瑞格列奈致老年糖尿病患者严重低血糖8例分析  

Study on serious hypoglycemia induced by repaglinide in treatment of elderly patients with diabetes mellitus

作　　者：余桂翔[1] 黄胜立[1] 

机构地区：[1]中国人民解放军第95医院内分泌科,福建莆田351100

出　　处：《临床和实验医学杂志》2012年第21期1703-1704,共2页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨老年糖尿病患者服用瑞格列奈致严重低血糖的临床特点。方法回顾性收集2008年1月至2011年6月住院治疗的瑞格列奈致严重低血糖8例,经末梢血糖检测诊断低血糖后,一边留取血清样本,一边立即予50%葡萄糖静推处理。血清样本检测胰岛素、C肽水平、肝肾功能、电解质水平,待病稳定后检测糖化血红蛋白、皮质醇、甲胎蛋白及进行胸片、全腹B超、颅脑CT等检查。结果所有病例中有肝脏疾病4例,胃癌1例,肺结核1例,未进食者1例。结论有肝脏疾病的老年糖尿病患者服用瑞格列奈可能更易致低血糖,对于这类病例用药应慎重。Objective To explore the clinical characteristics of serious hypoglycemia caused by repaglinide in treatment of elderly patients with diabetes mellitus. Methods The clinical data of 8 elderly patients with diabetes mellitus suffered from serious hypoglycemia during the treatment course of repaglinide admitted in this hospital during January 2008 to June 2011 were retrospectively analyzed. Under finger blood glucose monitoring, serum samples of patients were collected, and patients were simultaneously treated with intravenous injection of glucose. Serum levels of insulin, C - peptide, hepatic and renal functions and serum electrolytes were immediately detected. After the recovery of consciousness of patients, serum levels of HbA1c, cnrtisol, and AFP were detected, then chest X -ray films, type -B ultrasonography and cranial computed tomography were performed. Results Among these patients, four patients suffered from liver diseases, one patient with stomach cancer, one case with pulmonary tuberculosis and one patient due to without taking food. Conclusion It is important to be mentioned that elderly patients with diabetes mellitus associated with liver diseases are easily to produce hypoglycemia during the therapeutic course of repaglinide.

关 键 词：老年糖尿病 瑞格列奈 低血糖 

分 类 号：R587.1[医药卫生—内分泌]