项全国性研究数据来源于台湾国家保险研究数据库,在台湾进行。该研究的参与者为在2009年和2012年间,年龄在20岁或以上的所有2型糖尿病患者。总共有10089对倾向评分配对的DPP-4抑制剂使用者和磺脲类使用者。

暴露于磺脲类和DPP-4抑制剂的Cox模型作为随时间变化的协变量被用来比较结果。研究人员下面的结果进行了分析:各种原因的死亡率、主要心血管不良事件(MACEs)(包括缺血性卒中和心肌梗死)、住院治疗心脏衰竭、低血糖。研究人员对患者进行术后随访直至死亡或2013年12月31日。

DPP-4抑制剂降低了全因死亡风险(危险比[HR],0.63[95%Cl,0.55〜0.72]),以及MACEs(HR,0.68[Cl,0.55〜0.83]),缺血性卒中(HR,0.64[Cl,0.51至0.81]),和低血糖(HR,0.43[CI,0.33至0.56])的概率,而磺酰脲类添加到二甲双胍中对心脏衰竭患者的心肌梗塞和住院风险没有影响。

与磺脲类药物相比,DPP-4抑制剂作为附加二甲双胍治疗使用时,均与全因死亡风险、主要心血管不良事件、缺血性卒中、低血糖风险的降低相关。

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    2016-02-20 jklm09
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    2015-10-28 gaoxiaoe
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    2015-10-28 梦想天空

    0

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    2015-10-28 miaotao

    Dpp4的临床应用确实不错

    0

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    2015-10-27 lixh1719

    DDP4的远期不良反应值得观注

    0

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