二甲双胍对葡萄糖耐量异常的缺血性卒中患者预后的影响

目的 探讨二甲双胍对合并葡萄糖耐量异常(abnormality of glucose tolerance,AGT)的缺血性卒中患者预后的影响.方法 从我院初诊的596例缺血性卒中中筛查出合并AGT者155例,随机分为干预组(77例)和对照组(78例),同时从其余糖耐量正常(normal glucose tolerance,NGT)者中随机选出80例作为NGT组.3组均予相同基础治疗(阿司匹林肠溶片,100 mg/d),干预组同时予二甲双胍(500 mg,2/d)治疗,随访观察2年,比较各组治疗前后颈动脉内膜-中层厚度(IMT)的变化、再发卒中及不良反应情况.结果 颈动脉IMT:干预组、对照组、NGT组治疗前分别为(1.08±0.42)mm、(1.06±0.38)mm、(0.83±0.32)mm,治疗2年后分别为(1.17±0.36)mm、(1.32±0.45)mm、(1.02±0.28)mm.干预组颈动脉IMT较治疗前无明显变化,差异无统计学意义(P＞0.05),对照组与NGT组颈动脉IMT均显著增厚,差异有统计学意义(P＜0.05),3组两两比较差异均有统计学意义(P＜0.05);卒中再发率:干预组、对照组、NGT组分别为12.16%、25.00%、10.26%,干预组与对照组比较差异有统计学意义(P＜0.05),与NGT组比较差异无统计学意义(P＞0.05),对照组与NGT组比较差异有统计学意义(P＜0.05);不良反应发生率:干预组、对照组、NGT组分别为3.90%、2.56%、2.50%,3组两两比较差异均无统计学意义(P＞0.05).结论 二甲双胍可延缓颈动脉IMT增厚并降低合并AGT的缺血性卒中患者卒中再发的风险.

Effect of Metformin On the Prognosis of Ischemic Stroke Patients with Abnormal Glucose Tolerance

Objective To study the effect of metformin on the prognosis of ischemic stroke patients with abnormal glucose tolerance(AGT).Methods 155 AGT cases were screened out from 596 patients hospitalized in our hospital for ischemic stroke and were randomly divided into intervention group(n=77)and control group(n=78).80 cases were selected randomly in the ischemic stroke patients with normal glucose tolerance(NGT group).All cases in the 3 groups were given the same elementary treatment(Aspirin,100 mg/d),but the int...