阿卡波糖治疗老年人糖尿病合并餐后低血压的临床疗效

Clinical efficacy of Acarbose on diabetes mellitus combined with postprandial hypotension in elderly patients

的分析阿卡波糖治疗老年人2型糖尿病合并餐后低血压(PPH)的临床疗效。方法选取2016年7月至2017年12月在我院诊治为2型糖尿病合并PPH的老年患者60例为研究对象,给予阿卡波糖干预治疗2周,监测治疗前后患者的血压、心率和血糖变化,评估治疗效果和不良反应。结果阿卡波糖干预治疗后,糖尿病合并PPH老年患者餐后收缩压、舒张压、平均动脉压波动幅度均较治疗前明显减少(F=9.311、8.710、7.710,P=0.033、0.026、0.021);治疗前后心率的波动变化差异无统计学意义(F=8.091,P=0.069)。阿卡波糖治疗前后患者的空腹血糖水平差异无统计学意义(t=0.209,P=0.120);阿卡波糖干预治疗后,糖尿病合并PPH老年患者餐后2h血糖水平(7.9±0.9)mmol/L,较治疗前(8.9±1.9)mmol/L明显降低(t=18.310,P=0.003)。治疗前患者PPH发生率为100.0%,阿卡波糖干预治疗后PPH发生率下降至43.3%(26/60),差异有统计学意义(χ^2=51.430,P=0.000)。5例患者发生不良反应,不良反应发生率为8.3%(5/60),无患者发生心脑缺血事件。结论阿卡波糖能够改善糖尿病合并PPH患者餐后血压下降幅度、降低餐后血糖波动、减少PPH发生率,安全性高,是一种能有效缓解老年人糖尿病合并PPH的治疗手段之一。

Objective To analyze the clinical efficacy of Acarbose on type 2 diabetes mellitus combined with postprandial hypotension(PPH)in elderly patient.Methods A total of 60 elderly patients with type 2 diabetes mellitus and PPH who were diagnosed and treated at our hospital from July 2016 to December 2017 were enrolled in this study.Patients were given Acarbose intervention for two weeks.The changes of blood pressure,heart rate and blood glucose before and after treatment were monitored,and the therapeutic effects and side effects were evaluated.Results After Acarbose intervention,postprandial systolic pressure(F=9.311,P=0.033),diastolic pressure(F=8.710,P=0.026)and mean arterial pressure(F=7.710,P=0.021)were decreased significantly in elderly patients with type 2 diabetes mellitus and PPH by comparison with those before intervention.There was no significant difference in heart rate fluctuation(F=8.091,P=0.069)and in fasting blood glucose level(t=0.209,P=0.120)before and after treatment.The 2-hour postprandial blood glucose level was lower in elderly patients with diabetes mellitus and PPH after treatment of acarbose than before treatment[(7.9±0.9)mmol/L vs.(8.9±1.9)mmol/L,t=18.310,P=0.003].The incidence rate of PPH was 100.0%before treatment,and decreased to 43.3%(26/60)after acarbose intervention(χ^2=51.430,P=0.000).There were 5 patients with adverse reactions,and the incidence rate of adverse reactions was 8.3%(5/60),and no patients had cerebral ischemia.Conclusions Acarbose can alleviate postprandial blood pressure,decrease the fluctuation of postprandial blood glucose and reduce the incidence of PPH,which has a high safety.It may be one of the effective measures in treating diabetes mellitus combined with postprandial hypotension in the elderly.