二甲双胍在高海拔地区糖尿病治疗中的安全性研究  

Safety of metformin in diabetic patients at high altitude area

作　　者：杨历新[1] 米娜[1] 王叶[1] 朱沁芳[1] 韩维良[1] 李金娟[1] 李澍[1] 陈鹏 何忠 

机构地区：[1]青海省人民医院内分泌科,西宁810007 [2]格尔木市人民医院

出　　处：《中华内分泌代谢杂志》2010年第10期865-867,共3页Chinese Journal of Endocrinology and Metabolism

基　　金：青海省科技项目计划基金（2009-Z-724）

摘　　要：高海拔地区初诊糖尿病患者61例,个体化治疗基础上全部加用二甲双胍1.5g/d治疗14 d.平均海拔2 260米和2 780米两地区（海拔差580米）,氧分压相差3.5 mm Hg（1 mm Hg=0.133 kPa）,初发糖尿病患者在治疗前血乳酸水平即高于正常值.高海拔地区中青年组及老年组治疗前血乳酸水平均较高[（3.90±0.85对3.65±0.70）、（4.67±0.80对3.69±0.78）mmol/L,均P＜0.05],中青年组糖尿病患者加用二甲双胍14 d后血乳酸水平未显著上升[（4.50±0.50和3.79±0.62）mmol/L,P＞0.05],老年组糖尿病患者加用二甲双胍14 d后血乳酸水平明显上升[（5.59±0.55和5.27±0.43）mmol/L,P＜0.05].因此,在高原地区的老年糖尿病患者应慎用或避免使用二甲双胍.Sixty-one newly-diagnosed diabetic patients from high altitude area were treated individually plus metformin 1.5 g/d for 14 days. The difference of oxygen partial pressure was 3.5 mm Hg （1 mm Hg=0. 133kPa） between altitude 2 260 m and 2 780 m districts. In these patients, their serum lactic acid was increased before treatment. At altitude 2 780 m district, serum lactic acid in middle-aged and elder groups were even higher [（3.90±0.85 vs 3.65±0.70）, （4. 67±0.80 vs 3.69±0.78） mmol/L, both P〈0. 05=. After 14-day treatment, serum lactic acid in middle-aged diabetic patients remained statistically unchanged [（4.50±0.50 and 3.79±0.62 ） mmol/L, P〉0.05], while that in elder patients was increased significantly [（5.59±0.55 and 5.27±0.43 ） mmol/L,P〈0. 05]. The results suggested that metformin should not be used or be used carefully in elder diabetic patients at high altitude area.

关 键 词：低氧 糖尿病 血乳酸 二甲双胍 

分 类 号：R686[医药卫生—骨科学]