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2型糖尿病合并症药物选择-学习笔记

  • 2026-02-09 04:09:17
2型糖尿病合并症药物选择-学习笔记

2型糖尿病合并症药物选择-学习笔记

💡 核心管理原则
伴动脉粥样硬化性心血管疾病（ASCVD）或其高风险、心力衰竭（HF）、慢性肾脏病（CKD）的T2DM患者，应优先选择具有器官特异性获益证据的降糖药物。
关键特征：循证选择、器官保护、分层管理

📋 合并症分层与药物选择
• ASCVD或其高风险：选择有ASCVD获益证据的GLP-1RA或SGLT2i
• 心力衰竭（HF）：选择SGLT2i
• 慢性肾脏病（CKD）：选择有CKD获益证据的SGLT2i或GLP-1RA

✓ 循证治疗路径
评估合并症 → 识别ASCVD/HF/CKD → 优先选择获益证据明确的药物 → 避免常规药物选择 → 实现心肾保护
证据等级：A级推荐

⚠️ 关键警示与注意事项
[获益证据] ：必须是具有明确ASCVD或CKD获益证据的GLP-1RA/SGLT2i
[优先选择] ：伴上述合并症时，应超越传统降糖目标，优先心肾保护
[禁忌忽略] ：不得常规使用无器官保护证据的降糖药物

📌 标签
#内分泌科 #糖尿病治疗 #ASCVD #心力衰竭 #慢性肾脏病 #临床指南 #住院医师

👉 获取【PPT】请参考以下链接：
 中国糖尿病防治指南(2024 版)-第六章|学习笔记PPT

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  1. CONNECT:[ UseTime:0.000613s ] mysql:host=127.0.0.1;port=3306;dbname=no_67808;charset=utf8mb4
  2. SHOW FULL COLUMNS FROM `fenlei` [ RunTime:0.000896s ]
  3. SELECT * FROM `fenlei` WHERE `fid` = 0 [ RunTime:0.000272s ]
  4. SELECT * FROM `fenlei` WHERE `fid` = 63 [ RunTime:0.000224s ]
  5. SHOW FULL COLUMNS FROM `set` [ RunTime:0.000458s ]
  6. SELECT * FROM `set` [ RunTime:0.000191s ]
  7. SHOW FULL COLUMNS FROM `article` [ RunTime:0.000524s ]
  8. SELECT * FROM `article` WHERE `id` = 462229 LIMIT 1 [ RunTime:0.001437s ]
  9. UPDATE `article` SET `lasttime` = 1770820943 WHERE `id` = 462229 [ RunTime:0.010780s ]
  10. SELECT * FROM `fenlei` WHERE `id` = 65 LIMIT 1 [ RunTime:0.000241s ]
  11. SELECT * FROM `article` WHERE `id` < 462229 ORDER BY `id` DESC LIMIT 1 [ RunTime:0.000703s ]
  12. SELECT * FROM `article` WHERE `id` > 462229 ORDER BY `id` ASC LIMIT 1 [ RunTime:0.000356s ]
  13. SELECT * FROM `article` WHERE `id` < 462229 ORDER BY `id` DESC LIMIT 10 [ RunTime:0.006768s ]
  14. SELECT * FROM `article` WHERE `id` < 462229 ORDER BY `id` DESC LIMIT 10,10 [ RunTime:0.003688s ]
  15. SELECT * FROM `article` WHERE `id` < 462229 ORDER BY `id` DESC LIMIT 20,10 [ RunTime:0.000595s ]
0.095578s