阿卡波糖治疗老年糖尿病伴餐后低血压的疗效及安全性分析

Analysis of the efficacy and safety of acarbose in the treatment of elderly patients with diabetes mellitus and postprandial hypotension

目的分析阿卡波糖治疗老年糖尿病伴餐后低血压的临床疗效与安全性。方法74例糖尿病伴餐后低血压老年患者,均给予阿卡波糖治疗。对比治疗前后收缩压、舒张压、平均动脉压(MAP)最大降幅、肠系膜上动脉血流最大增幅、餐后血糖最大增幅,分析治疗后餐后低血压发生情况及不良反应发生情况。结果治疗后,患者收缩压、舒张压、平均动脉压最大降幅、肠系膜上动脉血流最大增幅、餐后血糖最大增幅分别为(22.93±6.877)mm Hg(1 mm Hg=0.133 kPa)、(9.82±4.27)mm Hg、(3.59±2.11)mm Hg、(364.75±87.05)ml/min、(2.13±0.98)mmol/L,均显著小于治疗前的(32.15±10.53)mm Hg、(12.73±4.84)mm Hg、(11.56±3.71)mm Hg、(487.63±112.03)ml/min、(3.49±1.79)mmol/L,差异具有统计学意义(P<0.05)。治疗后餐后低血压发生率为40.54%(30/74)。治疗后7例(9.46%)患者发生轻微消化道反应,其中4例腹泻,3例腹胀,停药后症状改善,未发生严重心脑缺血疾病。结论阿卡波糖治疗老年糖尿病伴餐后低血压疗效确切,安全性较高,可作为糖尿病伴餐后低血压患者理想药物的选择。

Objective To analyze the clinical efficacy and safety of acarbose in the treatment of elderly diabetic patients with postprandial hypotension.Methods 74 elderly patients with diabetes mellitus and postprandial hypotension were selected and given acarbose intervention treatment.The maximum decrease in systolic blood pressure,diastolic blood pressure,mean arterial pressure(MAP),maximum increase in superior mesenteric artery blood flow,and the maximum increase in postprandial blood glucose before and after treatment were compared before and after treatment,and the occurrence of postprandial hypotension and adverse reactions after treatment were analyzed.Results After treatment,the maximum decrease in systolic blood pressure,diastolic blood pressure,mean arterial pressure,maximum increase in superior mesenteric artery blood flow,and maximum increase in postprandial blood glucose were(22.93±6.877)mm Hg(1 mm Hg=0.133 kPa),(9.82±4.27)mm Hg,(3.59±2.11)mm Hg,(364.75±87.05)ml/min,(2.13±0.98)mmol/L,which were significantly less than(32.15±10.53)mm Hg,(12.73±4.84)mm Hg,(11.56±3.71)mm Hg,(487.63±112.03)ml/min,(3.49±1.79)mmol/L before treatment,and the differences were statistically significant(P<0.05).The incidence of postprandial hypotension after treatment was 40.54%(30/74).After treatment,7 patients(9.46%)had mild gastrointestinal reactions,including 4 cases of diarrhea and 3 cases of abdominal distension.The symptoms improved after discontinuation of the drug,and no serious cardiac and cerebral ischemia occurred.Conclusion Acarbose is effective and safe in the treatment of diabetes mellitus with postprandial hypotension in the elderly,and can be the ideal drug for patients with diabetes mellitus and postprandial hypotension.