方洁 沈志钢

【摘要】  目的  对比分析不同剂量二甲双胍用于糖尿病伴急性脑梗死的效果和对患者血糖的改善作用。方法  将2021年1月- 2022年8月南京市高淳人民医院神经内科采用二甲双胍治疗的糖尿病伴急性脑梗死患者作为研究对象。选择其中二甲双胍用药剂量＞500mg/d的患者30例为观察组，按照组间基线可比的原则选择其中二甲双胍用药剂量≤500mg/d的患者30例为对照组。将两组患者治疗前后的体重、糖化血红蛋白、空腹血糖、餐后2h血糖、神经功能缺损得分及不良反应作为观察指标。结果  治疗后，观察组患者体重指数、糖化血红蛋白、空腹血糖、餐后2h血糖及神经功能缺损得分均低于对照组，差异有统计学意义（P<0.05）。两组患者不良反应发生率比较，差异无统计学意义（P>0.05）。结论  和≤500mg/d二甲双胍相比，＞500mg/d二甲双胍用于糖尿病伴急性脑梗死患者效果更为理想，能更好控制患者的血糖水平，减轻神经功能缺损，同时不会显著增加不良反应出现，安全性较高。

【关键词】  二甲双胍；糖尿病；急性脑梗死；血糖

中图分类号  R578.1   文献标识码  A    文章编号  1671-0223（2024）13--03

Comparative analysis of clinical effects of different doses of metformin on diabetes patients with acute cerebral infarction  Fang Jie， Shen Zhigang. Department of Neurology， Nanjing Gaochun People's Hospital， Nanjing 211300， China

【Abstract】  Objective To compare and analyze the effect of different doses of metformin on diabetes patients with acute cerebral infarction and the improvement of blood sugar in patients with diabetes. Methods  From January 2021 to August 2022， the patients with diabetes accompanied by acute cerebral infarction who were treated with metformin in the Department of Neurology of Nanjing Gaochun People's Hospital were taken as the research objects. Select 30 patients with a dosage of metformin>500mg/d as the observation group， and select 30 patients with a dosage of metformin ≤ 500mg/d as the control group according to the principle of baseline comparability between groups. The body weight， glycated hemoglobin， fasting blood glucose， 2-hour postprandial blood glucose， neurological deficit score， and adverse reactions of two groups of patients before and after treatment were used as observation indicators. Results  After treatment， the body mass index， glycated hemoglobin， fasting blood glucose， 2-hour postprandial blood glucose， and neurological deficit score of the observation group were all lower than those of the control group， with statistical significance （P<0.05）. There was no statistically significant difference in the incidence of adverse reactions between the two groups of patients （P>0.05）. Conclusion Compared with metformin ≤ 500mg/d， metformin ＞ 500mg/d is more ideal for patients with diabetes complicated with acute cerebral infarction， which can better control the blood sugar level of patients， reduce neurological impairment， and will not significantly increase the occurrence of adverse reactions. It is safe and worth using.

【Key words】 Metformin; Diabetes; Acute cerebral infarction; Blood sugar

糖尿病属于临床一类高发慢性病，据有关资料显示[1]，该病2011年的患病数量在3.66亿左右，其中国内患病率为9.7％，且仍呈现升高趋势。疾病易引起大中动脉和微血管病变，造成机体脏器功能紊乱或者丧失，对患者生活质量及身体健康产生严重影响[2]。急性脑梗死属于临床一类多发疾病，也是糖尿病患者常见并发症，两类疾病同时存在会增加患者的致残致死机率[3]。因此，对于糖尿病伴急性脑梗死患者需要选取合理药物开展有效治疗。二……