贝特类调脂药物可减少2型糖尿病患者心血管事件——循证医学的新证据

Fibrates Reducing Cardiovascular Events in Type 2 Diabetes——Evidence-based Therapy

积极有效的调脂治疗对减少2型糖尿病心血管并发症具有重要意义,为了将最新、最可靠的调脂治疗进展提供给临床医生,本文对贝特类药物在糖尿病性血脂异常中应用的系统评价(SystematicReview,SR)、Meta-分析和大样本随机对照试验(RandomizedControlledTrial,RCT)进行了检索和评价,发现早期系统评价具有相当大的局限性,应及时进行数据更新和重新评价。而几项最新的大规模临床随机对照试验对贝特类药物在减少糖尿病人心血管并发症中可能具有独特的治疗作用进行了重要研究,发现贝特类药物可明显降低糖尿病人和/或具有典型糖尿病性血脂异常的超重病人的心血管事件的发生率。临床医生应根据2型糖尿病脂代谢异常的特点及病人的具体实际进行科学的选择。

All published evidences about the effects o f fibrates on reducing cardiovascular events in diabetes were reviewed.The earl ier Meta-analysis should be reviewed again because there is emerging evidence fo r a selective and preferential effect of fibrates in reducing cardiovascular eve nts in subjects with a typical diabetic dyslipidemia who have an increased body weight and/or diabetes in recent clinical trials.Physicians should pay more att ention to fibrates in therapy of diabetic dyslipidemia.