Del Prato Stefano, Pulizzi Nicolò
Department of Endocrinology and Metabolism, Section of Diabetes and Metabolic Diseases, University of Pisa, Italy.
Metabolism. 2006 May;55(5 Suppl 1):S20-7. doi: 10.1016/j.metabol.2006.02.003.
Sulfonylureas are still largely used for treatment of type 2 diabetic patients, and they still occupy a central position in many international therapy guidelines. More recently concern has been raised with respect to possible adverse effects associated with the use of these agents. Sulfonylureas are, indeed, believed to favor the development of hypoglycemia, to accelerate beta cell apoptosis and beta-cell exhaustion, and to impair endothelial function with increased risk for ischemic complications. However, because of the intrinsic pathogenetic heterogeneity of type 2 diabetes, sulfonylureas are likely to remain a therapeutic option. Careful choice of a specific sulfonylurea should be made on the basis of efficacy, safety, convenience, tissue specificity, and neutrality with respect to the beta cell. In this review the advantage:disadvantage ratio of available sulfonylureas is analyzed with the purpose of providing a critical clinical appraisal of the role of sulfonylureas in the modern treatment of type 2 diabetes.
磺脲类药物仍广泛用于2型糖尿病患者的治疗，并且在许多国际治疗指南中仍占据核心地位。最近，人们对使用这些药物可能产生的不良反应表示担忧。事实上，磺脲类药物被认为会促进低血糖的发生，加速β细胞凋亡和β细胞耗竭，并损害内皮功能，增加缺血性并发症的风险。然而，由于2型糖尿病内在的发病机制异质性，磺脲类药物可能仍然是一种治疗选择。应根据疗效、安全性、便利性、组织特异性以及对β细胞的中性作用等因素，谨慎选择特定的磺脲类药物。在本综述中，分析了现有磺脲类药物的利弊比，目的是对磺脲类药物在2型糖尿病现代治疗中的作用进行批判性临床评估。
