糖尿病口服药物治疗住院医讲课.pptVIP

目前,临床Ⅱ期以上的二肽基肽酶Ⅳ（DDPIV）抑制剂药物列表如下:表1 Ⅱ期临床研究以后阶段的二肽基肽酶Ⅳ（DDPIV）抑制剂 研发公司 通用名 全球研究状态 默克 sitagliptin phosphate 墨西哥上市，美国注册前 诺华 vildagliptin 注册前 武田 SYR-322 Ⅲ期临床 百时美-施贵宝 saxagliptin Ⅲ期临床 罗氏 Ro-0730699 Ⅱ期临床 Mitsubishi Pharma MP-513 Ⅱ期临床 OSI Pharmaceuticals PSN-9301 Ⅱ期临床 Phenomix PHX-1149 Ⅱ期临床 Tanabe Seiyaku denagliptin Ⅱ期临床 数据来源:Pharmaproject数据库,截至2006年8月 谢谢! * Slide 6-6 TYPE 2 DIABETES…A PROGRESSIVE DISEASE Natural History of Type 2 Diabetes The natural history of type 2 diabetes shows the progressive emergence of the disorder. Well before diagnosis, patients may have had significant hyperglycemia for years, perhaps more than a decade. Patients with type 2 diabetes have altered islet b-cell function and impaired insulin action in varying degrees. Plasma glucose may rise above normal in early adulthood, and as age-related declines in b-cell function occur—together with less physical activity and increases in adipose tissue mass—plasma glucose continues to rise. By the time diabetes is diagnosed, plasma glucose may range from 180 to 220 mg/dL. It has been estimated that only about one third of the population has acceptable glycemic control by current standards. Based on the progressive nature of diabetes, complications that may take years to develop are often already present at the time of diagnosis. Riddle MC. Tactics for type II diabetes. Endocrinol Metab Clin North Am. 1997;26:659-677; Skyler JS. Insulin therapy in type 2 diabetes mellitus. In: DeFronzo RA, ed. Current Therapies of Diabetes Mellitus. St Louis, Mo: Mosby-Year Book Inc; 1998:108-116. * * * * * * 随着医学的发展，医疗知识的普及，急性并发症的发生及预后已经有明显改善，一是发生率减低，二是发生后抢救成功率较高 这时，慢性并发症却成为糖尿病治疗的一大大敌 ，糖尿病被称为“无声的杀手” 提醒患者的注意，阐明糖尿病本身而论并不可怕，可怕的是血糖控制不稳定之后出现的各种并发症，主要有以下7个方面，均会在系列篇中阐述： 1.心血管并发症（冠心病，即心绞痛心肌梗塞等，以及糖尿病性心肌病变等） 2.脑血管并发症（多件脑梗塞，老百姓所说的中风，后果严重，致残率高，严重影响生活质量） 3.周围血管病变（多为血管粥样硬化后形成闭塞性血管病变，严重可导致截肢） 4.肾脏病变(糖尿病已经成为终末期肾病的首要危险因素，在2型糖尿病患者中50％的患者存在不同程度的肾脏损害（DEMAND研究数据），因此，在血液透析、肾移植的患者中糖尿病肾病所占比例越来越大) 5.视网膜并发症（失明的