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1/3的糖尿病患者合并有心血管疾病。糖尿病治疗过程中应充分考虑到心血管方面的因素。二甲双胍、磺脲类药物或吡格列酮可用于合并稳定性冠状动脉疾病患者的治疗。对于急性冠脉综合征的患者,多次、不同剂量的胰岛素强化治疗可减少死亡率,而长期应用吡格列酮可减少心血管事件的复发率。但目前关于合并有慢性心力衰竭的糖尿病患者的血糖控制的试验几乎没有,二甲双胍和胰岛素为这类患者的常用降糖手段。二肽基肽酶-4(DPP4)抑制剂是一种新型口服降糖药,对体重具有中性作用;注射用胰高血糖素样肽-1(GLP-1)受体激动剂则具有减重作用。它们对心血管是否存在益处仍需长期研究来证实。
One third of people with diabetes have cardiovascular disease. Diabetes treatment should take full account of cardiovascular factors. Metformin, sulfonylureas or pioglitazone can be used in the treatment of patients with stable coronary artery disease. For patients with acute coronary syndrome, multiple, different doses of insulin intensive therapy reduce mortality, while long-term use of pioglitazone can reduce the recurrence rate of cardiovascular events. However, there are few trials on glycemic control in diabetic patients with chronic heart failure. Metformin and insulin are commonly used as hypoglycemic agents in these patients. Dipeptidyl peptidase-4 (DPP4) inhibitor is a novel oral hypoglycemic agent that has a neutral effect on body weight; the glucagon-like peptide-1 (GLP-1) receptor agonist for injection has a reduced Rework. Their long-term studies on the cardiovascular benefits still need to be confirmed.