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Diabetes Care：二甲双胍能改善心血管高危的2型糖尿病患者心血管预后（SPREAD-DIMCAD研究

2012-12-25 湘杉 翻译 中国医学论坛报

冠心病二甲双胍糖尿病
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　　12月10日，3项中国研究同时亮相《糖尿病护理》（Diabetes Care）杂志，让我们在品味研究结果的同时不禁为中国研究者喝彩。 　　上海交通大学医学院附属瑞金医院宁光教授牵头的）组糖化血红蛋白（HbA1c）均明显降低。中位随访5年时，91例发生103次主要终点事件（心血管死亡、全因死亡、非致死性心肌梗死、非致死性卒中和冠脉血运重建）。意向治疗分析显示，与格列吡嗪相比，二甲双胍

　　12月10日，3项中国研究同时亮相《糖尿病护理》（Diabetes Care）杂志，让我们在品味研究结果的同时不禁为中国研究者喝彩。

　　上海交通大学医学院附属瑞金医院宁光教授牵头的）组糖化血红蛋白（HbA1c）均明显降低。中位随访5年时，91例发生103次主要终点事件（心血管死亡、全因死亡、非致死性心肌梗死、非致死性卒中和冠脉血运重建）。意向治疗分析显示，与格列吡嗪相比，二甲双胍组发生主要终点的校正风险比为0.54。

　　宁光教授在接受本报采访时介绍：降糖药在治疗糖尿病同时能否减少心血管并发症一直受到研究者关注。目前二甲双胍和磺脲类是历史最悠久、应用最广泛的降糖药。该研究旨在比较两类药物对2型糖尿病患者心血管事件的影响，其结果将为内分泌及相关领域临床工作者提供糖尿病患者心血管保护的治疗范例和有效参考。

　　新浪微博网友@郭启煜评论：① 该获益是相对格列吡嗪而言的；② 研究中格列吡嗪使用剂量较大，为指南推荐之最大剂量，不宜模仿，应谨防低血糖；③ 低血糖的危害远远大于高血糖，对心血管疾病高危人群尤甚；④ 对合并冠心病的糖尿病患者，降糖务须谨慎，安全乃第一要务，达标诚可贵，安全价更高；⑤ 单靠降糖实现心血管获益到目前还只是假说。

与二甲双胍相关的拓展阅读：

原始链接：
Hong J, Zhang Y, Lai S, Lv A, Su Q, Dong Y, Zhou Z, Tang W, Zhao J, Cui L, Zou D, Wang D, Li H, Liu C, Wu G, Shen J, Zhu D, Wang W, Shen W, Ning G; on behalf of the SPREAD-DIMCAD Investigators.Effects of Metformin Versus Glipizide on Cardiovascular Outcomes in Patients With Type 2 Diabetes and Coronary Artery Disease. Diabetes Care. 2012 Dec 10
    

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    2013-11-15 木头人513

    #Diabetes#

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    2013-03-18 ms5439512287675881

    #BET#

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    2013-09-19 ms9608593228839890

    #DIA#

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    2013-08-16 zhaozuguo

    #二甲双胍能#

    0

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    2012-12-27 aids213

    #2型糖尿病患者#

    0

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    2012-12-27 xue8604

    #糖尿病患者#

    0

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    2012-12-27 xiaogang320

    #心血管预后#

    0

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