服用格列本脲治疗的患者心血管及恶性肿瘤死亡率比格列齐特高
Title：Are sulphonylureas all the same? A cohort study on cardiovascular and cancer-related mortality.文题：所有磺脲类降糖药都是一样的吗？心血管及恶性肿瘤死亡率的队列研究。
Author：Monami M, Balzi D, Lamanna C, Barchielli A, Masotti G, Buiatti E, Marchionni N, Mannucci E.
Resource: Diabetes Metab Res Rev. 2007 Mar 23.
Abstract：BACKGROUND: Aim of the present study is the comparison of all-cause, cardiovascular and non-cardiovascular mortality, and cardiac morbidity, between patients treated with glibenclamide and gliclazide. METHODS: A retrospective observational cohort study was performed on a consecutive series of 568 outpatients (282 women, 286 men) with type 2 diabetes treated with either glibenclamide (n = 378) or gliclazide (n = 190). Information on all-cause mortality and on causes of death up to 31 December 2004 was obtained by the City of Florence Registry Office. Non-fatal cases requiring hospitalization were identified through the regional hospital discharge system using International Classification of Diseases. RESULTS: Mean follow-up was 5.0 +/- 1.6 and 4.4 +/- 2.0 years for death and cardiac events, respectively; during follow-up, 33 and 11 deaths were observed in the glibenclamide and gliclazide groups, with a yearly mortality rate of 4.3 and 2.2%, respectively (p < 0.05). At Cox regression, after adjustment for potential confounders, including comorbidity, glibenclamide treatment was associated with a significant increase in all-cause mortality [OR 2.1(1.2;2.7), p < 0.05], while the difference in cardiovascular mortality was not statistically significant after adjustment for age and sex. Mortality for malignancies was significantly higher in patients treated with glibenclamide after adjustment for age, sex, BMI, and insulin and metformin treatment, [OR 3.6(1.1;11.9); p < 0.05]. A higher incidence of cardiac events was associated with glibenclamide treatment only in patients with previously known ischaemic heart disease. CONCLUSIONS: Treatment with glibenclamide could be associated with higher mortality for cardiovascular diseases and malignancies, in comparison with gliclazide.
PMID: 17385195
标题：所有磺脲类降糖药作用相同吗？一项心血管及恶性肿瘤相关死亡率的队列研究。
摘要：
背景：该项研究的目的是比较服用格列苯脲和格列齐特患者之间的全因死亡率、心血管或非心血管死亡率、以及心血管病发病率。
方法：对门诊连续就诊的568例（男286例，女282例）2型糖尿病患者进行回顾性队列研究，其中服格列苯脲组为378例，服格列齐特组为190例。截止2004年12月31日的全因死亡率和死亡原因从 Florence 登记办公室获得。非致死性病例必须住院，通过地区出院系统应用国际疾病分类来鉴别。
结果：两组对死亡和心血管事件的平均随访时间分别为 5.0±1.6年和 4.4±2.0 年 。在随访期间，格列苯脲组和格列齐特组分别有 33和 11例死亡，年死亡率分别为4.3 %和 2.2% (p < 0.05)。校正潜在混杂因子，包括并存疾病后，Cox 回归分析显示格列苯脲治疗与全因死亡率的显著增加相关[OR 2.1(1.2;2.7), p < 0.05]，然而在校正了年龄和性别后，心血管死亡率的差异无统计学意义 。在校正年龄、性别、体重指数、胰岛素和二甲双胍治疗后，格列苯脲组的恶性肿瘤死亡率比格列齐特组显著增高[OR 3.6(1.1;11.9); p < 0.05]。格列苯脲治疗与心血管病发病率增加相关，但仅见于有已知的缺血性心脏病的患者。
结论：与格列齐特相比，服用格列苯脲与更高的心血管和恶性肿瘤相关死亡率有关。 [jump] [jump]
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