關(guān)鍵信息

    對(duì)糖尿病患者而言，在診斷肝硬化后持續(xù)性使用二甲雙胍治療，因其可增加肝臟損傷風(fēng)險(xiǎn)而引起關(guān)注。為明確在確診肝硬化后使用二甲雙胍是否可以改善生存，該回顧性研究的作者調(diào)查了250名服用二甲雙胍治療糖尿病患者的病歷，其中172名患者在診斷肝硬化后繼續(xù)使用二甲雙胍治療。與中斷二甲雙胍治療的患者相比，持續(xù)***用二甲雙胍治療的患者存活時(shí)間更久（中位數(shù)11.8年  vs 5.6年；P < 0.0001）。沒有患者發(fā)生二甲雙胍相關(guān)的乳酸酸中毒。

    對(duì)伴肝硬化的糖尿病患者而言，持續(xù)性使用二甲雙胍可降低57%的死亡風(fēng)險(xiǎn)。

    TAKE-HOME MESSAGE

    In patients with diabetes, continuation of metformin after cirrhosis diagnosis carries concerns regarding increased risk due to liver impairment. To evaluate whether use of metformin after cirrhosis diagnosis improves survival, the authors of this retrospective study examined medical records of 250 patients with diabetes who were on metformin, 172 of whom continued on metformin after cirrhosis diagnosis. Patients who continued taking metformin survived longer than those who discontinued use （median 11.8 vs 5.6 years; P < .0001）。 None of the patients had metformin-associated lactic acidosis.

    In diabetic patients with cirrhosis, continuation of metformin reduced the risk of death by 57%.