二甲双胍的心血管保护作用

二甲双胍(Metformin)属双胍类药物,作为口服降糖药应用于2型糖尿病(T2DM)已有50年的历程,其降糖作用已得到公认。近年越来越多的研究发现,二甲双胍具有降糖以外的心血管保护作用,能抑制动脉粥样硬化(Atherosclero-sis,AS)、心衰、心肌梗死等心血管病的发生和发展。但二甲双胍确切的心血管保护机制仍不明确,本文综述了二甲双胍对心血管疾病的作用,并探讨其可能的作用机制。     

二甲双胍降糖外作用的研究进展

二甲双胍作为目前治疗2型糖尿病的一线药物,疗效安全稳定。其降糖机理主要是通过抑制肝产生葡萄糖,并降低小肠对葡萄糖的吸收,从而发挥降糖作用。二甲双胍除了作为安全稳定的降糖药物,近年来越来越多的学者开始将目光聚焦于二甲双胍降糖外的作用。已有研究证明二甲双胍在肌肉、脂肪、上皮、脑、骨组织及卵巢等器官中皆可发挥作用。某些口腔疾病的治疗涉及骨再生、神经再生、癌细胞的消灭等,基于二甲双胍在许多组织中的多向作用,有理由相信其在口腔疾病的治疗方面存在潜在价值。     

二甲双胍抗衰老临床研究与作用机制研究进展

二甲双胍是一种安全有效的糖尿病治疗药物,除具有降糖作用外,还具有保护心脏、抗炎和抗癌等作用.近年来,多项细胞和动物实验结果显示,二甲双胍具有抗衰老作用,一些临床试验结果也证明二甲双胍对年龄相关疾病具有积极作用,包括心血管疾病、癌症和神经退行性疾病等.该文对二甲双胍抗衰老相关的临床试验分子机制进行综述,探索二甲双胍在抗衰...     

二甲双胍临床应用研究概述

二甲双胍（mefformin）于1957年上市,经大量临床和实验研究证实,治疗2型糖尿病T2DM安全、有效。目前美国糖尿病学会（ADA）／欧洲糖尿病研究会（EASD）以及中国等多个国家指南中,二甲双胍作为T2DM一线药物的地位获得了进一步的确定与巩固。近年随着对其降糖及降糖外作用的研究不断深入,临床应用范围不断拓宽,已显示出二甲双胍不仅能有效地降低血糖,还能防治其他疾病。现将其临床应用和研究进展作一简要综述。     

浅谈二甲双胍的抗肿瘤作用

二甲双胍是目前治疗2型糖尿病的一线口服药.除了有效发挥降糖作用外,流行病学研究和动物实验表明,二甲双胍还具有抗卵巢癌等抗肿瘤的作用,其可以降低卵巢癌发病率、提高患者生存率.本文就近年来二甲双胍与肿瘤发展和治疗的临床研究进展和潜在机制进行了综述,将为糖尿病肿瘤患者的治疗提供新的思路.     

二甲双胍缓释剂型对糖尿病患者治疗依从性的影响

英国前瞻性糖尿病研究（UKPDS）及许多大型临床研究证明,二甲双胍降糖作用强而有效,是目前超重或肥胖2型糖尿病患者一线治疗药物。二甲双胍除安全有效的降糖作用外,还可改善胰岛素抵抗、控制体重、调节血脂、血压,减轻高凝状态、改善血管反应性,     

双胍类降糖药物对2型糖尿病治疗价值的重新认识

双胍类药物用于治疗2型糖尿病已有50多年。许多国际糖尿病研究组织均推荐以应用二甲双胍和生活方式干预作为2型糖尿病的起始和基础治疗,并贯穿于治疗的始终,除非患者存在严重的肝、肾功能障碍或胃肠疾病。它可和任何降糖药物联合用于2型糖尿病患者的治疗。二甲双胍除了降低血糖外,还具有抗动脉粥样硬化、减少肿瘤发生危险等作用。该文对双胍类药物研究历史,作用及其机制,不良反应等方面进行综述。     

二甲双胍降糖疗效的综合评价

二甲双胍降糖机制全面,无论单药或联合用药,均能有效降低血糖,全面降低空腹血糖、餐后血糖和糖化血红蛋白。除降糖作用外,二甲双胍还对其他器官及疾病有一定的临床作用,有很好地应用前景。本文通过查阅国内外文献,对二甲双胍降糖疗效进行综合评价。     

二甲双胍的临床应用新进展

目的:为拓展二甲双胍的临床应用提供参考。方法:检索国内、外相关文献,对二甲双胍的临床应用研究进行综述。结果:二甲双胍除主要用于糖尿病患者的降糖治疗外,还具有改善脂代谢紊乱,减轻体质量的作用,可用于非酒精性脂肪肝病和多囊卵巢综合征的防治,此外其对骨质疏松、肿瘤及心血管疾病的治疗也有一定益处。结论:二甲双胍所具有的多种降糖以外的作用不断被发现,为其临床应用开辟了新的领域。     

二甲双胍—老药新用

二甲双胍是一种常见口服降糖药物,有研究发现其可用来治疗多囊卵巢综合征、脂肪性肝炎以及艾滋病毒感染相关的代谢异常等疾病。新研究表明二甲双胍可降低糖尿病患者癌症的发病率和死亡率,随着人们对二甲双胍的抗肿瘤作用机制的深入研究,二甲双胍有望成为一种新型抗肿瘤药物。     

Metformin before and during pregnancy and lactation in polycystic ovary syndrome

Metformin improves the endocrinopathy of polycystic ovary syndrome (PCOS), facilitates conception, appears to reduce first trimester miscarriage and gestational diabetes and does not appear to be teratogenic. The concentrations of metformin in breast milk are generally low and the mean infant exposure to metformin has been reported in the range 0.28-1.08% of the weight-normalized maternal dose, well below the level of concern for breastfeeding. No adverse effects on blood glucose of nursing infants have been reported. Metformin during lactation versus formula feeding appears to have no adverse effects on infants' growth, motor-social development and intercurrent illness during the first 6 months of life. Systematic studies have not yet been done assessing how hyperinsulinemia, polycystic ovary syndrome and metformin may affect lactation.     

二甲双胍遗传药理学研究进展

遗传药理学研究发现药物代谢酶、受体和转运体基因遗传多态性是药物作用个体差异的重要决定因素。二甲双胍是治疗2型糖尿病(type2diabetes mellitus,T2DM)的一线药物,同时还可治疗多囊卵巢综合征(polycystic ovary syn-drome,PCOS)等其他与胰岛素抵抗有关的疾病。二甲双胍在临床使用中表现出显著的药物反应个体差异,这种差异性导致药物反应性降低或药物毒副反应的发生。有机阳离子转运体(organiccation transporters,OCTS)遗传多态性对二甲双胍药物反应个体差异有重要影响。本文阐述了OCTS等多个药物相关基因的遗传多态性对二甲双胍药代动力学和药效学的影响,可为临床制定二甲双胍的个体化用药提供参考。     

多囊卵巢综合征合并高胰岛素血症患者的内分泌特征及治疗探讨

目的研究多囊卵巢综合征(PCOS)合并高胰岛素血症(HI)患者的内分泌特征,探讨盐酸二甲双胍治疗的机制及效果。方法测定21例HI和15例非HI的PCOS患者血清瘦素(Leptin)、胰岛素样生长因子1(IGF-1)、IGF结合蛋白1(IGFBP-1)、空腹胰岛素(FINS)、黄体生成素(LH)及睾酮(T)水平,并进行比较。PCOS合并HI者应用盐酸二甲双胍500mg,3次/d,治疗8周,比较治疗前后各指标的变化。结果HI组血清Leptin、FINS水平高于非HI组,血清IGFBP-1低于非HI组。盐酸二甲双胍治疗HI组后,血清Leptin、FINS及T水平降低,血清IGFBP-1增高。结论PCOS是否合并HI其内分泌特征不同,盐酸二甲双胍可以改善PCOS合并HI者的内分泌紊乱。     

Metformin in the treatment of polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is one of the most frequent diseases that affects women in their reproductive age. The heterogeneity of PCOS makes not only the diagnosis but also the choice of an adequate treatment difficult. The biguanide, N, N' dimethyl-biguanide: Metformin is an antidiabetic drug that increases glucose utilization in insulin-sensitive tissues and is useful in the reduction of both insulin resistance and circulating androgens as well as restoring ovulation. However, metformin is being clinically used without a complete understanding of the mechanism involved. The present review explores some of the actions and efficacy of metformin in the treatment of PCOS during different reproductive periods.     

EV71病毒致病机制的研究现状

多囊卵巢综合征(PCOS)是导致育龄期妇女无排卵性不孕最常见的疾病之一,以高雄激素血症、胰岛素抵抗、无排卵、肥胖为特征。二甲双胍作为胰岛素增敏剂的代表在一定程度上改善了PCOS患者的临床症状及内分泌指标,并在临床上得到了广泛应用,但其临床效果尚存在一些争议。该文主要就此进行阐述。     

Dialysis therapy for lactic acidosis caused by metformin intoxication: presentation of two cases

Metformin is an oral antidiabetic, which is frequently used in the treatment of type II diabetes mellitus. Serious side effects may be seen during the administration of high doses of metformin. Two cases of lactic acidosis due to ingestion of high dose metformin for suicidal purposes have been presented here; in both cases, clinical improvement was seen with bicarbonate hemodialysis.     

The antihyperglycaemic effect of metformin: therapeutic and cellular mechanisms

Metformin is regarded as an antihyperglycaemic agent because it lowers blood glucose concentrations in type 2 (non-insulin-dependent) diabetes without causing overt hypoglycaemia. Its clinical efficacy requires the presence of insulin and involves several therapeutic effects. Of these effects, some are mediated via increased insulin action, and some are not directly insulin dependent. Metformin acts on the liver to suppress gluconeogenesis mainly by potentiating the effect of insulin, reducing hepatic extraction of certain substrates (e.g. lactate) and opposing the effects of glucagon. In addition, metformin can reduce the overall rate of glycogenolysis and decrease the activity of hepatic glucose-6-phosphatase. Insulin-stimulated glucose uptake into skeletal muscle is enhanced by metformin. This has been attributed in part to increased movement of insulin-sensitive glucose transporters into the cell membrane. Metformin also appears to increase the functional properties of insulin- and glucose-sensitive transporters. The increased cellular uptake of glucose is associated with increased glycogen synthase activity and glycogen storage. Other effects involved in the blood glucose-lowering effect of metformin include an insulin-independent suppression of fatty acid oxidation and a reduction in hypertriglyceridaemia. These effects reduce the energy supply for gluconeogenesis and serve to balance the glucose-fatty acid (Randle) cycle. Increased glucose turnover, particularly in the splanchnic bed, may also contribute to the blood glucose-lowering capability of metformin. Metformin improves insulin sensitivity by increasing insulin-mediated insulin receptor tyrosine kinase activity, which activates post-receptor insulin signalling pathways. Some other effects of metformin may result from changes in membrane fluidity in hyperglycaemic states. Metformin therefore improves hepatic and peripheral sensitivity to insulin, with both direct and indirect effects on liver and muscle. It also exerts effects that are independent of insulin but cannot substitute for this hormone. These effects collectively reduce insulin resistance and glucotoxicity in type 2 diabetes.     

多囊卵巢综合征96例疗效分析

目的探讨二甲双胍联合达英-35治疗多囊卵巢综合征（PCOS）的疗效。方法对96例POCS患者给予口服二甲双胍和达英-35,连续服用3个月。观察治疗前后临床症状、性激素、血糖、胰岛素和卵巢的变化情况。结果治疗后患者临床表现改善明显;61例患者的卵巢多囊性改变明显;性激素中LH和T较治疗前均显著下降,差异有统计学意义（P〈0．01）,FSH、P、PRL、E2则无明显差异（P〉0．05）;治疗前后空腹血糖水平无明显差异（P〉0．05）;治疗后患者胰岛素水平较治疗前有明显下降（P〈0．05）。结论二甲双胍联合达英-35治疗PCOS的疗效显著。