沙龙会课件——干预血糖即刻行动jin.ppt

STOP-NIDDM研究是一项多中心、双盲、安慰剂对照研究。1429例IGT患者随机接受安慰剂或阿卡波糖治疗3年。研究主要终点是观察阿卡波糖能否延缓或预防IGT患者发展至2型糖尿病，次要终点是评价阿卡波糖治疗对严重心血管事件和高血压的影响。结果显示，与安慰剂相比，阿卡波糖显著降低任何心血管事件的发生率49%，降低心肌梗死91%，新发高血压34%。 MeRIA研究荟萃分析了7项双盲、随机、安慰剂对照试验，旨在探讨阿卡波糖治疗对2型糖尿病患者心血管事件的影响。纳入2180例2型糖尿病患者，平均随访时间超过400天。结果显示，降低任一心血管事件35%，心肌梗死64%。 * 欧洲心脏病学协会和欧洲糖尿病研究协会联合指南还强调心血管疾病患者应综合控制多重危险因素，除血糖之外，还包括血压、血脂，以及吸烟、体重和饮食习惯等，并推荐了各项危险因素的控制目标。 * * 针对1429例IGT人群的STOP-NIDDM研究发现，在拜唐苹平均治疗3.3年的情况下，不仅能够降低IGT人群进展为2型糖尿病的发病风险，同时还显著改善了IGT人群收缩压和舒张压的水平。 IGT人群新发高血压的发生率降低了34%。 * 在近期发表的一篇文章中，对拜唐苹、瑞格列奈、那格列奈等几种降低餐后血糖药物的对血脂的作用进行了综述。 综述中提到，多项研究证实，拜唐苹?能够显著降低总甘油三酯（TG）、脂蛋白残粒胆固醇(RLP-C)的含量，对血脂具有积极影响；而对于格列奈类药物的研究均未发现其对血脂的阳性调节作用。 * SUMMARY In order to estimate the incidence of severe hypoglycaemia (de?ned as episodes severe enough to require hospitalization in general medical wards) among known diabetics in Hong Kong in 1990, both the total number of such admissions to the Prince ofWales Hospital and the age and sex distribution and number of known diabetics among its catchment population were de?ned. The latter was derived from the 1991 census and two studies or the prevalence of diabetes mellitus in Chinese subjects in the New Territories East region in 1987 and 1990. The incidence of severe hypoglycaemia was generally higher in women than in men and in older than in younger subjects. The incidence was 15±19 times higher in subjects aged 560 years than in those aged 459 years (men 3.51 versus 0.17%, women 6.86 versus 0.43%, overall 5.16 versus 0.29%). As many as 24.16% of the subjects aged 70±74 years had severe hypoglycaemia in 1990. The overall incidence of severe hypoglycaemia in all known diabetics was 1.40%. Based on the data from a drug utilization study (70.24% and 5.93% of diabetics receiving sulphonylureas and insulins, respectively), it could be estimated that in 1990, the incidence of hypoglycaemia requiring hospitalization in general medical wards was 1.42% for sulphonylureas and 6.84% for insulins. * Background: Target organ damage (mainly card