阿卡波糖治疗老年餐后低血压合并糖代谢异常患者的疗效及机制研究  

The investigation of therapeutic effect and its mechanism of acarbose on postprandial hypotension with concomitant abnormal glucose metabolism in elderly patients

作　　者：乔薇[1] 李靖[2] 李瑛[1] 黄静[1] 魏先森[1] 金江丽[1] 钱端[1] 

机构地区：[1]中日友好医院干部保健病区,100029 [2]中日友好医院干部肾内科,100029

出　　处：《中华老年医学杂志》2016年第10期1087-1090,共4页Chinese Journal of Geriatrics

基　　金：中央保健科研课题（W2013BJ26）

摘　　要：目的探讨餐后低血压（PPH）发生的机制，并为阿卡波糖治疗PPH提供理论依据。方法回顾性分析选取病情平稳的年龄〉80岁的PPH合并糖代谢异常患者43例，数字抽签随机分为为阿卡波糖治疗组（21例）和对照组（22例）。监测两组治疗前和治疗2周后的空腹至餐后2h的血压、血糖及肠系膜上动脉血流量。结果（1）阿卡波糖组与对照组比较，减弱了PPH患者餐后收缩压的降幅[（22．3±6．9）mmHg比（30．7±8．4）mmHg，1mmHg：0．133kPa，P=0．0003、餐后血糖的增幅[（2．3±1．6）mmol／L比（3．5±0．9）mmol／L，P=0．0023及餐后肠系膜上动脉血流量的增幅[（479．8±101．7）ml／min比（367．2±95．5）ml／min，P=0．0283，两组餐后舒张压的降幅无统计学差异[（11．3±5．3）mmHg比（10．8±5．6）mmHg，P=0．0583。阿卡波糖组PPH发生率由治疗前的100％（21例）减少为47．6％（10例），（P=0．002）；对照组用药前后PPH发生率均为100％（22例），（P〉0．05）。阿卡波糖组无明显药物不良反应发生。结论餐后内脏血流灌注异常增多是餐后低血压形成的机制之一。阿卡波糖通过抑制餐后肠系膜上动脉血流量的增加发挥了治疗餐后低血压的作用，阿卡波糖治疗老年PPH合并糖代谢异常有效且安全。Objective To explore the of therapeutic effect and its mechanism of acarbose on postprandial hypotension（PPH）with concomitant abnormal glucose metabolism in elderly patients. Methods The 43 elderly patients （〉 80 years）with PPH and concomitant abnormM glucose metabolism were randomly divided into two groups：acarbose group（n= 21）and control group（n= 22）. Before and two weeks after treatment, the blood pressure, blood glucose level, and the superior mesenteric artery blood flow of the two groups were monitored. Results The decrement of postprandial systolic blood pressures was lower in acarbose group than in control group（（22.3 ±6.9） vs. （30.7 ± 8.4） mmHg, 1 mmHg = 0. 133 kPa, P = 0. 0003. The increment of postprandial blood glucose was lower in acarbose group than in control group [ （ 2.3 ± 1.6） vs. （ 3.5 ± 0.9） mmol/L, P = 0. 0023. The decrement of postprandial diastolic blood pressure had no significant difference between two groups[（11.3±5.3）vs. （10.8±5.6）mmHg,P=0. 0583. The incidence rate of PPH before versus after treatment was 100% （21/21 cases） vs. 47.6vs. （10/21 cases） （P= 0. 002） in acarbose treatment group and 100% （21/21 cases）vs. 100% （21/21 cases）in control group（P〉0.05）. Acarhose treatment showed no significant side effects. Conclusions The abnormal increase in postprandial splanchnic peifusion is one of the reasons for PPH. Acarbose may exert its role in PPH treatment by reducing superior mesenteric artery blood flow. Giving aearbose to treat PPH with concomitant abnormal glucose metabolism is effective and safe in very old patients.

关 键 词：低血压 饭后间期 肠系膜动脉 

分 类 号：R587[医药卫生—内分泌] R544.2[医药卫生—内科学]