慢性阻塞性肺疾病和2型糖尿病患者应用二甲双胍安全及有效性评价

Safety and efficacy evaluation of metformin in treatment of patients with chronic obstructive pulmonary disease and type 2 diabetes mellitus

目的二甲双胍对于2型糖尿病治疗有明确的效果,同时也可能给慢性阻塞性肺病(慢阻肺)患者带来额外的收益。由于二甲双胍存在乳酸酸中毒的风险,所以在慢性阻塞性肺病患者上使用的安全性需要证实。方法选取我院住院2型糖尿病合并慢性阻塞性肺病的患者,随机分为二甲双胍组和对照组。主要观察服用二甲双胍患者,服药后对患者乳酸浓度及APACHEII评分及1年的生存率进行评价。结果相对与对照组,二甲双胍组70例患者治疗1年后乳酸浓度没有明显的差异(P>0.05)。通过治疗两组患者APACHEII评分均有下降,二甲双胍组下降幅度高于正常对照组(P<0.05)。二甲双胍组1年生存率有明显高于对照组(P<0.05);结论二甲双胍在慢阻肺患者应用是安全的,不会引起乳酸的升高,并且能降低APACHEII评分,增加患者的生存时间。

Objective To evaluate the safety and efficacy of metformin in treatment of patients with chronic obstructive pulmonary disease and type 2 diabetes mellitus. Methods COPD patients complicated with type 2 diabe- tes mellitus were randomly divided into two groups ： the metformin group and the control group. Their lactic acid concentration, APACHEII score and survival rate of 1 year were evaluated. Results There was no significant difference in the concentration of lactic acid 1 year after treatment （P 〉 0.05）. Through the treatment, their APACHEII score both decreased, and the decrease was more pronounced in the metformin group than in the control group （ P 〈 0. 05 ）. The survival rate of 1 -year was obviously higher in the metformin group than in the control group （ P 〈 0. 05 ）. Con- clusion The application of metformin in patients with COPD is safe, which can not cause the increase of lactic acid, reduce the patients APACHEII score, and increase the survival time of patients.