钠-葡萄糖耦联转运体2抑制剂对合并糖尿病急性缺血性脑卒中患者近期神经功能的影响OA

Objective:To investigate the association between the use of sodium-glucose linked transporter 2(SGLT2)inhibitors and functional outcomes at discharge in diabetic patients with acute ischemic stroke(AIS).Methods:A retrospective cohort study was conducted using data from the Acute Stroke Patients for Stroke Management Quality Evaluation online database(CASE-Ⅱ,NCT04487340)for patients admitted between January 2022 and November 2024.Diabetic patients with AIS were categorized as SGLT2 inhibitor users or non-users(control group).Patients'functional outcomes were assessed using the modified Rankin Scale(mRS)score.Propensity score matching(PSM)was performed in a 1∶2 ratio.Multivariate logistic regression models were used to assess the association between SGLT2 inhibitor use and outcomes.Stratified analyses were performed based on pre-existing diabetes versus newly diagnosed diabetes during the hospitalization and the impact of long-term and short-term use of SGLT2 inhibitors on patients'functional outcomes at discharge was analyzed.Results:The study included 9220 patients(mean age 67±11 years;39.38%female),of whom 1915(20.77%)were SGLT2 inhibitor users.There were 1912 cases in the user group and 3683 cases in the non-user group after PSM.Before PSM,the proportion of patients with an mRS score 0-2 at discharge was significantly higher in the SGLT2 inhibitor group than that in the control group(79.84%vs.69.19%,P<0.01).After multivariable adjustment,SGLT2 inhibitor use remained significantly associated with higher proportion of mRS score 0-2(adjusted OR=1.24,95%CI:1.08-1.42,P<0.01)and mRS score 0-3(adjusted OR=1.62,95%CI:1.32-1.99,P<0.01)at discharge.Results were consistent after PSM.In stratified analyses,SGLT2 inhibitor use was associated with improved functional outcomes in both patients with pre-existing diabetes and those with newly diagnosed diabetes.Conclusion:Among diabetic patients with AIS,SGLT2 inhibitor use is independently associated with better functional outcomes at discharge,showing a potential benefit for short-term neurological recovery.