盘点:2019年4月13日BMJ研究精选

2019-04-13 MedSci MedSci原创

BMJ

2019年4月13日BMJ研究精选



【1】封面文章--应激相关疾病与血管疾病风险


近日研究人员评估应激相关疾病与随后的血管疾病风险之间的关联。

136637名应激相关疾病患者参与研究,包括创伤后应激障碍(PTSD)、急性应激反应、适应障碍和其他应激反应;171314名上述患者的未受影响的兄弟;以及1366370名健康志愿者,研究的主要终点是心血管疾病事件,包括缺血性心脏病、脑血管疾病、栓子/血栓形成、高血压疾病、心力衰竭、心律失常/传导障碍和致命性心血管疾病。

在长达27年的随访期间,暴露患者、未受影响的兄弟姐妹和志愿者的任何心血管疾病的粗发病率分别为每1000人10.5人、10.4人和6.9人。在基于兄弟姐妹的比较中,任何心血管疾病的风险比为1.64,在任何应激相关疾病诊断后的第一年内观察到的最高亚型特异性风险比为心力衰竭(6.95)。一年后风险比率降低(1.29)。相比于晚发疾病(≥50岁,1.24),应激相关疾病与早发性心血管疾病(<50岁,风险比率1.40)更密切。

【2】儿童糖尿病患者胰岛素治疗策略比较研究


近日研究人员比较了在儿童和年轻I型糖尿病患者中,采用持续皮下胰岛素输注(CSII)或每日多次注射(MDI)方案的疗效、安全性和成本效应差异。

293名纳入治疗分析(CSII人数: 144, MDI人数:149)。在12个月时,CSII与MDI组平均HbA1c的临床差异不显著(60.9 vs 58.5mmol/mol)。HbA1c低于58 mmol/mol的比例CSII组较低(66 vs 78例,46% vs 55%,RR=0.84)。组间患者严重低血糖糖尿病酮症酸中毒发生率均较低。在CSII治疗期间共报告了54起非严重事件和14起严重不良事件,在MDI治疗期间有17例非严重事件和8例严重不良事件。CSII比MDI花费增加1863英镑,但质量调整寿命年增量无显著增加。

【3】Sotagliflozin用于I型糖尿病效果显著


近日研究人员就双葡萄糖转运体(SGLT)1/2抑制剂Sotagliflozin对I性糖尿病患者的疗效和安全性进行了考察。

研究证实,Sotagliflozin可降低糖化血红蛋白、空腹血糖、餐后2小时血糖以及每日总、基础和推注胰岛素剂量,可改善一段时间内或连续血糖监测参数、降低体重、降低动脉血压以及蛋白尿,同时减少低血糖以及严重低血糖风险,但导致酮酸中毒、生殖感染以及腹泻不良事件风险增加。400 mg/d剂量组的治疗效果优于200 mg/d剂量组,且不会增加不良事件风险。

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1848733, encodeId=a1e81848e3333, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Fri Mar 20 15:55:00 CST 2020, time=2020-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364690, encodeId=8489364690e0, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqYPFHuMA3bhYQrHvycmum7IJoCsLK0FP6X56Eoj9PZAECDke8zLCKxZZvk9q7B6rZmPuFgN5YCfw/132, createdBy=00912551888, createdName=12543c13m83暂无昵称, createdTime=Mon Apr 15 10:56:42 CST 2019, time=2019-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364670, encodeId=e0523646e002, content=好好好好好好, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/29/bbc5cc0eed9b8d17623d2fd49dbdf19a.jpg, createdBy=79522135794, createdName=yjs木玉, createdTime=Mon Apr 15 05:58:59 CST 2019, time=2019-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364616, encodeId=248636461656, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqYPFHuMA3bhYQrHvycmum7IJoCsLK0FP6X56Eoj9PZAECDke8zLCKxZZvk9q7B6rZmPuFgN5YCfw/132, createdBy=f52d2514454, createdName=SCI我的梦, createdTime=Sun Apr 14 00:02:00 CST 2019, time=2019-04-14, status=1, ipAttribution=)]
    2020-03-20 gaoxiaoe
  2. [GetPortalCommentsPageByObjectIdResponse(id=1848733, encodeId=a1e81848e3333, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Fri Mar 20 15:55:00 CST 2020, time=2020-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364690, encodeId=8489364690e0, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqYPFHuMA3bhYQrHvycmum7IJoCsLK0FP6X56Eoj9PZAECDke8zLCKxZZvk9q7B6rZmPuFgN5YCfw/132, createdBy=00912551888, createdName=12543c13m83暂无昵称, createdTime=Mon Apr 15 10:56:42 CST 2019, time=2019-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364670, encodeId=e0523646e002, content=好好好好好好, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/29/bbc5cc0eed9b8d17623d2fd49dbdf19a.jpg, createdBy=79522135794, createdName=yjs木玉, createdTime=Mon Apr 15 05:58:59 CST 2019, time=2019-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364616, encodeId=248636461656, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqYPFHuMA3bhYQrHvycmum7IJoCsLK0FP6X56Eoj9PZAECDke8zLCKxZZvk9q7B6rZmPuFgN5YCfw/132, createdBy=f52d2514454, createdName=SCI我的梦, createdTime=Sun Apr 14 00:02:00 CST 2019, time=2019-04-14, status=1, ipAttribution=)]
    2019-04-15 12543c13m83暂无昵称

    谢谢分享

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1848733, encodeId=a1e81848e3333, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Fri Mar 20 15:55:00 CST 2020, time=2020-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364690, encodeId=8489364690e0, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqYPFHuMA3bhYQrHvycmum7IJoCsLK0FP6X56Eoj9PZAECDke8zLCKxZZvk9q7B6rZmPuFgN5YCfw/132, createdBy=00912551888, createdName=12543c13m83暂无昵称, createdTime=Mon Apr 15 10:56:42 CST 2019, time=2019-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364670, encodeId=e0523646e002, content=好好好好好好, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/29/bbc5cc0eed9b8d17623d2fd49dbdf19a.jpg, createdBy=79522135794, createdName=yjs木玉, createdTime=Mon Apr 15 05:58:59 CST 2019, time=2019-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364616, encodeId=248636461656, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqYPFHuMA3bhYQrHvycmum7IJoCsLK0FP6X56Eoj9PZAECDke8zLCKxZZvk9q7B6rZmPuFgN5YCfw/132, createdBy=f52d2514454, createdName=SCI我的梦, createdTime=Sun Apr 14 00:02:00 CST 2019, time=2019-04-14, status=1, ipAttribution=)]
    2019-04-15 yjs木玉

    好好好好好好

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1848733, encodeId=a1e81848e3333, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Fri Mar 20 15:55:00 CST 2020, time=2020-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364690, encodeId=8489364690e0, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqYPFHuMA3bhYQrHvycmum7IJoCsLK0FP6X56Eoj9PZAECDke8zLCKxZZvk9q7B6rZmPuFgN5YCfw/132, createdBy=00912551888, createdName=12543c13m83暂无昵称, createdTime=Mon Apr 15 10:56:42 CST 2019, time=2019-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364670, encodeId=e0523646e002, content=好好好好好好, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/08/29/bbc5cc0eed9b8d17623d2fd49dbdf19a.jpg, createdBy=79522135794, createdName=yjs木玉, createdTime=Mon Apr 15 05:58:59 CST 2019, time=2019-04-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=364616, encodeId=248636461656, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqYPFHuMA3bhYQrHvycmum7IJoCsLK0FP6X56Eoj9PZAECDke8zLCKxZZvk9q7B6rZmPuFgN5YCfw/132, createdBy=f52d2514454, createdName=SCI我的梦, createdTime=Sun Apr 14 00:02:00 CST 2019, time=2019-04-14, status=1, ipAttribution=)]
    2019-04-14 SCI我的梦

    谢谢分享

    0

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