Heine R J
Department of Endocrinology, Academisch Ziekenhuis Vrije Universiteit, Amsterdam, The Netherlands.
Horm Metab Res. 1996 Sep;28(9):522-6. doi: 10.1055/s-2007-979845.
Non-insulin dependent diabetes mellitus carries a markedly elevated risk of cardiovascular disease. For that reason the efficacy of any treatment modality for this disease should be assessed in terms of the known cardiovascular risk factors, as for example serum lipids. Sulfonylurea do not affect serum lipid levels to any significant extent. These drugs promote beta-cell secretion by dosing potassium ion channels. These channels are also present in vascular smooth muscle cells. Some, though not all, sulfonylureas are able to inhibit the vascular dilatory response to potassium ion openers, thereby adversely affecting the cardioprotective vascular response to ischaemia. Sulfonylureas, in contrast to insulin, seem able to inhibit the fibrinolytic system, possibly via the stimulating effect of proinsulin on the endothelial PAI-1 expression. These observations need further confirmation. Of clinical importance is the frequent occurrence of hypoglycaemia for which several risk factors are recognized.
非胰岛素依赖型糖尿病患者患心血管疾病的风险显著升高。因此，对于这种疾病的任何治疗方式的疗效都应根据已知的心血管危险因素来评估，例如血脂。磺脲类药物在很大程度上不会影响血脂水平。这些药物通过作用于钾离子通道来促进β细胞分泌。这些通道也存在于血管平滑肌细胞中。一些（并非全部）磺脲类药物能够抑制血管对钾离子开放剂的舒张反应，从而对缺血时的心脏保护血管反应产生不利影响。与胰岛素相比，磺脲类药物似乎能够抑制纤溶系统，可能是通过胰岛素原对内皮细胞PAI - 1表达的刺激作用。这些观察结果需要进一步证实。具有临床重要性的是低血糖频繁发生，对此已识别出多个危险因素。
