|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | 钠-葡萄糖共转运蛋白-2抑制剂或胰高血糖素样肽-1受体激动剂治疗成人2型糖尿病:临床实践指南显示文摘临床问题对于存在不同心血管风险及肾脏结局的2型糖尿病患者,在原有生活方式干预和/或其他降糖药物的基础上加用钠-葡萄糖共转运蛋白2(SGLT-2)抑制剂和胰高血糖素样肽1(GLP-1)受体激动剂的获益及风险是什么?现行做法几十年来,2型糖尿病的治疗决策都以控制血糖为主导。SGLT-2抑制剂和GLP-1受体激动剂在传统观念中常被用于二甲双胍治疗后血糖仍控制不佳的患者。目前这一现状已经发生了改变,这得益于多项临床研究结果。研究显示SGLT-2抑制剂和GLP-1受体激动剂拥有独立于药物降糖作用之外的对于动脉粥样硬化性心血管病(CVD)和慢性肾脏病(CKD)的获益。建议本指南阐述了针对不同风险分层的成人2型糖尿病患者使用SGLT-2抑制剂或GLP-1受体激动剂的建议。•伴有3种或更少的心血管风险因素且不存在CVD或CKD:不建议启动SGLT-2抑制剂或GLP-1受体激动剂治疗。(推荐等级:弱)•伴有3种以上心血管风险因素且不存在CVD或CKD:建议启动SGLT-2抑制剂治疗,不建议启动GLP-1受体激动剂治疗。(推荐等级:弱)•已经存在CVD或CKD:建议启动SGLT-2抑制剂治疗和GLP-1受体激动剂治疗。(推荐等级:弱)•已经存在CVD和CKD:建议启动SGLT-2抑制剂治疗(推荐等级:强)和GLP-1受体激动剂治疗。(推荐等级:弱)•对于那些想要进一步降低CVD和CKD结局风险的患者:推荐优先启用SGLT-2抑制剂治疗而非GLP-1受体激动剂治疗。(推荐等级:弱)这项指南是如何制订的一个由患者、临床医生和方法学家共同组成的国际小组提出了这些推荐意见。这些推荐意见基于可信度较高的指南的标准,并使用GRADE分级方法进行评估。该小组采用了息者个体化的观点。证据一项关于获益与风险的系统综述和网络meta分析(764项随机对照研究,包括421346例参与者)发现SGLT-2抑制剂和GLP-1受体激动剂可以降低总体死亡率、心肌梗死发生率、终末期肾病或肾衰竭的发生率(中等至高等质量的证据)。在不同的亚组中这些药物对卒中、因心力衰竭所致住院和其他主要不良事件有不同的影响。药物绝对获益的程度因患者个体风险的不同有很大的差异。(例如,对于接受了超过5年药物治疗的1000例患者,在最低风险人群中死亡人数减少了5人,在最高风险人群中死亡人数减少了48人)。一项关于预后的综述确认了14种风险预测模型,其中一种(RECODe)在证据总结中报告了大部分基线风险评估数据,小组利用该模型以支持风险分层的建议。考虑到患者的价值观及个体差异,指南推荐的支撑证据包括一项对已发表论文的系统综述、一项患者焦点小组研究、一项临床问题总结,以及一项指南调查。指南解读我们依据不同的CVD和CKD风险水平,综合考虑获益、风险和其他因素的平衡,以及每一个风险组别的实际问题,来对推荐意见进行分层。本指南强烈建议CVD和CKD患者使用SGLT-2抑制剂治疗,这说明专家组认为其具有显著的获益。而对于其他成人2型糖尿病患者,推荐等级较弱,这说明专家组想要在获益、风险及治疗花费上取得一个更好的平衡。临床医生通过该指南可以使用可靠的风险计算模型,如RECODe,来明确其患者的个体心血管和肾脏疾病风险。医患交互式总结临床证据和制订决策有助于患者知晓治疗选择,包括进行共同决策。2型糖尿病人群(全球患病率不断增长1-2)正面临着不断增加的心血管疾病、肾脏病和其他并发症的风险3。数十年来,2型糖尿病的管理始终以控制血糖及糖化血红蛋白(HbA1c)为治疗目标4-5,但是,最近的高质量随机对照研究已经对这种以血糖为中心的治疗模式发起了挑战。研究结果显示,强化血糖控制未必会降低大血管不良事件,它还可能带来不利影响监管机构现在要求新型糖尿病药物必须证明其具有心血管和肾脏获益才能获得批准。对两类新药--钠-葡萄糖共转运蛋白2(SGLT-2)抑制剂和胰高血糖素样肽1(GLP-1)受体激动剂(见框图1)的临床试验结果显示,在现有治疗方案(常规治疗)之上加用这些药物,对死亡、心肌梗死、卒中、心力衰竭和肾脏的结局(如进展为终末期肾病)都有获益8-12。 | Sheyu Li Per Olav Vandvik Lyubov Lytvyn Gordon H Guyatt Suetonia C Palmer Rene Rodriguez-Gutierrez Farid Foroutan Thomas Agoritsas Reed A C Siemieniuk Michael Walsh Lawrie Frere David J Tunnicliffe Evi V Nagler Veena Manja Bjφrn Olav Asvold Vivekanand Jha Mieke Vermandere Karim Gariani Qian Zhao Yan Ren Emma Jane Cartwright Patrick Gee Alan Wickes Linda Fems Robin Wright Ling Li Qiukui Hao Reem A Mustafa 无 郭鹤鸣(译) | 2021 | 英国医学杂志中文版2021，24，9： | 7 |
| 2 | In vitro effect of pantoprazole on lower esophageal sphincter tone in rats显示文摘AIM:To investigate the in vitro effects of pantoprazole on rat lower esophageal sphincter(LES)tone.METHODS:Rats weighing 250-300 g,provided by the Yeditepe University Experimental Research Center(Yü-DETAM),were used throughout the study.They were anesthetized before decapitation.LES tissues whose mucosal lining were removed were placed in a stan-dard 30-mL organ bath with a modif ied Krebs solution and continuously aerated with 95% oxygen-5% carbon dioxide gas mixture and kept at room temperature.The tissues were allowed to stabilize for 60 min.Sub-sequently,the contractile response to 10-6 mol/L carba-chol was obtained.Different concentrations of freshly prepared pantoprazole were added directly to the tis-sue bath to generate cumulative concentrations of 5×10-6 mol/L,5×10-5 mol/L,and 1.5×10-4 mol/L.Activi-ties were recorded on an online computer via a 4-channeltransducer data acquisition system using the software BSL PRO v 3.7,which also analyzed the data.RESULTS:Pantoprazole at 5×10-6 mol/L caused a small,but statistically insignif icant,relaxation in the car-bachol-contracted LES(2.23% vs 3.95%).The 5×10-5 mol/L concentration,however,caused a signif icant relax-ation of 10.47% compared with the control.1.5×10-4 mol/L concentration of pantoprazol caused a 19.89% relaxation in the carbachol contracted LES(P<0.001).CONCLUSION:This is the fi rst study to demonstrate that pantoprazole has a relaxing effect in isolated LESs.These results might have signif icant clinical implications for the subset of patients using proton pump inhibitors who do not receive full symptomatic alleviation from gastroesophageal reflux disease. | Mustafa Duman Mahmut zer Enver Rean Yeliz Demirci Ali E Atιcι Tahsin Dalgι Erdal B Bostancι Ece Gen | 2011 | World Journal of Gastroenterology2011，17，46： | 3 |
| 3 | Influence of Aggregate Type and Size on Ductility and Mechanical Properties of Engineered Cementitious Composites显示文摘 | Sahmaran Mustafa Lachemi Mohamed Hossain Khandaker M A Ranade Ravi Li Victor C | 2009 | ACI Materials Journal2009，，3： | 2 |
| 4 | Maternal and perinatal outcomes in women with gestational diabetes mcllitus as compared to nondiabetic controls显示文摘 | Fatih S Mustafa C Ismail M | 2001 | Reprod Med2001，46，12： | 1 |
| 5 | Performance and exhaust emissions of biodiesel engine 显示文摘 | MUSTAFA C AHMET E EROL A | 2006 | Applied Energy2006，，83： | 1 |
| 6 | Increased levels of vascular endothelial growth factor in the aqueous hu- mor of patients with diabetic retinopathy显示文摘 | Selim KM Sahan D Muhittin T Osman C Mustafa O | 2010 | Indian J Ophthal- mol2010，58，5： | 1 |
| 7 | A new complex homozygous large rearrangement of the PINK1 gene in a Sudanese family with early onset Parkinson’s disease显示文摘 | Cécile Cazeneuve Channkanira San Salah A. Ibrahim Maowia M. Mukhtar Musa M. Kheir Eric LeGuern Alexis Brice Mustafa A. Salih | 2009 | neurogenetics2009，，3： | 1 |
| 8 | Ambient volatile organic compound (VOC)concentrations around a petrochemical complex and a petroleum refinery显示文摘 | Eylem C Mustafa O Remzi S | | 0，，1： | 1 |
| 9 | Prostaglandins (eicosanoids) and their role in ectothermic organisms 显示文摘 | MUSTAFA T SRIVASTAVA K C | 1989 | Advances in Comparative and Environmental Physiology1989，5，： | 1 |
| 10 | A new model for the analysis of settlement of drilled piers显示文摘 | Vallabhan C V G Mustafa G | 1996 | International Journal for Numerical and Analytical Methods in Geomechanics1996，20，3： | 1 |
| 11 | Wet and dry deposition of formaldehyde in Izmir Turkey显示文摘 | Remzi S Mustafa O Eylem C | 2006 | Sci Total Environ2006，366，： | 1 |
| 12 | Asymmetric plane flow with application to ice jams显示文摘 | Tatinclaux J C Mustafa G M | 1983 | Journal of Hydraulic Engineering1983，103，11： | 1 |
| 13 | Corrosion inhibition of A1 by molybdate citric acid & nitrite in simulated cooling water显示文摘 | Mustafa C M | 1997 | Corrosion Prevention & Control1997，44，2： | 1 |
| 14 | The effectiveness of exercise programmes after lumbar disc surgery:a randomized controlled study显示文摘 | Mustafa F Emel O Aysegul C | 2005 | Clinical Rehabilitation2005，19，1： | 1 |
| 15 | Composition,antioxidant and antimicrobial properties of the essential oils of three Salvia species from Turkish flora显示文摘 | Mustafa K Bektas T C | 2008 | Bioresource Technology2008，99，： | 1 |
| 16 | Liquid products from Verbascum stalkby supercritical fluid extraetion显示文摘 | Mustafa C Mehmet M K | 2001 | Energy Conversion andManagement2001，42，2： | 1 |
| 17 | The preventive effect on bone loss of 50-Hz,1-mT electromagnetic field in ovariectomized rats显示文摘 | Sert C Mustafa D D(u)z MZ | | 0，，06： | 1 |
| 18 | Evaluation of atherosclerotic plaque,coronary stent and coronary by-pass grafts with 128-Slice CT and technical optimization:our single center experiences显示文摘 | Mustafa K Meltem C Yasin T | | 0，，： | 1 |
| 19 | Vascular complications after liver transplantation: evaluation with Doppler US显示文摘 | Sad?k Tamsel Gulgun Demirpolat Refik Killi Unal Ayd?n Murat K?l?c Murat Zeytunlu Mustafa Par?ldar Ismail Oran Hakan Ucar | 2007 | Abdominal Imaging2007，，3： | 1 |
| 20 | Unexpected intermediates and products in the C--F bond activation of tetrafluorobenzenes with a bis (triethylphosphine)nicke] synthon: direct evidence of a rapid and reversible C--H bond activation by Ni(0)显示文摘 | Johnson S A Huff C W Mustafa F | 2008 | J Am Chem Soc2008，130，17： | 1 |
您所在的机构暂未开通此部分的功能，请联系管理员