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罗格列酮为噻唑烷二酮类口服降糖药,能改善胰岛素敏感性,用于治疗2型糖尿病。近年,罗格列酮的心血管风险受到人们关注。一项荟萃分析显示:罗格列酮组与对照组比较,心肌梗死的优势比(OR)为1.43,[95%可信区间(CI)1.03～1.98,P=0.03];心血管性死亡OR为1.64,(95%CI0.98～2.74,P=0.06),表明罗格列酮与心肌梗死及心血管性死亡有关联。然而,最近RECORD中期研究显示:罗格列酮组心肌梗死49例,对照组40例(P=0.34),而两组的充血性心力衰竭分别为47例和22例(P=0.003),表明罗格列酮不增加心肌梗死和心血管性死亡风险,但可使充血性心力衰竭风险增加。另外,FDA2008年发布了有关罗格列酮的用药指南和处方信息,罗格列酮禁用于严重心力衰竭患者。因此,使用罗格列酮时应权衡利弊,并应个体化用药。
Rosiglitazone is an oral hypoglycemic agent of thiazolidinediones that improves insulin sensitivity for the treatment of type 2 diabetes. In recent years, the cardiovascular risk of rosiglitazone has received much attention. A meta-analysis showed that the odds ratio (OR) of myocardial infarction was 1.43 (95% confidence interval [CI] 1.03 to 1.98, P = 0.03] in rosiglitazone group compared with control group; cardiovascular death OR Was 1.64 (95% CI 0.98-2.74, P = 0.06), indicating that rosiglitazone is associated with myocardial infarction and cardiovascular death. However, a recent RECORD interim study showed 49 cases of myocardial infarction in rosiglitazone group and 40 cases in control group (P = 0.34), while congestive heart failure in both groups was 47 and 22 (P = 0.003), respectively Rosiglitazone does not increase the risk of myocardial infarction and cardiovascular death but may increase the risk of congestive heart failure. In addition, the FDA released its 2008 guidelines on the use of drugs and its products and rosiglitazone was banned in patients with severe heart failure. Therefore, the use of rosiglitazone should weigh the pros and cons and should be personalized medication.