浙江大学学报（医学版）2026，Vol.55Issue(2)：129-136,8.DOI:10.3724/zdxbyxb-2025-0474
钠-葡萄糖耦联转运体2抑制剂对合并糖尿病急性缺血性脑卒中患者近期神经功能的影响
Association of sodium-glucose linked transporter 2 inhibitors with functional outcomes at discharge in diabetic patients with acute ischemic stroke
摘要
Abstract
Objective:To investigate the association between the use of sodium-glucose linked transporter 2(SGLT2)inhibitors and functional outcomes at discharge in diabetic patients with acute ischemic stroke(AIS).Methods:A retrospective cohort study was conducted using data from the Acute Stroke Patients for Stroke Management Quality Evaluation online database(CASE-Ⅱ,NCT04487340)for patients admitted between January 2022 and November 2024.Diabetic patients with AIS were categorized as SGLT2 inhibitor users or non-users(control group).Patients'functional outcomes were assessed using the modified Rankin Scale(mRS)score.Propensity score matching(PSM)was performed in a 1∶2 ratio.Multivariate logistic regression models were used to assess the association between SGLT2 inhibitor use and outcomes.Stratified analyses were performed based on pre-existing diabetes versus newly diagnosed diabetes during the hospitalization and the impact of long-term and short-term use of SGLT2 inhibitors on patients'functional outcomes at discharge was analyzed.Results:The study included 9220 patients(mean age 67±11 years;39.38%female),of whom 1915(20.77%)were SGLT2 inhibitor users.There were 1912 cases in the user group and 3683 cases in the non-user group after PSM.Before PSM,the proportion of patients with an mRS score 0-2 at discharge was significantly higher in the SGLT2 inhibitor group than that in the control group(79.84%vs.69.19%,P<0.01).After multivariable adjustment,SGLT2 inhibitor use remained significantly associated with higher proportion of mRS score 0-2(adjusted OR=1.24,95%CI:1.08-1.42,P<0.01)and mRS score 0-3(adjusted OR=1.62,95%CI:1.32-1.99,P<0.01)at discharge.Results were consistent after PSM.In stratified analyses,SGLT2 inhibitor use was associated with improved functional outcomes in both patients with pre-existing diabetes and those with newly diagnosed diabetes.Conclusion:Among diabetic patients with AIS,SGLT2 inhibitor use is independently associated with better functional outcomes at discharge,showing a potential benefit for short-term neurological recovery.关键词
急性缺血性脑卒中/糖尿病/钠-葡萄糖耦联转运体2抑制剂/临床结局/改良Rankin量表/回顾性研究Key words
Acute ischemic stroke/Diabetes mellitus/Sodium-glucose linked transporter 2 inhibitors/Clinical outcomes/Modified Rankin Scale/Retrospective study分类
医药卫生引用本文复制引用
黄鑫,王晓翔,江毅卿,沈珂,贾震雷,马向东,钟碧峰,何宇平,楼敏..钠-葡萄糖耦联转运体2抑制剂对合并糖尿病急性缺血性脑卒中患者近期神经功能的影响[J].浙江大学学报（医学版）,2026,55(2):129-136,8.基金项目
国家自然科学基金(82171276,U23A20426) （82171276,U23A20426）
国家卫生健康委医药卫生科技发展研究中心脑卒中防治技术研究项目(WKZX2023CZ0220)This study was supported by National Natural Science Foundation of China (82171276,U23A20426) and Research Project on Prevention and Treatment Techniques for Stroke of the Development Center for Medical Science & Technology,National Health Commission of the People's Republic of China (WKZX2023CZ0220) （WKZX2023CZ0220）
