短期双胍类降糖药治疗对糖尿病患者血乳酸水平的影响-东南大学学报医学版

短期双胍类降糖药治疗对糖尿病患者血乳酸水平的影响

单位：南方医科大学附属深圳医院,内分泌科,广东,深圳,518035

分类号：R977.15

出版年·卷·期（页码）：2008·27·第一期（65-67）

摘要：

目的:观察短期苯乙双胍和二甲双胍治疗高龄2型糖尿病(DM)患者对血浆乳酸水平的影响.方法: 苯乙双胍组为16例高龄(60～74岁)2型DM患者,每日服用苯乙双胍150 mg,连续7 d;二甲双胍组为16例高龄(60～76岁)2型DM患者,每日服用二甲双胍1.5 g,连续7 d.于服药前、服药1～7 d,每日监测血浆乳酸水平的变化.结果: 苯乙双胍组服药后血乳酸水平[分别为(2.64 ±0.74)、(2.76±0.72)、(3.42 ±1.01)、(3.44±0.78)、(3.67±0.78)、(3.74±0.87)、(3.76±0.86)mmol·L -1]较服药前水平[(2.32±0.59)mmol·L-1]显著增高(F=7.833,P=0.000).二甲双胍组服药前后血浆水平无明显变化(F=0.942,P=0.479).结论:高龄2型DM患者短期服用苯乙双胍可以引起血浆乳酸水平明显增高,继续服用有发生乳酸酸中毒的倾向.

Objective To observe the changes of plasma lactic acid following short-term phenformin and meltformin treatment in patients with type Ⅱ diabetes.Methods Sixteen patients with type 2 diabetes(aged 60~74 years)with oral administration of phenformin 150 mg daily for 7 days)and 16 patients with diabetes(aged 60~76 years)with oral adminstration of meltformin 1.5 g daily for 7 days were included.Plasma lactic acid was measured before the treatment and 1,2,3,4,5,6,7day after the treatment.Results The levels of plasma lactic acid of 0 to 7 days in the phenformin group were(2.32±0.59),(2.64±0.74),(2.76±0.72),(3.42±1.01),(3.44±0.78),(3.67±0.78),(3.74±0.87) and(3.76±0.86)mmol·L-1,respectively.The levels of plasma lactic acid after the treatment were apparently increased compared with those before the treatment(F=7.833,P=0.000).The levels of plasma lactic acid in meltformin were not obviously changed before and after the treatment(F=0.942,P=0.479).Conclusions The results reveal that short-term phenformin treatment for older patients with diabetes may lead to the increase of plasma lactic acid or even lactic acidosis when the treatment is prolonged.

参考文献：

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