速效胰岛素类似物临床应用专家指导意见  

Experts Opinion of Rapid-acting Insulin Analogs on Clinical Applications

作　　者：母义明[1] 朱大龙 李焱[3] 姬秋和[4] 石勇铨[5] 李启富[6] 李强[7] 李全民 MU Yi-ming ZHU Da-long LI Yah JI Qiu-he SHI Yong-quan LI Qi-fu LI Qiang LI Quan-min(Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China Department of Endocrinology, Nanjing Drum Tower Hospital, Nanjing Jiangsu 210000, China Department of Endocrinjology, Sun Yat-sen Memorial Hospital Sun Yat-sen University, Guangzhou Guangdong 510120, China Department of Endocrinology, XiJing Hospital, Xi＇an Shanxi 710032, China Department of Endocrinology, Shanghai Changzheng Hospital, Shanghai 200433, China Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China Department of Endocrinology, the 2nd Affiliated Hospital of Harbin Medical University, Harbin Heilongjiang 150081, China Department of Endocrinology, Rocket PLA General Hospital, Beijing 100088, China)

机构地区：[1]解放军总医院内分泌科,北京100853 [2]南京鼓楼医院内分泌科,江苏南京210000 [3]中山大学孙逸仙纪念医院内分泌科,广东广州510120 [4]第四军医大学西京医院内分泌科,陕西西安710032 [5]第二军医大学附属长征医院内分泌科,上海200433 [6]重庆医科大学附属第一医院内分泌科,重庆400016 [7]哈尔滨医科大学附属第二医院内分泌科,黑龙江哈尔滨150081 [8]火箭军总医院内分泌科,北京100088

出　　处：《药品评价》2016年第21期13-17,53,共6页Drug Evaluation

摘　　要：速效胰岛素类似物模拟餐时胰岛素分泌,在控制餐后血糖和低血糖风险等方面优于重组人胰岛素,而且餐前即刻注射更为方便,有助于提高糖尿病患者治疗的依从性。目前速效胰岛素类似物主要有赖脯胰岛素、门冬胰岛素和谷赖胰岛素。为了帮助临床医生更好地使用速效胰岛素类似物,中国专家基于国内外临床证据及临床经验,制订了《速效胰岛素类似物临床应用专家指导意见》。本指导意见概述了速效胰岛素类似物结构和药代/药效动力学特点,重点阐述了速效胰岛素类似物在基础-餐时方案和胰岛素泵中的临床应用,针对妊娠、儿童及老年等特殊糖尿病人群也给出了具体指导,同时列出了速效胰岛素类似物起始剂量及调整方法供临床参考。Rapid-acting insulin analogs mimic postprandial insulin secretion, which contributes to its advantage over recombined human insulin on control postprandial blood glucose and hypoglycemia risk. Furthermore, pre-meal injection immediate followed by dieting provided more convenience and increased the patient＇s compliance for treatment. Nowadays, rapid-acting insulin analogs include insulin lispro, insulin aspart and insulin glulisine. To support the clinical application for clinicians, Chinese experts established the experts opinion of rapid-acting insulin analogs on clinical applications by domestic and foreign clinical evidences and experiences. This experts opinion summarized structure and pharmacodynamics and pharmacokinetics of rapid-acting insulin analogs. It mainly focused on application of basal-bolus insulin treatment and insulin pump, and provided detailed suggestions on special patients such as pregnancy, juvenile, and senile diabetes. Meanwhile, this experts opinion demonstrated initial dose and titration methods of rapid-acting insulin analogs.

关 键 词：胰岛素 临床应用 速效胰岛素类似物 

分 类 号：R587.1[医药卫生—内分泌]