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磺脲类药物对2型糖尿病合并急性非腔隙性脑梗死患者短期病死率及神经功能的影响

Effects of Sulfonylureas on Patients with Type 2 Diabetes and Acute Nonlacunar Ischemic Stroke

  • 摘要: 目的 观察磺脲类药物对2型糖尿病合并急性非腔隙性脑梗死患者短期病死率及神经功能的影响。方法 将2型糖尿病合并急性非腔隙性脑梗死患者按照脑梗死发生前是否正在服用磺脲类药物分为磺脲组(SU组)和非磺脲组(NSU组)。其中根据SU组患者入组前是单用磺脲类药物控制血糖还是联合其它降糖药控制血糖分为单药亚组和联合用药亚组;NSU组根据降糖药种类进一步分为不同的亚组。比较SU组与NSU组患者之间、单药组与联合用药组及NSU各亚组与SU组之间入院时基本临床资料、短期病死率及入院时、入组2周/出院时、入组12周时3个时间点美国国立卫生研究院卒中量表(NIHSS)、改良Rankin量表(MRS)、日常生活能力量表-Barthel 指数(BI)评分得分。结果 本研究共纳入SU组26例,NSU组72例,两组患者入院时基本临床资料差异无统计学意义,12周时两组患者均无死亡病例。两组患者入院时、入组2周/出院时、入组12周时NIHSS、MRS、BI三个指标评分差异均无统计学意义。NSU组的亚组分析结果显示,任一NSU亚组与SU组相比,上述主要观察指标差异均无统计学意义;SU组单药亚组和联合用药亚组上述主要观察指标差异无统计学意义。结论 磺脲类药物对2型糖尿病合并急性非腔隙性脑梗死患者无独立于降糖作用之外的神经保护作用。

     

    Abstract: Objective To explore the influence of sulfonylurea(SU) on the patients with Type 2 Diabetes and nonlacunar ischemic stroke. Methods Patients with type 2 Diabetes and nonlacunar ischemic stroke met the standardized criteria were included and divided into sulfonylurea(SU) group and Non-SU group. The primary outcomes were the scores of National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (MRS) and Barthel index (BI) evaluated at baseline, the end of 2nd week/discharge and the end of 12th week. We compared these outcomes between SU group and NSU group, as well as among each subgroup of NSU group according to different hypoglycemic medications. We also compared these outcomes between subgroups of SU group according to patient taking SUs alone or combined other hypoglycemic medications. Results After exclusions, the cohort comprised 26 patients taking sulfonylurea before stroke (SU group) and 72 patients not taking sulfonylurea (non-SU group). No significant differences were observed among basic clinical characters, lipid profile, fast blood glucose and HbA1c between SU and non-SU group. No patient died during the 12-week follow-up in either group. No significant differences were observed among all the primary outcomes between SU and non-SU groups. Among non-SU group, the primary outcomes did not show any significant differences in no-medication subgroup, insulin subgroup and metformin subgroup. No significant differences were found between subgroup of SU alone and subgroup of SU combined other medicaiton. Conclusion Sulfonylureas has no hypoglycemic-independent neuropretection function in the patients with Type 2 Diabetes and nonlacunar ischemic stroke.

     

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