尼可地尔作为一种特殊的钾离子通道开放剂,同时还具有类硝酸酯作用和药物预适应的作用,作为抗心肌缺血的药物已经在临床上应用多年.日本和欧洲的大量研究证实了它在心血管疾病人群中使用的安全性和有效性.其作为钾离子通道开放剂的作用机制正好与磺脲类药物降低血糖的作用机制相反,血糖升高和磺脲类药物均可通过关闭钾离子通道达到刺激胰岛素释放,降低血糖的作用.因此尼可地尔的作用机制是否会对糖尿病人群的血糖产生影响引起人们的关注,它是否能在冠心病合并糖尿病人群中应用,且长期使用的安全性如何？大家一直都没有停止过对这方面的研究,但目前证据并不十分充分,在国内的相关报道甚少.现就尼可地尔的作用机制,作为钾离子通道开放剂,其具有的药物预适应作用、类硝酸酯类作用以及综合作用与糖尿病的关系进行综述,为尼可地尔在冠心病合并糖尿病人群安全使用及后期的实验提供证据.%Nicorandil is a specific K+ channels opener, meanwhile has an effect like nitrate and another effect-drug preconditioning. As an anti-myocardial ischemia drug, nicorandil has been used in clinical for many years. In Japan and Europe, vast studies proved its safety and validity. But asaK+ channels opener, the mechanism of nicorandil is opposite to the mechanism of sulfonylureas reducing blood glucose. Hyperglycemia and sulfonylureas could close K+ channels stimulating insulin releasing, so reduce blood glucose. Whether nicorandil may influence the blood glucose of diabetes patients? Thus cause people pay attention to this question. Whether nicorandil could use in the patients who with cardiovascular disease and diabetes? Is it safety? Although researches about these questions have never stopped, evidences are not sufficient, especially in China. In this article, we will expound mechanisms of nicorandil around its three effects and its comprehensive effect. When using nicorandil in patients who with cardiovascular diseases and diabetes, this article may be a reference r and provided as a basis theoretical argument for later experiment.
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