老年2型糖尿病合并动脉粥样硬化性心血管疾病多重用药管理规范  

Management Standards of Polypharmacy in Type 2 Diabetes Combined with Atherosclerotic Cardiovascular Diseases in the Elderly

作　　者：曾森祥 杨锐[2] 邓勋[3] 杨睿涛 杨晓燕[2] ZENG Senxiang;YANG Rui;DENG Xun;YANG Ruitao;YANG Xiaoyan(School of Pharmacy,Southern Medical University,Guangzhou 510515,China;Department of Endocrinology and Metabolism,Zhujiang Hospital,Southern Medical University,Guangzhou 510262,China;Department of Pharmacy,Zhujiang Hospital,Southern Medical University,Guangzhou 510262,China)

机构地区：[1]南方医科大学药学院,广东省广州市510515 [2]南方医科大学珠江医院内分泌代谢科,广东省广州市510262 [3]南方医科大学珠江医院药剂科,广东省广州市510262

出　　处：《中国全科医学》2024年第5期597-603,共7页Chinese General Practice

摘　　要：2型糖尿病(T2DM)是老年人常见的慢性病之一,持续的高血糖易损伤全身血管,影响心、肾、眼和神经等器官组织,导致各种并发症的出现。其中,动脉粥样硬化性心血管疾病(ASCVD)是T2DM患者死亡的主要原因,此类患者需要进行降糖、调脂、降压、抗血小板和降低尿蛋白等综合治疗。多重用药对合并多种并发症的老年人有较好的疾病控制作用,但如果应用不合理、不科学,也会带来潜在的药物相互作用和药物不良反应等问题。本文针对老年T2DM合并ASCVD患者多重用药管理进行分析,重点阐述降糖药、降压药、调脂药和抗血小板药等之间的相互作用和注意事项,保证药物使用有效性的前提下提高患者用药的合理性、安全性和规范性,减少不良反应的发生,为临床医师用药提供参考。Type 2 diabetes mellitus(T2DM)is one of the common chronic diseases among the elderly.Persistent hyperglycemia damages blood vessels throughout the body,affecting organs and tissues such as heart,kidneys,eyes,and nerves,leading to various complications.Atherosclerotic cardiovascular diseases(ASCVD)are the main cause of death in T2DM patients.Such patients need comprehensive treatment such as glucose-lowering,lipid-regulation,antihypertensive,antiplatelet,and urinary protein-lowering treatments.Polypharmacy plays a good role in disease control in older adults with multiple comorbidities,but it also poses a number of problems such as potential drug interactions and adverse drug reactions if applied in an irrational and unscientific manner.This paper analyses the management of polypharmacy in elderly T2DM patients combined with ASCVD,with a particular emphasis on the interactions among hypoglycemic,antihypertensive,lipidregulating,and antiplatelet medications,as well as precautions,so as to improve the rationality,safety and standardization of medication under the premise of ensuring the efficacy of medication,reduce the occurrence of adverse reactions and provide reference for clinicians in the use of drugs.

关 键 词：糖尿病 2型 动脉粥样硬化性心血管疾病 多重用药 合理用药 管理 

分 类 号：R587.1[医药卫生—内分泌] R543.5[医药卫生—内科学]