Cardiovasc Diabetol:降糖治疗对糖尿病透析患者生存预后的影响

2021-09-09 Nebula MedSci原创

对于透析合并糖尿病的患者,透析后持续采用降糖药物治疗或可改善患者生存预后

2型糖尿病在进行透析的患者中很常见。但是,降糖药物使用与患者的生存结果之间的关联尚未有很多相关报道。本研究旨在调查持续使用降糖药物是否会影响糖尿病透析患者的生存结果,以及不同的降糖药物使用是否会影响预后。

通过国家数据库,研究人员纳入了于2011年至2015年期间接受维持性透析治疗的终末肾病患者,并分成既往糖尿病透析组(PDD)、透析后新发糖尿病组(IDD)和非糖尿病透析组(NDD)。PDD组进一步细分为透析后继续使用降糖药物(PDD-M)和透析后停用降糖药物(PDD-NM)的患者。

四组患者的Kaplan-Meier生存曲线

共纳入了 5249 为透析患者。PDD-NM 组患者的死亡率明显高于 IDD、PDD-M 和 NDD 组患者(p<0.001)。无论是使用胰岛素 (p<0.001) 还是口服降糖药 (OHA) (p<0.001),PDD-M 组的死亡风险均显著降低。初始胰岛素给药或 OHA 对 IDD 组的总死亡率没有统计学意义的影响。但是对于老年人(p=0.02)和男性亚组(p=0.05),使用 OHA 比使用胰岛素具有更好的生存趋势。

PDD组继续使用降糖药或胰岛素或停用降糖治疗的患者的Kaplan-Meier生存曲线

总而言之,对于透析合并糖尿病的患者,透析后持续采用降糖药物治疗或可改善患者生存预后。

原始出处:

Ou, SH., Chen, HY., Fang, NW. et al. Effect of anti-diabetic drugs in dialysis patients with diabetes: a nationwide retrospective cohort study. Cardiovasc Diabetol 20, 179 (2021). https://doi.org/10.1186/s12933-021-01364-w

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beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98176, encryptionId=84da981e6db, topicName=降糖治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1af122008128, createdName=neurosurgeon, createdTime=Tue Jan 18 07:20:08 CST 2022, time=2022-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1570668, encodeId=4fa715e066883, content=<a href='/topic/show?id=e53d94835a5' target=_blank style='color:#2F92EE;'>#透析患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94835, encryptionId=e53d94835a5, topicName=透析患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4b0915676167, createdName=ewsr6, createdTime=Sat Sep 11 07:20:08 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043784, encodeId=1e0a1043e8494, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Thu Sep 09 19:20:08 CST 2021, time=2021-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052691, encodeId=466810526912b, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Thu Sep 09 19:20:08 CST 2021, time=2021-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1016102, encodeId=233b101610239, content=糖尿病药物的作用~, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/PiajxSqBRaEIclzlSymN79iaDSDUTJxiar5IM31YBJbHXBrO1Uicd1qQYSHlUkEsicxICsuJaNagPbiam22gdJwZlxOg/132, createdBy=d2f12305320, createdName=小包子竹, createdTime=Thu Sep 09 17:12:19 CST 2021, time=2021-09-09, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=2041299, encodeId=aced20412993e, content=<a href='/topic/show?id=2f826902418' target=_blank style='color:#2F92EE;'>#生存预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69024, encryptionId=2f826902418, topicName=生存预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Mon Sep 20 22:20:08 CST 2021, time=2021-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1761679, encodeId=fb161e6167993, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Sun Oct 17 20:20:08 CST 2021, time=2021-10-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1639870, encodeId=6caf16398e0fa, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Wed Oct 20 14:20:08 CST 2021, time=2021-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1932703, encodeId=34671932e035c, content=<a href='/topic/show?id=5cd95305803' target=_blank style='color:#2F92EE;'>#患者生存#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, 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beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98176, encryptionId=84da981e6db, topicName=降糖治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1af122008128, createdName=neurosurgeon, createdTime=Tue Jan 18 07:20:08 CST 2022, time=2022-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1570668, encodeId=4fa715e066883, content=<a href='/topic/show?id=e53d94835a5' target=_blank style='color:#2F92EE;'>#透析患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94835, encryptionId=e53d94835a5, topicName=透析患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4b0915676167, createdName=ewsr6, createdTime=Sat Sep 11 07:20:08 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043784, encodeId=1e0a1043e8494, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Thu Sep 09 19:20:08 CST 2021, time=2021-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052691, encodeId=466810526912b, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Thu Sep 09 19:20:08 CST 2021, time=2021-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1016102, encodeId=233b101610239, content=糖尿病药物的作用~, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/PiajxSqBRaEIclzlSymN79iaDSDUTJxiar5IM31YBJbHXBrO1Uicd1qQYSHlUkEsicxICsuJaNagPbiam22gdJwZlxOg/132, createdBy=d2f12305320, createdName=小包子竹, createdTime=Thu Sep 09 17:12:19 CST 2021, time=2021-09-09, status=1, ipAttribution=)]
    2022-05-12 quxin068
  6. [GetPortalCommentsPageByObjectIdResponse(id=2041299, encodeId=aced20412993e, content=<a href='/topic/show?id=2f826902418' target=_blank style='color:#2F92EE;'>#生存预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69024, encryptionId=2f826902418, topicName=生存预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Mon Sep 20 22:20:08 CST 2021, time=2021-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1761679, encodeId=fb161e6167993, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, 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level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/PiajxSqBRaEIclzlSymN79iaDSDUTJxiar5IM31YBJbHXBrO1Uicd1qQYSHlUkEsicxICsuJaNagPbiam22gdJwZlxOg/132, createdBy=d2f12305320, createdName=小包子竹, createdTime=Thu Sep 09 17:12:19 CST 2021, time=2021-09-09, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=2041299, encodeId=aced20412993e, content=<a href='/topic/show?id=2f826902418' target=_blank style='color:#2F92EE;'>#生存预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69024, encryptionId=2f826902418, topicName=生存预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Mon Sep 20 22:20:08 CST 2021, time=2021-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1761679, encodeId=fb161e6167993, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, 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  8. [GetPortalCommentsPageByObjectIdResponse(id=2041299, encodeId=aced20412993e, content=<a href='/topic/show?id=2f826902418' target=_blank style='color:#2F92EE;'>#生存预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69024, encryptionId=2f826902418, topicName=生存预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Mon Sep 20 22:20:08 CST 2021, time=2021-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1761679, encodeId=fb161e6167993, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, 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level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/PiajxSqBRaEIclzlSymN79iaDSDUTJxiar5IM31YBJbHXBrO1Uicd1qQYSHlUkEsicxICsuJaNagPbiam22gdJwZlxOg/132, createdBy=d2f12305320, createdName=小包子竹, createdTime=Thu Sep 09 17:12:19 CST 2021, time=2021-09-09, status=1, ipAttribution=)]
    2021-09-09 misszhang

    谢谢MedSci提供最新的资讯

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=2041299, encodeId=aced20412993e, content=<a href='/topic/show?id=2f826902418' target=_blank style='color:#2F92EE;'>#生存预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69024, encryptionId=2f826902418, topicName=生存预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Mon Sep 20 22:20:08 CST 2021, time=2021-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1761679, encodeId=fb161e6167993, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, 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level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/PiajxSqBRaEIclzlSymN79iaDSDUTJxiar5IM31YBJbHXBrO1Uicd1qQYSHlUkEsicxICsuJaNagPbiam22gdJwZlxOg/132, createdBy=d2f12305320, createdName=小包子竹, createdTime=Thu Sep 09 17:12:19 CST 2021, time=2021-09-09, status=1, ipAttribution=)]
    2021-09-09 misszhang

    谢谢MedSci提供最新的资讯

    0

  10. 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level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/PiajxSqBRaEIclzlSymN79iaDSDUTJxiar5IM31YBJbHXBrO1Uicd1qQYSHlUkEsicxICsuJaNagPbiam22gdJwZlxOg/132, createdBy=d2f12305320, createdName=小包子竹, createdTime=Thu Sep 09 17:12:19 CST 2021, time=2021-09-09, status=1, ipAttribution=)]
    2021-09-09 小包子竹

    糖尿病药物的作用~

    0

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