摘要
目的研究沙格列汀干预对缺血性卒中合并2型糖尿病人群认知功能的影响。方法前瞻性队列研究,将255例新发缺血性卒中合并2型糖尿病患者随机分配至沙格列汀组和非沙格列汀组(格列齐特干预),记录基线状态下资料包括人口学特征、生化检验结果等,并使用蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)进行初始认知功能评估,得分<26分及血糖不达标者排除。筛选合格者206例,分别于卒中后1、3、5个月时再次评估,以得分<22分记为终点事件,认为出现卒中后认知障碍(post-stroke cognitive impairment,PSCI)。采用多因素Cox回归分析比较两组患者MoCA得分情况。结果最终130例受试者完成研究,比较两组患者的基线水平资料,差异无统计学意义。观察结束时,沙格列汀组患者共62人纳入分析,其中37人达终点事件,PSCI发生率59.7%,非沙格列汀组共68人纳入分析,其中50人达终点事件,PSCI发生率73.5%。多因素COX回归分析提示,沙格列汀干预的风险比(hazard rate,HR)为0.617,95%CI为0.388~0.983(P<0.05)。结论沙格列汀降糖治疗可减轻缺血性脑卒中合并2型糖尿病患者的PSCI程度。
Objective To investigate the effect of saxagliptin on cognitive function in patients with ischemic stroke and type 2 diabetes.Methods This is a prospective cohort study.A total of 255 new ischemic stroke patients combined with type 2 diabetes were randomly divided into two groups,saxagliptin group and non-saxagliptin group(intervened with gliclazide).Demographic characteristics and basic biochemistry data were collected.The initial cognitive function was evaluated by Montreal Cognitive Assessment(MoCA).The participants with MoCA score below 26 and/or serum glucose disqualified were excluded.Totally 206 patients were screened,and cognitive function assessment was re-evaluated at 1,3,and 5 months after stroke.The score below 22 points was set as the end point event,which was defined as post-stroke cognitive impairment(PSCI).MoCA scores between the two groups were analyzed with multivariate COX regression analysis.Results Totally 130 cases complete this research.Baseline data were compared between the two groups and no statistical differences were observed.At the end of the observation,37 patients in the saxagliptin group reached the end point(62 analyzed),with the incidence of PSCI 59.7%,and 50 patients in the non-saxagliptin group reached the end point(68 analyzed),with the incidence of PSCI 73.5%.Multivariate COX regression analysis suggested that the hazard ratio(HR)for saxagliptin intervention was 0.617,with 95%CI 0.388~0.983 and P<0.05.Conclusion Saxagliptin hypoglycemic therapy can reduce the degree of PSCI in patients with ischemic stroke complicated with type 2 diabetes.Conclusion Saxagliptin hypoglycemic therapy can reduce the degree of PSCI in patients with ischemic stroke complicated with type 2 diabetes.
作者
李森
黄安琪
郭健飞
白洁
张光珍
王婷
赵咏梅
Li Sen;Huang Anqi;Guo Jianfei;Bai Jie;Zhang Guangzhen;Wang Ting;Zhao Yongmei(Department of Endocrinology,Liaocheng People's Hospital,Liaocheng 252000,Shandong Province,China;Department of Neurology,Liaocheng People's Hospital,Liaocheng 252000,Shandong Province,China;Key Laboratory for Pediatrics of Integrated Traditional and Western Medicine,Liaocheng People's Hospital,Liaocheng 252000,Shandong Province,China;Key Laboratory of Neurodegenerative Disease of Ministry of Education,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)
出处
《首都医科大学学报》
CAS
北大核心
2019年第5期715-720,共6页
Journal of Capital Medical University
基金
山东省自然科学基金(ZR2017PH054)
山东省医药卫生科技发展计划(2017WS327)~~
关键词
认知功能
卒中
卒中后认知障碍
糖尿病
沙格列汀
cognitive function
stroke
post-stroke cognitive impairment
diabetes
saxagliptin
