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为了预防2型糖尿病心血管并发症,最重要的是要把血糖控制在最佳水平。单一用药常常是短期内奏效,为了常期维持良好血糖水平,需要多药联用。目前,口服降糖药种类很多,例如:二甲双胍、磺脲类药物、格列奈类药物、α葡萄糖苷酶抑制剂及噻唑烷二酮类药物(TZD)。本文对2型糖尿病口服降糖药联合疗法进行了简要回顾。特别分析了不同种类的降糖药对心血管风险因子(特别是高血压和血脂紊乱)及已知心血管疾病(CVD)的抑制或治疗作用。TZD在改善糖尿病患者伴有的高血压、血脂紊乱、炎症及血管内皮功能方面发挥着重要作用。本文还讨论了不同药物联合应用可能带来的不良后果。
In order to prevent cardiovascular complications of type 2 diabetes, the most important thing is to control blood glucose at the optimal level. Single drug often works in the short term, in order to maintain good blood sugar level often, need multi-drug combination. Currently, many oral hypoglycemic agents, such as: metformin, sulfonylureas, glinides, alpha glucosidase inhibitors and thiazolidinediones (TZD). This article reviews the combination therapy of oral hypoglycemic agents for type 2 diabetes. In particular, the effects of various hypoglycemic agents on the inhibition or treatment of cardiovascular risk factors (especially hypertension and dyslipidemia) and known cardiovascular disease (CVD) were analyzed. TZD plays an important role in improving hypertension, dyslipidemia, inflammation and vascular endothelial function in diabetic patients. This article also discusses the possible adverse consequences of the combination of different drugs.