糖尿病强化治疗对心脑血管疾病预防效果及安全性的Meta分析  

Meta-analysis of the efficacy and the safety of intensive glucose in preventing stroke and cardiovascular events in patients with diabetes

作　　者：杨帆[1] 蒋小波[1] 陈应辉[1] 

机构地区：[1]四川省成都市第五人民医院内分泌科,611130

出　　处：《疑难病杂志》2015年第9期902-905,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的：系统评价糖尿病强化治疗预防脑卒中及心肌梗死的疗效及安全性。方法检索1990—2014年MEDLINE、EMBASE、万方数据、中国知网关于糖尿病强化治疗的临床随机试验（RCT），同时筛检纳入文献的参考文献。由2名研究者对纳入文献的质量进行严格评价和资料提取，对符合标准的研究采用RevMan 5．1软件进行分析。结果共纳入6篇RCT，共46009例患者。 Meta分析结果显示：糖尿病强化治疗对脑卒中的预防优于一般治疗组，但其差异无统计学意义（OR＝0．93，95％CI 0．81～1．06， P ＝0．28）；糖尿病强化治疗对心血管事件的预防与一般治疗组相当，差异无统计学意义（OR＝1．00，95％CI 0．91～1．11， P ＝0．93）；糖尿病强化治疗低血糖事件发生率显著高于一般治疗组，其差异有统计学意义（OR＝3．99，95％CI 2．41～6．60， P ＜0．01）。结论强化血糖治疗相比一般治疗并不能减少脑卒中及心肌梗死的发生，且增加了低血糖的风险。Objective To systemic review the effect and safety of the intensive treatment in patients with diabetes mellitus for the prevention of stroke and myocardial infarction .Methods Retrieval MEDLINE, EMBASE, Wanfang Data, CNKI from 1990 to 2014 of randomized clinical trials （ RCT） on intensive treatment of diabetes , and screening included refer-ences.The quality of the included literature was evaluated by 2 researchers, and the data were extracted.The RevMan 5.1 software was used for the study analysis .Results A total of 6 RCT included 46 009 patients were enrolled .Metaanalysis showed that diabetic patients with intensive insulin therapy on stroke prevention was better than general treatment group , but the difference did not show statistical significance （OR=0.93, 95%CI 0.81-1.06, P =0.28）;intensive diabetes treatment the prevention of cardiovascular events was similar to general treatment group , the difference did not show statistically signifi-cant （OR=1.00, 95% CI 0.91-1.11, P =0.93）; intensive diabetic hypoglycemia events were significantly higher than those in the treatment group, the difference has statistical significance （OR=3.99, 95%CI 2.41-6.60, P 〈0.01）.Conclu-sion Strengthen treatment of blood glucose did not reduce the occurrence of stroke and myocardial infarction compared with general therapy , but increases the risk of hypoglycemia .

关 键 词：强化治疗 糖尿病 心脑血管疾病 疗效 安全性 META分析 

分 类 号：R587.1[医药卫生—内分泌]