最大剂量格列本脲治疗症状明显的非胰岛素依赖型糖尿病临床疗效观察  

Clinical effective observation of maximal dose glyburide therapy in markedly symptomatic patients with NIDDM

作　　者：时立新[1] 李红[1] 马启玲[1] 张松[1] 范良敏[1] 庄惠君[1] 简桂生[1] 刘宗阳[2] 

机构地区：[1]贵阳医学院附属医院内分泌科,550004 [2]贵阳医学院附属医院内科,550004

出　　处：《贵州医药》2001年第1期22-24,共3页Guizhou Medical Journal

摘　　要：目的通过本项研究进一步评价最大剂量优降糖治疗症状明显的NIDDM患者的临床疗效。方法本研究中 39例NIDDM患者空腹血糖≥ 30 0mg/dl(其中 11例尿酮 +～ + + + + )并有明显的多饮 ,多尿 ,体重减轻及乏力等。患者年龄 <6 5岁者优降糖 10 0mg早、晚餐前 30分钟服用 ,年龄≥6 5岁者予半量即优降糖 5mg早、晚餐前 30分钟服用。结果 (1) 94.2 %的MIDDM患者在治疗后第 1周血糖从 36 5± 45mg/dl降至 2 0 5± 18mg/dl,第 4周降至 110± 10mg/dl。(2 )GHb在治疗后第 4月从治疗前的 17.1%± 0 .5 %降至 7.3%± 0 .2 % (P <0 .0 0 1)。 (3) 10 0 %的患者症状在 3～ 5天内得以明显缓解 ,11例尿酮阳性患者均在治疗后 1～ 3天转阴。(4 )患者的胰岛素 /血糖及C肽 /血糖比值在治疗后第一周得到最大改善 (P <0 .0 0 1)。 (5 )整个实验中无一例患者有明显低血糖反应。结论我们认为 ,最在剂量优降糖治疗症状明显的NIDDM患者不失为一种安全有效的治疗措施 ,患者的症状及血糖能得到快速改善 ,因而避免了胰岛素治疗的过早干预。Objective The clinical effects of maximal dose glyburide therapy in markedly symptomatic patients with NIDDM were further evaluated. Methods 39 patients with polyuris,polydipsia,weight loss,fatigue and fasting blood glucose concentrations of 300mg/dl or greater were randonmly selected.The protocols for treatment were maximal dose glyburide (10mg,twice daily) in patients <65Yr of age,and half the dose in patients > 65Yr of age.Results (1)94.5% of patients responded rapidly with a fall in blood glucose levels from 365+45mg/dl at baseline to 205+18mg/dl at I week to 10+10mg/dl at 4 months.(2)Glycated hemoglobi levels fell from 17.1+0.5% at baseline to 7.3+0.2% ( P <0.01) at 4 months.(3)100% ofpatients had symptomatic improvement within 3 to 5 days,and 11 patients with positive urinary ketons got negative within 1 to 3 days.(4) Insulin to glucose and C peptide to glucose ratios improved maximally ( P <0.01) at I week.(5) No patients experienced hypoglycemia in the fiest month of treatment.Conclusion The maximal dose glyburide therapy as a safe and effective method for treating markedly symptomatic patients with NIDDM.The symptoms and blood glucose of the patients were improved rapidly and able to avoid the immediate institution of insulin therapy.

关 键 词：非胰岛素依赖型糖尿病 优降糖 最大剂量 药物疗法 治疗 疗效 

分 类 号：R587.105[医药卫生—内分泌] R977.15[医药卫生—内科学]