SGLT2抑制剂联合胰岛素治疗1型糖尿病疗效与安全性的Meta分析

发布时间：2018-05-07 22:30

本文选题：钠-葡萄糖转运体抑制剂 + 胰岛素　；参考：《解放军医学杂志》2016年12期

【摘要】：目的评价钠葡萄糖转运蛋白2(SG LT 2)抑制剂联合胰岛素治疗1型糖尿病的疗效及安全性。方法计算机检索Pub Med、The Cochrane Library、EMbase、CENTRAI、中国生物医学文献数据库、相关期刊论文、维普及万方数据库,检索时限均从建库至2016年4月5日,同时手检纳入文献的参考文献,纳入比较SGLT2抑制剂联合胰岛素与胰岛素加安慰剂治疗1型糖尿病的随机对照试验(RCTs),对合格研究进行资料提取及偏倚风险评价后,采用Rev Man 5.3软件进行Meta分析。结果共纳入4项RCTs,共529例研究对象。Meta分析结果显示,与对照组比较,SGLT2抑制剂联合胰岛素能明显降低空腹血糖(WMD= 0.69mmol/L,95%CI= 1.32~ 0.07,P0.05)、糖化血红蛋白(WMD= 0.37%,95%CI= 0.54~ 0.20,P0.0001),减轻体重(WMD= 2.54kg,95%CI= 3.48~ 1.60,P0.0001),减少每日胰岛素用量(WMD= 6.23U,95%CI= 8.0~ 4.40,P0.0001),且总不良事件、低血糖事件、泌尿系感染风险等与对照组比较差异均无统计学意义。结论 SGLT2抑制剂作为胰岛素补充药物治疗1型糖尿病的疗效肯定,能改善血糖,降低体重,并减少每日胰岛素用量,对血压、血脂等也可能有改善作用,且联合用药不增加总不良反应、低血糖事件、泌尿生殖道系统感染的风险。
[Abstract]:Objective to evaluate the efficacy and safety of sodium glucose transporter (2(SG LT 2) inhibitor combined with insulin in the treatment of type 1 diabetes mellitus. Methods the Cochrane Library EMbase CENTRAI, Chinese Biomedical Literature Database, Chinese Journal Full-text Database, Weipu and Wanfang databases were searched by computer. The retrieval time was from the establishment of the database to April 5, 2016, and the references included in the literature were checked by hand. A randomized controlled trial of SGLT2 inhibitor combined with insulin plus placebo in the treatment of type 1 diabetes mellitus was carried out. After data extraction and bias risk evaluation of eligible study, Meta analysis was performed with Rev Man 5.3 software. Results A total of 4 RCTs were included, and 529 cases of RCTs were included. Meta-analysis showed that, Compared with the control group, SGLT2 inhibitor combined with insulin could significantly reduce fasting blood glucose WMD = 0.69 mmol / L ~ (95) CI = 1.32 ~ 0.07 ~ 0.07% P0.05, glycosylated hemoglobin (WMD) = 0.37 ~ 0.20 ~ 0.20 渭 g P 0.0001, reduce body weight WMD= 2.54 kg95CI = 3.48 ~ 1.60 ~ 1.60 mg / L P0.0001, reduce daily insulin dosage WMD= 6.23U95CI= 8.0- 4.40g P0.0001, and total adverse events, hypoglycemic events. The risk of urinary tract infection was not significantly different from that of the control group. Conclusion the effect of SGLT2 inhibitor as insulin supplement drug on type 1 diabetes mellitus is definite, it can improve blood sugar, reduce body weight, reduce daily insulin dosage, and may also improve blood pressure, blood lipid and so on. Combined medication did not increase the risk of total adverse reactions, hypoglycemia, and genitourinary tract infection.
【作者单位】：西南医科大学附属医院内分泌科;
【分类号】：R587.1

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