利用本國健保資料庫為材料,針對 2001 年至 2007 年成年糖尿病藥物新使用 族群進行分析,在最長七年的研究期間內,有使用sulfonylureas 藥物的族群相較於 未使用者,平均年齡較高且平均追蹤時間也較長。而納入研究後,有使用
sulfonylureas 藥物族群在心血管與糖尿病藥物的使用人數比例均高於未使用 sulfonylureas 藥物族群。而使用過 sulfonylureas 藥物的族群中,曾使用過 glyburide 者在年齡、性別分布上和未使用過glyburide 者沒有明顯差異,但是在心血管藥物 與糖尿病藥物的使用人數比例上以前者較高。
心肌梗塞事件與心臟血管手術事件的分析結果顯示,整體而言,在心肌梗塞 事件前30 天或 365 天曾暴露過 sulfonylureas 藥物者相較於未暴露者,發生心肌梗 塞事件的風險並未較高。但是若將各種sulfonylureas 分開後再進行評估,則發現在 事件前365 天使用過 gliclazide 的病人,發生心肌梗塞事件的風險較高。過去大部 分的文獻均指出,gliclazide 對心血管系統較不具影響,因此我們的研究結果尚需 後續研究進行更深入的探討。而根據本研究結果,sulfonylureas 藥物在糖尿病藥物 的新使用者上,似乎不會增加心肌梗塞的風險。
在心衰竭事件上,sulfonylureas 藥物無論在事件前 30 天或 365 天的迴歸模式 均未達到統計顯著意義,顯示其和心衰竭事件並沒有特別的相關性。然而將 sulfonylureas 藥物分開後再進行分析,發現在心衰竭事件前 365 天使用過 gliquidone 的病人,發生心衰竭事件的風險較高。過去的文獻鮮少針對此議題進行探討。
在中風事件上,分析結果顯示 sulfonylureas 藥物在中風事件前 30 天可能具有 保護性的作用,其中以gliclazide 與 glimepiride 較為顯著。而在 365 天模式分析的 結果,發現上述兩個藥物的保護性效果可能受到對中風事件具有不良影響的 glyburide 稀釋。而若進一步以累積暴露劑量分析,上述兩個藥物的保護性效果則 再度達到顯著,顯示其保護性的效果就長期而言與暴露程度相關。
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