阿斯匹林治疗2型糖尿病的系统评价

目的评价阿斯匹林在2型糖尿病(T2DM)治疗和延缓其并发症进展方面的疗效和安全性。方法对Med line数据库、Cochrane图书馆临床对照试验资料库、中国生物医学文献光盘数据库中建库至2005年10月间的所有文献进行检索,查找符合纳入标准的随机/半随机对照试验(RCT/CCT)进行质量评价,运用RevMan4.2.8统计软件对提取的相关数据进行Meta分析。结果共纳入14篇RCT/CCT研究资料,包括阿斯匹林治疗T2DM(n=7)、T2DM并发心血管病变(n=3)和T2DM并发视网膜病变(n=4)的研究文献。统计分析显示:与安慰剂相比较,阿斯匹林可改善T2DM患者的血糖控制状况[标准化均数差为-0.73,95%CI(-1.11,-0.36),P=0.000 1],减少心血管终点事件的发生[相对危险度为0.78,95%CI(0.68,0.98),P=0.03],对其视网膜病变无改善和(或)加重作用[相对危险度为1.02,95%CI(0.97,1.07),P=0.54];阿斯匹林不良反应发生率为6%~8%,与安慰剂组相比无明显差异。结论对于T2DM患者,尤其是伴有心血管疾病高危因素或已经伴有心血管疾病的患者,在排除使用禁忌证的情况下均可考虑使用阿斯匹林,其不仅可改善T2DM患者的血糖控制状况,同时可减少T2DM患者心血管终点事件的发生。

Systematic Review of Aspirin for Type 2 Diabetes Mellitus

Objective To assess the efficacy and safety of aspirin for type 2 diabetes mellitus(T2DM).(Methods)Electronic database searching was performed on Medline,Cochrane Library and CBM,and the data from the beginning of the database to October 2005 were included.Randomised and quasi-randomised trials concerning aspirin treatment for T2DM were selected and assessed for the methodological quality,and the extracted data were performed Meta-analysis by statistical software RevMan4.2.8. Results Fourteen randomised and quasi-randomised trials met the inclusion criteria,including 7 papers of aspirin treatment for T2DM,3 papers of aspirin treatment for cardiovascular complication of T2DM and 4 papers of aspirin treatment for type 2 diabetic retinopathy.Compared with placebo treatment,aspirin showed significant positive effects on lowering blood glucose(SMD,0.73;95%CI,(-1.11 ~-0.36;)P=0.0001).In diabetic patients,aspirin treatment was associated with a significant reduction in the total cardiovascular events(RR,0.78;95%CI,0.68 ~ 0.98;P=0.03).Aspirin treatment neither lowered(nor increased) the risk of the development of diabetic retinopathy(RR,1.02;95% CI,0.97 ~ 1.07;P=0.54).(Conclusion Aspirin treatment) can be a choice for T2DM,especially for the patients who have evidence of cardiovascular disease or have high risks for cardiovascular disease.