心血管疾病合并糖代谢异常的精品课件

心血管疾病合并糖代谢异常的 药物治疗 目 录 各类降糖药物的特点及适应证 心血管疾病合并糖代谢异常患者降糖药物 的联合应用 3 血糖控制目标 组织 糖化血红蛋白(%) 空腹血糖 (mmol/L) 餐后血糖 (mmol/L) ADA76.7/ IDF欧洲6.56.07.5 AACE6.56.010 kg的患者的比例高于常规组 N Engl J Med 2008;358:2630-33. （1399/5036）（713/5042） 增重10 kg的患者的比例% 强化组使用增加体重的药物 的比例远高于常规组 药药物种类类名称强化治疗疗(N = 5128)标标准治疗疗(N = 5123) 单独用药病例数（%）患者年病例数（%）患者年 二甲双胍4856 (94.7)14,4444452 (86.9) 12,693 促分泌剂4443 (86.6)12,0213779 (73.8)10,059 格列美脲4010 (78.2)9,142 3465 (67.6)8,955 瑞格列奈2574 (50.2)4,447908 (17.7)1,293 噻唑啉二酮类4702 (91.7)12,8442986 (58.3)6,719 罗格列酮4677 (91.2)12,6392946 (57.5) 6,563 -葡萄糖苷酶抑制剂1191 (23.2)941 263 (5.1) 200 肠促胰岛素911 (17.8)566251 (4.9)175 依泽那太622 (12.1)415204 (4.0)155 任意胰岛素3965 (77.3)11,9022837 (55.4) 7,842 任意快速注射胰岛素2834 (55.3）6,806 1794 (35.0) 4,336 N Engl J Med 2008;358:2630-33. 联合降糖降糖安全的重要部分 药物联合降糖是安全降糖的重要部分 注意合理的联合使用降糖药 不适当的强化降糖可能带来安全隐患 小 结 控制血糖药物按是否引起低血糖分为降糖药和抗 糖药 心血管疾病患者降糖药选择应注重心血管安全性 需要联合用药的患者选择不同作用机制的药物 关注降糖药引起的低血糖、体重增加、水钠潴留 谢 谢 ! 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