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1.
目的: 探讨男性2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清游离睾酮(free testosterone,FT)水平及其相关影响因素。方法: 回顾性分析2018年2月至2019年2月郑州大学第一附属医院收治的18~70岁男性2型糖尿病患者303例,并以年龄1∶1匹配于本院体检的非糖尿病健康男性303例作为对照,比较2组间不同年龄段血清FT水平的差异。根据血清FT水平将T2DM组患者按四分位法分为Q1组、Q2组、Q3组和Q4组,采用Spearman秩相关分析FT水平的相关因素并采用logistic回归分析探讨男性T2DM患者低血清FT水平的影响因素。结果: 男性T2DM患者血清FT水平明显低于同年龄组的健康男性对照,且随年龄增长而降低;Spearman秩相关分析显示,FT与年龄(r=-0.402,P<0.001)、体质指数(body mass index,BMI)(r=0.215,P=0.001)、糖尿病病程(r=-0.121,P=0.035)呈负相关,与总胆固醇(total cholesterol,TC)(r=0.115,P=0.049)、25-羟维生素D3[25-hydroxyl vitamin D3,25-(OH)D3](r=0.340,P<0.001)、促甲状腺激素(thyroid-stimulating hormone,TSH)(r=0.231,P=0.025)呈正相关;多元logistic回归分析显示,在校正年龄、城乡分布、糖尿病病程、吸烟史、饮酒史后,高BMI(OR=1.101,95%CI=1.023~1.183,P=0.009)、高糖化血红蛋白(glycosylated hemoglobin,HbA1c)(OR=1.175,95%CI=1.060~1.302,P=0.002)、低25-(OH)D3OR=0.937,95%CI=0.900~0.975,P=0.001)及低TSH(OR=0.838,95%CI=0.710~0.989,P=0.037)是低FT水平的影响因素。结论: 成年男性T2DM患者血清FT水平低于同年龄组健康男性,低FT水平与高BMI、高HbA1c、低25-(OH)D3及低TSH密切相关。  相似文献   

2.
目的 探讨精神分裂症患者25-羟维生素D[25-(OH)D]水平与代谢综合征相关指标的关系。方法 选择2016年5月至2017年4月合肥市第四人民医院住院的精神分裂症患者229例,采用单因素、多元线性回归分析探索精神分裂症患者25-(OH)D水平与代谢综合征相关指标(空腹血糖、腰围、收缩压、舒张压)的关联。结果 单因素分析显示,25-(OH)D水平与空腹血糖存在显著负相关(β=-0.007,P=0.018)。多元线性回归结果显示,25-(OH)D水平仍与空腹血糖呈显著负相关(β=-0.008,P=0.006)。结论 精神分裂症患者25-(OH)D水平与空腹血糖存在负相关。  相似文献   

3.
目的 分析2型糖尿病(T2DM)患者出现亚临床甲状腺功能亢进的影响因素并探讨其相互作用机制。方法 回顾性分析2020年4月至2022年9月在安徽省第二人民医院全科医学科住院确诊T2DM患者263例的临床资料,根据其是否合并亚临床甲状腺功能亢进分为试验组(n=124)和对照组(n=139)。记录并比较两组患者一般资料(年龄、性别等)、血常规、生化常规、甲状腺功能等指标。采用单因素及多因素logistic回归分析2型糖尿病患者出现亚临床甲状腺功能亢进的危险因素。结果 两组患者的清蛋白、空腹血糖、糖化血清蛋白、血脂等因素,差异存在统计学意义(P<0.05)。logistic回归模型多因素分析提示空腹血糖(OR=0.883,95%CI:0.788~0.990,P=0.032)、糖化血清蛋白(OR=1.008,95%CI:1.004~1.013,P<0.001)为患者发生亚临床甲状腺功能亢进的独立危险因素。结论 空腹血糖水平升高,糖化血清蛋白水平降低是T2DM患者出现亚临床甲状腺功能亢进的独立危险因素。  相似文献   

4.
目的 探讨25-羟维生素D水平与肾癌发病的关系。方法 选取2015年3月至2017年8月安徽医科大学第二附属医院收治的初治肾癌患者100例设为肾癌组,同期选择本院体检者采用倾向性评分法匹配200例非肿瘤人群为对照组,检测两组人群25-羟维生素D水平,比较两组患者的一般临床资料、实验室检查(如血钠、血磷、血钙及血肌酐)及25-羟维生素D水平等资料。采用单因素分析与因变量相关的变量,将有统计学意义的变量纳入多因素二分类logistic回归中再次分析。结果 25-羟维生素D (B=-0.067,OR=0.935,P=0.001)及高血压(B=0.064,OR=1.896,P=0.001)是影响肾癌发病的独立危险因素。结论 高水平的25-羟维生素D是肾癌的保护因素。  相似文献   

5.
蒋加雁  李雨  卢岚 《医学研究杂志》2015,44(4):107-110,113
目的 1α, 25-二羟维生素D [1α,25(OH)2D3]是维生素D信号生物学功能的主要执行者,其血清水平不仅受其前体25-羟维生素D[25(OH)D]水平的调控,还受体内炎性状态的影响。本研究旨在分析慢性阻塞性肺疾病(COPD)患者中血清1α,25(OH)2D3水平及其影响因素。 方法 收集124例COPD患者和188名健康对照者,采用酶联免疫吸附法检测血清1α,25(OH)2D3及25(OH)D水平,同期收集COPD患者血清C反应蛋白(CRP)、白细胞计数(WBC)、血红蛋白量(Hb)及白蛋白(Alb)等实验室资料。 结果 经两独立样本t检验,与对照组相比,COPD组中血清1α,25(OH)2D3和25(OH)D平均水平明显降低,分别为:28.33±5.87 vs 30.58±6.48pg/ml, t=3.108, P=0.002; 25.73±5.44 vs 27.14±5.89ng/ml, t=2.128, P=0.034。根据患者病程分层分析,与稳定期COPD相比,急性加重期患者中血清1α,25(OH)2D3和25(OH)D平均水平亦显著降低,分别为:27.04±4.67 vs 29.17±5.01pg/ml, t=2.377, P=0.019; 24.31±4.22 vs 26.66±4.56ng/ml, t=2.888, P=0.005。采用Spearman相关分析法检验COPD组中血清1α,25(OH)2D3水平的相关影响因素,纳入的变量包括血清25(OH)D水平及CRP、WBC、Hb、Alb等血清学指标。结果显示COPD组中血清1α,25(OH)2D3水平与25(OH)D和CRP呈正相关(r=0.291, P=0.002; r=0.352, P=0.004),与Alb呈负相关(r=-0.346, P=0.001),而与WBC和Hb无关(P>0.05)。 结论 COPD患者中血清1α,25(OH)2D3水平与血清25(OH)D、CRP和Alb水平密切相关,并可能影响患者的病程。  相似文献   

6.
目的 构建复杂性肛瘘术后并发肛门失禁的风险预测模型并进行效果评价。方法 回顾性分析2020年1月至2021年5月福建中医药大学附属人民医院肛肠科收治的195例复杂性肛瘘患者资料。根据术后肛门失禁症状,将CCFIS评分≥2分划为肛门失禁组(42例),CCFIS评分<2分划为功能正常组(153例)。结合患者一般情况、瘘管性质、肛门直肠压力测定结果、手术方式等变量进行单因素及logistic回归分析。结果 术后肛门失禁发生率为21.54%,CCFIS平均分为(3.40±1.170)分。logistic回归分析结果显示,瘘管类型为括约肌上瘘(OR=1.024,95%CI=0.405~2.585,P=0.025)、既往有1次以上的瘘管手术(OR=16.224,95%CI=3.291~29.977,P=0.001)、低静息压(OR=0.909,95%CI=0.869~0.952,P=0.000)、手术方式为切割挂线术(OR=1.389,95%CI=1.044~1.848,P=0.024)是复杂性肛瘘术后并发肛门失禁的独立危险因素(P<0.05)。根据筛选出的独立危险因素构建预测模型,绘制受试者工作特征(receiver operating characteristic,ROC)曲线,曲线下面积(area under the curve,AUC)为0.879(95%CI=0.818~0.939,P<0.001),提示该模型有较好的预测价值。结论 通过独立危险因素建立的预测模型准确度较高,为临床复杂性肛瘘治疗方案的制订提供较好的参考依据。  相似文献   

7.
目的:研究骨转换标志物Ⅰ型胶原氨基端前肽(procollagen type Ⅰ N-terminal propeptide,PINP)、Ⅰ型胶原羧基端前肽(β-cross-linked ctelopeptide of type I collagen,β-CTX)在帕金森病(Parkinson’s disease,PD)并发骨质疏松中的预测价值。方法:纳入PD患者105例,根据是否合并骨质疏松分为骨质疏松组和非骨质疏松组,对所有患者检测25(OH)D、甲状旁腺激素、骨钙素、β-CTX、PINP等骨代谢指标,分析各指标与骨质疏松发生之间的关系。结果:①骨质疏松组少动强直型比例、女性比例、PINP、骨钙素、β-CTX水平均高于非骨质疏松组,骨质疏松组25(OH)D水平低于非骨质疏松组,差异均具有统计学意义; ②相关分析结果显示PD患者骨质疏松发生与骨钙素(r=0.28,P=0.005)、β-CTX(r=0.36,P=0.001)、PINP(r=0.40,P<0.001)均呈正相关,与25(OH)D(r=-0.30,P=0.002)、PINP/β-CTX(r=-0.56,P<0.001)均呈负相关,差异具有统计学意义;③多因素二元Lo- gistic 回归分析显示,25(OH)D(OR=0.95,95%CI:0.84~0.98,P=0.041)、PINP/β-CTX(OR=0.90,95%CI:0.83~0.98,P=0.017)是 PD病合并骨质疏松的独立危险因素;④ROC曲线分析示25(OH)D联合PINP/β-CTX时ROC曲线下面积最大,AUC=0.82,灵敏性=0.80,特异性=0.84,P<0.001。结论:血清25(OH)D水平及PINP/β-CTX比值与PD患者骨质疏松发生密切相关,在PD患者骨质疏松的发生中具有重要的预测价值,二者联合检测时诊断价值更高。  相似文献   

8.
刘茜  王炜  周婉  叶山东 《安徽医学》2020,41(5):510-514
目的 分析新诊断男性2型糖尿病(T2DM)患者体内25-羟维生素D水平的变化,探讨其与体质指数(BMI)、胰岛素抵抗(IR)和胰岛β细胞功能的关系。方法 收集2018年1月至2019年12月中国科学技术大学附属第一医院(安徽省立医院)内分泌科住院新诊断男性T2DM患者84例作为T2DM组,选择同期在医院健康体检中心的男性体检者30例作为对照组。检测血清25(OH) D3、空腹血糖(FPG)、空腹胰岛素水平(FIns)等指标,并于75 g葡萄糖耐量试验(OGTT)或馒头餐试验后30、60和120 min采集静脉血检测血糖和胰岛素。结果 T2DM组血清25(OH) D3水平低于对照组,差异有统计学意义(P<0.05)。随着BMI水平增高,25(OH) D3水平降低,胰岛β细胞功能指数(HOMA-β)呈下降趋势(P<0.05),胰岛素抵抗指数(HOMA-IR)呈上升趋势(P<0.05)。T2DM组行馒头餐或OGTT试验后不同时间的血糖、胰岛素、C肽水平差异有统计学意义(P<0.05)。随时间的推移各数值均有上升趋势,组别和时间因素对血糖、胰岛素、c肽水平变化有交互作用(P<0.05)。25(OH) D3与BMI、糖化血红蛋白(HbA1c)、HOMA-IR、HOMA-β呈负相关(P<0.05)。结论 低水平25(OH) D3可能与导致T2DM发病的IR及胰岛素敏感性下降有关。  相似文献   

9.
目的: 运用回顾性研究的分析方法,探究异时双原发肺癌(metachronous dual primary lung cancer,mDPLC)的独立预后因素,并建立列线图预后模型。方法: 通过美国癌症监测、流行病学和结果(Surveillance,Epidemiology and End Results,SEER)数据库获得mDPLC患者的临床数据。将数据分为训练集和验证集进行建模和验证。采用单因素和多因素Cox回归分析确定训练集患者的独立预后因素,并纳入列线图对患者生存时间进行预测。通过C-指数、校准图、受试者工作特征(receiver operating characteristic,ROC)曲线、决策曲线分析(decision curve analyses,DCA)和综合鉴别改进(integrated discrimination improvement,IDI)评分对预后模型的准确性和可靠性进行评价。结果: 共有610例mDPLC患者纳入训练集,260例mDPLC患者纳入验证集。Cox回归分析表明,年龄(59~76岁:HR=1.453,95%CI=1.007~2.096,P=0.046;≥77岁:HR=1.953,95%CI=1.303~2.926,P<0.001)、性别(女性:HR=0.669,95%CI=0.529~0.845,P=0.001)、病理类型(腺癌+鳞癌:HR=2.251,95%CI=1.583~3.200,P<0.001)、TNM 分期(Ⅲ:HR=1.611,95%CI=1.126~2.305,P=0.009;Ⅳ:HR=2.443,95%CI=1.713~3.486,P<0.001)、淋巴结转移(是:HR=1.653,95%CI=1.199 ~2.280,P=0.002)、手术(1次:HR=1.431,95%CI=1.110~1.844,P=0.006;0次:HR=1.845,95%CI=1.183~2.878,P=0.007)和化疗(是+否:HR=0.603,95%CI=0.433~0.842,P=0.003)是独立预后因素。训练集和验证集的C-指数分别为0.711(95%CI=0.696~0.726,P<0.05),0.677(95%CI=0.655~0.699,P<0.05)。训练集中ROC曲线的3年生存率和5年生存率AUC值分别为0.756(95%CI=0.713~0.800,P<0.05)和0.785(95%CI=0.732~0.838,P<0.05),验证集中ROC曲线的3年生存率和5年生存率AUC值分别是0.695(95%CI=0.621~0.769,P<0.05)和0.711(95%CI=0.618~0.804,P<0.05)。训练集中3年和5年的IDI值分别为9.0%(P<0.001)和11.9%(P<0.001),验证集中3年和5年的IDI值分别为6.6%(P<0.001)和7.8%(P<0.001)。根据独立预后因素建立的模型经验证可准确预测患者预后,并且效果优于TNM分期。结论: 本研究建立了一个mDPLC预后预测模型,内部验证表明该模型具有较好的效能,可为mDPLC患者提供准确和个性化的生存预测。  相似文献   

10.
目的 研究维生素D缺乏对新疆地区急性脑梗死患者神经功能缺损程度的影响。方法 收集自2016年12月~2017年7月收治于新疆医科大学第一附属医院的156例急性脑梗死患者为病例组,同期77例健康体检者为对照组,测定其血清25-羟维生素D水平,并进行NIHSS评分评估神经功能缺损程度;比较急性脑梗死患者及健康体检者血清25-羟维生素D差异,分析血清25-羟维生素D与NIHSS评分及脑梗死面积关系,同时建立多元Logistic回归模型分析其神经功能缺损程度的关系。结果 急性脑梗死患者血清25-羟维生素D水平较健康体检组显著偏低(P<0.01);NIHSS评分与25(OH) D3水平呈负相关(P<0.01);与梗死面积不相关(P>0.05);Logistic回归分析显示血清25(OH) D3水平是影响神经功能缺损的独立危险因素(OR=0.94,95%CI:0.91~0.97,P=0.001)。结论 血清25(OH) D3参与脑梗死的发生、发展,急性脑梗死患者血清25(OH) D3水平越低,神经功能缺失程度越重,可以作为患者病情严重程度的预测指标之一。  相似文献   

11.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

12.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

13.
Shock wave lithotripsy (SWL) is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it's difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.  相似文献   

14.
Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.  相似文献   

15.
INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5  相似文献   

16.
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.  相似文献   

17.
People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.  相似文献   

18.
FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…  相似文献   

19.
Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and > 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.  相似文献   

20.
Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.  相似文献   

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