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| 1 | 糖尿病与高血压交互作用对缺血性卒中严重程度的影响显示文摘目的糖尿病和高血压都是卒中的强预测因子,然而两者对卒中严重程度是否存在交互作用仍不明确.文中通过流行病学交互作用的研究方法,探讨糖尿病、高血压及其交互作用对卒中严重程度的影响.方法回顾性分析南京卒中注册系统2 0 1 3年1 月至2 0 1 5年6 月期间于南京军区南京总医院神经内科住院的缺血性卒中患者8 8 6例.卒中严重程度评价采用国立卫生院神经功能评分( National Institute of Health Stroke Scale, NIHSS) ,NIHSS 〈 1 0分为轻/ 中型卒中,而NIHSS≥1 0 为重型卒中.采用logistic回归分析影响卒中严重程度的因素,糖尿病和高血压交互作用分析采用相加尺度和相乘尺度.最后按患者年龄、性别分层分析糖尿病、高血压的交互作用.结果重型卒中患者2 6 0例,占29.3%.多变量logistic回归调整年龄、性别后,糖尿病(OR = 1.707,9 5 % CI 1.267-2.300)、高血压(0 R = 1.603,9 5 % CI: 1.111 -2.312)增加了重型卒中的危险性.糖尿病、高血压之间存在协同的相加交互作用[相对超危险度比( the relative excess risk due to interaction, RERI)= 1.001,9 5 % CI:0.099- 1.903],但不存在相乘交互作用(X^2 = 1 . 7 0 0 , = 0.192).在男性患者中,糖尿病、高血压相乘交互作用( Pmultiplicative = 0.015)和相加交互作用(R ERI=1.82,95%C I:0.72-2.92)均有统计学意义.结论糖尿病、高血压可能存在交互作用使重型卒中风险显著增加.改善血糖、血压的控制可能会协同参与阻止卒中的发展. | 蔡洹 刘新峰 | 2016 | 医学研究生学报2016，29，11： | 16 |
| 2 | Effects of glucose-lowering agents on ischemic stroke显示文摘Diabetes mellitus(DM) is a major risk factor for cardiovascular events, including ischemic stroke. Moreover, ischemic stroke appears to be more severe in these patients and to be associated with less favorable outcomes. However, strict glycemic control does not appear to reduce the risk of ischemic stroke. On the other hand, newer glucose-lowering agents(glucagon-like peptide 1 receptor agonists and sodiumglucose cotransporter 2 inhibitors) reduced the risk of cardiovascular events in recent randomized, placebocontrolled trials. Semaglutide also reduced the risk of ischemic stroke. These benefits are independent of glucose lowering and might be due to the favorable effects of these agents on body weight and blood pressure. Pioglitazone also reduced the risk of recurrent stroke in patients with insulin resistance or type 2 DM but the unfavorable safety profile limits its use. In contrast, sulfonylureas and dipeptidyl peptidase 4 inhibitors have a neutral effect on cardiovascular morbidity and might be less attractive options in this high-risk population. | Konstantinos Avgerinos Konstantinos Tziomalos | 2017 | World Journal of Diabetes2017，8，6： | 3 |
| 3 | DPP-4 Inhibitor Linagliptin is Neuroprotective in Hyperglycemic Mice with Stroke via the AKT/mTOR Pathway and Anti-apoptotic Effects显示文摘Dipeptidyl peptidase 4 (DPP-4) inhibitors have been shown to have neuroprotective effects in diabetic patients suffering from stroke, but less research has focused on patients with mild hyperglycemia below the threshold for a diagnosis of diabetes. In this investigation, a hyperglycemic mouse model was generated by intraperitoneal injection of streptozotocin and then subjected to focal cerebral ischemia. We demonstrated that the DPP-4 inhibitor linagliptin significantly decreased the infarct volume, reduced neuronal cell death, decreased inflammation, and improved neurological deficit compared with control mice. Linagliptin up-regulated the expression of p-Akt and p-m TOR and regulated the apoptosis factors Bcl-2, Bax, and caspase 9. Taken together, these results suggest that linagliptin exerts a neuroprotective action likely through activation of the Akt/m TOR pathway along with anti-apoptotic and anti-inflammatory mechanisms.Therefore, linagliptin may be considered as a therapeutic treatment for stroke patients with mild hyperglycemia. | Gang Zhang Samuel Kim Xiaohuan Gu Shan Ping Yu Ling Wei | 2020 | Neuroscience Bulletin2020，36，4： | 3 |
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