中国医学科学院学报2024，Vol.46Issue(2)：176-183,8.DOI:10.3881/j.issn.1000-503X.15772
强化胰岛素治疗对急性心肌梗死患者的预后影响
Effect of Intensive Insulin Therapy on Prognosis in Patients With Acute Myocardial Infarction
摘要
Abstract
Objective To evaluate the clinical efficacy and safety of intensive insulin therapy in the pa-tients with acute myocardial infarction and provide guidance for improving the prognosis.Methods The articles involving the randomized controlled trials(RCT)focusing on the effects of intensive versus conventional insulin therapy on the clinical outcomes of the patients with acute myocardial infarction were retrieved from Cochrane,Embase,PubMed,CNKI,Wanfang Data,VIP,and CBM with the time interval from inception to October 2022.The data of each RCT were extracted and used for meta-analysis in RevMan5.4.Results A total of 8 arti-cles were included in this study,involving 726 patients(372 in the intensive insulin group and 354 in the nor-mal insulin group).The meta-analysis results showed that the intensive insulin group had lower incidence of major cardiovascular adverse events(RR =0.53,95%CI =0.44-0.64,P<0.001),lower all-cause mortality(RR = 0.51,95%CI =0.33-0.78,P =0.002),lower high-sensitivity C-reactive protein level on day 7(WMD =-2.00,95%CI =-2.17--1.83,P<0.001),higher left ventricular ejection fraction on day 30(WMD = 3.94,95%CI =2.45-5.43,P<0.001),and higher incidence of hypoglycemia events(RR =2.96,95%CI =1.12-7.83,P =0.030)than the normal insulin group.There was no significant difference between the two groups in terms of no-reflow event after percutaneous coronary intervention(RR =0.39,95%CI =0.14-1.13,P =0.080).Conclusion Intensive insulin therapy might be associated with more clinical benefits in the patients with acute myocardial infarction,while the conclusion remains to be confirmed by more studies.关键词
急性心肌梗死/强化胰岛素治疗/荟萃分析Key words
acute myocardial infarction/intensive insulin therapy/meta-analysis分类
医药卫生引用本文复制引用
刘慧箬,杨泽禹,陆大洲,徐峰,陈玉国,李传保..强化胰岛素治疗对急性心肌梗死患者的预后影响[J].中国医学科学院学报,2024,46(2):176-183,8.基金项目
国家自然科学基金(82070388)、泰山学者青年专家建设工程专项(tsqn202211310)和中华国际医学交流基金会项目(Z-2016-23-2101-11) （82070388）
