关键信息

    对糖尿病患者而言，在诊断肝硬化后持续性使用二甲双胍治疗，因其可增加肝脏损伤风险而引起关注。为明确在确诊肝硬化后使用二甲双胍是否可以改善生存，该回顾性研究的作者调查了250名服用二甲双胍治疗糖尿病患者的病历，其中172名患者在诊断肝硬化后继续使用二甲双胍治疗。与中断二甲双胍治疗的患者相比，持续***用二甲双胍治疗的患者存活时间更久（中位数11.8年  vs 5.6年；P < 0.0001）。没有患者发生二甲双胍相关的乳酸酸中毒。

    对伴肝硬化的糖尿病患者而言，持续性使用二甲双胍可降低57%的死亡风险。

    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%.