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目的通过本项研究进一步评价最大剂量优降糖治疗症状明显的NIDDM患者的临床疗效。方法本研究中 39例NIDDM患者空腹血糖≥ 30 0mg/dl(其中 11例尿酮 +～ + + + + )并有明显的多饮 ,多尿 ,体重减轻及乏力等。患者年龄 <6 5岁者优降糖 10 0mg早、晚餐前 30分钟服用 ,年龄≥6 5岁者予半量即优降糖 5mg早、晚餐前 30分钟服用。结果 (1) 94.2 %的MIDDM患者在治疗后第 1周血糖从 36 5± 45mg/dl降至 2 0 5± 18mg/dl,第 4周降至 110± 10mg/dl。(2 )GHb在治疗后第 4月从治疗前的 17.1%± 0 .5 %降至 7.3%± 0 .2 % (P <0 .0 0 1)。 (3) 10 0 %的患者症状在 3～ 5天内得以明显缓解 ,11例尿酮阳性患者均在治疗后 1～ 3天转阴。(4 )患者的胰岛素 /血糖及C肽 /血糖比值在治疗后第一周得到最大改善 (P <0 .0 0 1)。 (5 )整个实验中无一例患者有明显低血糖反应。结论我们认为 ,最在剂量优降糖治疗症状明显的NIDDM患者不失为一种安全有效的治疗措施 ,患者的症状及血糖能得到快速改善 ,因而避免了胰岛素治疗的过早干预。
Objective To further evaluate the clinical efficacy of maximal dose of glyburide in the treatment of patients with NIDDM who have obvious symptoms through this study. Methods In this study, 39 cases of NIDDM patients with fasting blood glucose ≥ 30 0mg / dl (of which 11 cases of urine ketone + ~ + + +) and significant polyhydration, polyuria, weight loss and fatigue. Patients aged <6 5-year-old patients with hypoglycemic 10 0 as early as 30 minutes before dinner, aged ≥ 65 years of age to half of the amount of hypoglycemic 5mg early, 30 minutes before dinner to take. RESULTS: (1) 94.2% of MIDDM patients had their blood glucose dropped from 36 5 ± 45 mg / dl to 205 ± 18 mg / dl during the first week and 110 ± 10 mg / dl during the fourth week. (2) GHb decreased from 17.1% ± 0.5% before treatment to 7.3% ± 0.2% (P <0.01) in the fourth month after treatment. (3) The symptoms of 100% of patients were relieved within 3 ~ 5 days, and 11 patients with positive urine-ketone were turned negative 1 ~ 3 days after treatment. (4) The patients’ insulin / blood glucose and C-peptide / blood glucose ratio showed the greatest improvement in the first week after treatment (P <0.01). (5) None of the patients in the experiment had a significant hypoglycemic response. Conclusions We believe that NIDDM, the most symptomatic treatment of patients with glyburide, may be a safe and effective treatment for patients with symptoms and rapid improvement in blood glucose, thus avoiding premature insulin intervention.