糖适平与胰岛素对老年男性Ⅱ型糖尿病早期肾病患者降糖疗效以及肾功能影响的对比观察

目的:评价糖适平对老年男性Ⅱ型糖尿病早期肾病患者的降糖疗效以及对肾功能的影响.方法:患者均为男性,年龄≥65岁,糖尿病病程在5年以上.尿微量白蛋白排泄率≥30μg/mg(糖尿病肾病),Cr＜177.8μmol/L(肾功能不全代偿期).其中56例使用糖适平治疗,33例使用胰岛素治疗,监测治疗前后的血糖指标和肾功能指标.结果:与胰岛素治疗比较,糖适平能有效降低老年男性Ⅱ型糖尿病早期肾病患者的空腹血糖、餐后血糖、糖化血红蛋白,但不升高尿素氮、肌苷、尿微量白蛋白排泄率,且副作用小,在本组观察中无低血糖的发生.结论:糖适平是一种安全、有效的降糖药物,可用在老年男性Ⅱ型糖尿病伴有早期肾病的患者.     

糖适平与胰岛素联合治疗磺脲药失效2型糖尿病的临床疗效

目的:将糖适平与中效胰岛素联合应用于继发性磺脲药失效的2型糖尿病患者,以探讨其临床应用价值.方法:40例入院诊断为磺脲药继发性失效的2型糖尿病患者,先予早晚注射中效胰岛素治疗,对其中30例空腹血糖(FBG)＜7.8 mmol·L-1,餐后2h血糖仍大于11.1 mmol·L-1的患者,给予3餐前口服糖适平,观察餐后血糖变化.结果:经糖适平治疗,平均餐后血糖(PBG)由13.6±2.6 mmol·L-1降至7.2±3.7 mmol·L-1,有统计学差异.结论:对磺脲药失效患者采用中效胰岛素与糖适平联合应用,可使空腹及餐后血糖得到良好控制.     

妊娠晚期葡萄糖耐量试验及其临床意义

本文对62例正常晚期妊娠妇女进行口服葡萄糖耐量试验,提出妊娠期及早发现糖尿病的重要性,认为空腹血糖≥104mg/dl,服糖后1小时≥210mg/dl,2小时≥146mg/dl,就有糖耐量减低存在。对妊娠期糖尿病患者的处理进行了讨论。     

国产与进口格列喹酮治疗II型糖尿病60例临床评价

为观察国产格列喹酮治疗Ⅱ型糖尿病的疗效，选择４０例Ⅱ型糖尿病人进行治疗，另外２０名应用进口糖适平作对照。观察治疗前后空腹血糖、餐后２ｈ血糖、尿糖、ＧＨｂＡ１Ｃ等指标的变化，结果显示国产格列喹酮有肯定的疗效，与糖适平相近，且具有降血脂及降低尿蛋白的作用，适宜临床推广使用。     

糖适平加胰岛素联合治疗Ⅱ型糖尿病的临床观察

磺脲类降糖药 (ＳＵ)加胰岛素 (Ｉｎｓ)联合治疗对ＳＵ继发失效的Ⅱ型糖尿病有较好疗效[1] 。近年来 ,由于对ＳＵ的胰腺外作用有更多了解 ,对Ⅱ型糖尿病的发病机理有新的认识 ,联合治疗逐渐受到重视 ,现用糖适平加胰岛素联合治疗效果满意。1　资料与方法1.1　一般资料　选取门诊及住院患者 ,按ＷＨＯ标准确诊为Ⅱ型糖尿病 ,无心、脑、肾严重并发症 ,男女不限 ,经ＳＵ或ＳＵ加双胍类降糖药 ,或单独应用Ｉｎｓ治疗病情控制不满意者 ,停用原治疗 ,予糖适平 6 0ｍｇ ,每日三餐前口服 2 0天 ,查空腹血糖仍 >7.8ｍｍｏｌ·Ｌ 1,餐后 2小时血糖 >11…     

复方降脂灵的制备及疗效观察

魔芋甘露聚糖是鹿芋的主要化学成分,笔者用魔芋甘露聚糖制成了复方魔芋片剂(降脂灵)并进行了疗效观察。36例高血脂者,血浆胆固醇水平从治疗前的214.8±29.9mg/dl 降到治疗后的156.4±22.3mg/dl,甘油三酯水平从339.1±361.8mg/dl 降到176.9±68.1mg/dl,β—脂蛋白从583.4±273.2mg/dl 降到391.6±75.1mg/dl(P<0.01,P<0.05),体重平均下降4.06kg.     

那格列奈与阿卡波糖治疗2型糖尿病临床疗效比较研究

目的比较那格列奈与阿卡波糖治疗2型糖尿病患者的临床疗效和安全性。方法将60名单纯饮食控制加运动疗法治疗不满意的2型糖尿病患者随机分为那格列奈组（A组）30例及阿卡波糖组（B组）30例,A组那格列奈治疗,120mg/次,3次/d;B组阿卡波糖100mg/次,3次/d,疗程均为12周。比较两组治疗前后空腹血糖（FPG）、餐后2h血糖（PG2h）,糖化血红蛋白（HbA1c）和体重指数（BMI）变化。结果那格列奈组FPG平均下降2.2mmol/L,PG2h平均下降6.9mmol/L;阿卡波糖组FPG平均下降1.4mmol/L,PG2h平均下降8.1mmol/L,两组P值均〈0.01;两种药物对P2hBG均有明显地降低作用（P〈0.01）,且降低程度相似;两组HbA1c均能显著降低,两组间降幅度比较无显著性差异（P〉0.05）。结论那格列奈和阿卡波糖均有明显降低空腹和餐后血糖以及HbA1c的作用,那格列奈有较少的胃肠道反应,依从性耐受性良好,安全性好。     

国产格列喹酮临床验证分析

对天津药物研究院研制的格列喹酮进行临床验证，观察组为Ⅱ型糖尿病１００例，服格列喹酮；对照组为Ⅱ型糖尿病６０例，服糖适平。结果显示观察组总有效率按空腹血糖≤８．３ｍｍｏｌ／Ｌ计为８５％，按餐后２小时血糖≤１０ｍｍｏｌ／Ｌ计为７９％，按尿糖≤１４０ｍｍｏｌ／２４ｈ计为８６％。说明该药为一疗效好、无明显副作用的治疗Ⅱ型糖尿病的降糖药物。     

危重病患者的加强胰岛素治疗

目的观察危重病人加强胰岛素治疗后的的疗效。方法将116例危重病人随机分为两组,传统治疗组(CT)和加强胰岛素治疗组(IT)。CT组:当血糖>215mg/dl,诺和R笔芯皮下注射,控制血糖180～200mg/dl;IT组:当血糖>110mg/dl,控制血糖80～110mg/dl。结果CT组死亡率44.83%远远高于IT组的12.07%,病人的ICU住院时间、使用呼吸机日数、每日6:00的平均血糖、每日TISS-28评分均明显高于IT组(P<0.05);CT组每日胰岛素用量、HLA-DR、CD4+/CD8+明显小于IT组(P<0.05)。两组并发症比较,CT组病人发生肾损害、输注红细胞、发热的人数均明显高于IT组(P<0.05)。结论加强胰岛素治疗控制危重病人血糖80～110mg/dl,能降低病人的死亡率。     

口服药治疗垂体性尿崩症疗效观察

本文总结我院1970～1982年间以口服药治疗垂体性尿崩症的疗效如下: 临床资料 1、一般资料男13,女11。年龄平均26.9岁(13～42)。病程一年零二月(0.5～14)。全部患者均有典型的临床症状。尿比重低(1.000～1.006),糖、蛋白、镜检均阴性。血NPN(19例)30.8mg/dl(24～49),肌酐(19例)1.29mg/dl(1.0～1.8),血钾(24例)4.18mEq/L(3.0～5.2),血钠(24例)139.5mEq/L(120～151),血氯(24例)108.8mEq/L (97～120)及空腹血糖(14例)87.3 mg/dl(70～125)。     

Protective Effects of Glurenorm (Gliquidone) Treatment on the Liver Injury of Experimental Diabetes

Oxidative stress plays an important role in chronic complications of diabetes mellitus, and hence the regulation of free radicals is essential in the treatment of diabetes. The aim of the current study is to investigate the effect of glurenorm (10 mg/kg) on liver tissue in experimental diabetes. Diabetes was induced by intraperitoneal injection of 65 mg/kg streptozotocin. Glurenorm was administered to one diabetic and one control group separately, from days 14 to 42. On day 42, cardiac blood samples and liver tissue were taken from each rat. In diabetic rats, blood glucose, serum alkaline phosphatase and serum amino transferase activities, serum uric acid, serum sodium and potassium levels, liver nonenzymatic glycosylation, and lipid peroxidation increased, whereas body weight and liver glutathione levels decreased. The diabetic group given glurenorm blood glucose, serum alkaline phosphatase and aminotransferase activities, serum uric acid, sodium and potassium, liver nonenzymatic glycosylation, and lipid peroxidation levels decreased, and liver glutathione levels increased. As a result of all the biochemical findings obtained, it was concluded that glurenorm has a protective effect on damage of liver of streptozotocin-induced diabetes in rats.     

Protective effects of glurenorm (gliquidone) treatment on the liver injury of experimental diabetes

Oxidative stress plays an important role in chronic complications of diabetes mellitus, and hence the regulation of free radicals is essential in the treatment of diabetes. The aim of the current study is to investigate the effect of glurenorm (10 mg/kg) on liver tissue in experimental diabetes. Diabetes was induced by intraperitoneal injection of 65 mg/kg streptozotocin. Glurenorm was administered to one diabetic and one control group separately, from days 14 to 42. On day 42, cardiac blood samples and liver tissue were taken from each rat. In diabetic rats, blood glucose, serum alkaline phosphatase and serum amino transferase activities, serum uric acid, serum sodium and potassium levels, liver nonenzymatic glycosylation, and lipid peroxidation increased, whereas body weight and liver glutathione levels decreased. The diabetic group given glurenorm blood glucose, serum alkaline phosphatase and aminotransferase activities, serum uric acid, sodium and potassium, liver nonenzymatic glycosylation, and lipid peroxidation levels decreased, and liver glutathione levels increased. As a result of all the biochemical findings obtained, it was concluded that glurenorm has a protective effect on damage of liver of streptozotocin-induced diabetes in rats.     

糖尿病并发缺血性脑病综合治疗的临床研究

目的 探讨糖尿病并发缺血性脑病综合治疗的临床疗效.方法 糖尿病并发缺血性脑病患者口服糖适平片、奥扎格雷静脉注射,结合中医辨证施治,配合控制饮食、进行适当的运动,观察其疗效.结果 治疗总有效率为92.63%,治疗前、后神经功能缺损评分比较差异有统计学意义.结论 对于糖尿病并发缺血性脑病患者不但要控制血糖,同时进行控制血液高凝状态的综合治疗.     

Effect of chlorpromazine on blood glucose and plasma insulin in man

Summary In three groups of normal subjects and in one group of patients with latent diabetes mellitus a study has been made of the effects of chlorpromazine (CPZ) on blood glucose and plasma insulin. CPZ 75 mg/day for 7 days did not alter the plasma insulin response after oral glucose; nor did CPZ 50 mg/day for 7 days affect the glucose assimilation rate or insulin response to glucose injection. Infusion of CPZ 50 mg in 60 min slightly increased the basal blood glucose level but had no significant effect on basal plasma insulin. The insulin/glucose ratio after the end of the infusion was significantly higher than during the period of infusion of the drug. In latent diabetic patients CPZ infusion significantly diminished the insulin/glucose ratio during an intravenous glucose tolerance test. These results suggest that, whereas prolonged treatment with low doses of CPZ did not modify glucose tolerance and glucose-stimulated pancreatic response, higher acute doses of the drug may induce hyperglycaemia and can inhibit insulin secretion both in normal man and in patients with latent diabetes mellitus.     

新型口服活性炭微球对链脲佐菌素诱导的糖尿病模型大鼠治疗作用的研究(英文)

制备并表征了孔径不同的活性炭微球,考察其对糖尿病模型大鼠的治疗作用。通过制备工艺的改良,制得了直径在0.2-0.3mm的活性炭微球。通过对葡萄糖的吸附实验,筛选最优的活性炭微球。采用雄性Sprague-Dawley大鼠腹腔注射链脲佐菌素诱导制得糖尿病大鼠模型。两组大鼠采用每天两次口服灌胃活性炭微球,连续给药30天。通过离体肠段外翻实验法,测定葡萄糖的跨膜透过量。与糖尿病组相比,在服药2周以后,活性炭微球治疗组的血糖水平明显降低,改善血糖耐受量。在肠粘膜侧有活性炭微球存在时,葡萄糖分子的渗透清除率显著增大,尤其是当浆膜侧的葡萄糖浓度较高时(10mg/mL)。筛选得到的活性炭微球BET比表面积为1566m2/g,微孔含量高(0.478cm3/g),球形良好,对葡萄糖吸附率高。作为口服微球制剂,活性炭微球对链脲佐菌素诱导的糖尿病大鼠有治疗作用。     

Diabetic control with gliquidone — A short acting sulphonylurea

Summary Gliquidone (Glurenorm) and glibenclamide were compared in a cross-over study of 20 non insulin dependent diabetics. Both drugs achieved similar levels of control, as measured by self home monitoring, glycosylated haemoglobin and N-acetyl--D-glucosamidase levels. However, with glibenclamide hyperglycaemic control was only achieved at the expense of more hypoglycaemic episodes. The study examined the tailoring of drug dosage to the patients needs and found that in the majority of patients it was necessary to give both glibenclamide and gliquidone thrice daily. It confirmed the acceptability of self glucose monitoring in a home population.     

尿糖与尿微量白蛋白联合检验糖尿病早期肾损伤的临床研究

目的分析尿糖与尿微量白蛋白联合检验糖尿病早期肾损伤的临床价值。方法选取49例糖尿病早期肾损伤患者作为观察组,另选取49例同期进行体检的人员作为对照组。检测并比较两组的尿微量白蛋白、尿糖水平以及其阳性率。结果观察组尿微量白蛋白(26.57±9.71)mg/L、尿糖(3.78±1.13)mmol/L均高于对照组的(16.31±5.63)mg/L、(0.26±0.54)mmol/L,差异有统计学意义(P<0.05)。观察组尿微量白蛋白和尿糖阳性率高于对照组,差异有统计学意义(P<0.05)。尿微量白蛋白与尿糖联合检测的阳性率为91.84%(45/49),高于单独检测。结论对糖尿病早期肾损伤患者实施尿糖、尿微量白蛋白联合检验的方式具有非常高的临床价值,能够提升糖尿病早期肾损伤患者的检出率。     

The effect of urapidil and ramipril on hyperglycemia in streptozotocin diabetic rats

Angiotensin-converting enzyme inhibitors and alpha1-adrenoceptor antagonists improve glucose disposal in diabetes mellitus. We compared the effect of the antihypertensive hybrid drug urapidil [alpha1-adrenoceptor antagonist serotonin 1A (5-hydroxytryptamine 1A, 5-HT1A) receptor agonist] on hyperglycemia in streptozotocin diabetic rats with the angiotensin-converting enzyme inhibitor ramipril. 5-HT1A receptor agonists induce hyperglycemia. This could be an important disadvantage during treatment of diabetes mellitus with urapidil. Diabetes was induced by streptozotocin (70 mg/kg i.p.). Treatment for 7 days (ramipril 10 mg/kg p.o.; urapidil 20 mg/kg p.o.) significantly decreased mean blood glucose values (urapidil: 15.7+/-0.9 mmol/l, P=0.007; ramipril: 15.0+/-0.8 mmol/l, P=0.038 vs. diabetic control group: 18.7+/-1.0 mmol/l). Both drugs reduced significantly blood pressure, urinary glucose, water consumption, and food requirement. Serotonin concentration in the brain (medulla oblongata, pituitary) was not affected. A normalization comparable with healthy control rats was observed only in a diabetic control group with insulin therapy. In conclusion, our results demonstrate that the antihypertensive drug urapidil has no detrimental effect on hyperglycemia compared with the angiotensin-converting enzyme inhibitor ramipril in experimental diabetes mellitus despite its 5-HT1A receptor agonistic properties.     

Steroid-induced diabetes mellitus and related risk factors in patients with neurologic diseases

STUDY OBJECTIVE: To determine the frequency of steroid-induced diabetes mellitus (SDM) and the related risk factors in patients with neurologic diseases who receive high doses of steroids. DESIGN: Retrospective chart review. SETTING: Neurology ward of a university-affiliated hospital. PATIENTS: Twenty-five patients with neurologic diseases who received prednisolone 30-60 mg/day orally after breakfast for more than 2 weeks. MEASUREMENTS AND MAIN RESULTS: Plasma glucose concentrations were determined immediately before and 2 hours after each meal. Steroid-induced diabetes mellitus was diagnosed if the patient had either a fasting glucose concentration of 126 mg/dl or greater, or a random glucose concentration of 200 mg/dl or greater. The patients were divided into two groups on the basis of whether SDM had developed (13 patients) or not (12 patients). Ages, body mass indexes, cumulative total doses and daily doses of prednisolone, duration of therapy, and serum cholesterol and triglyceride concentrations were compared between the groups. Thirteen of the 25 patients were identified with SDM, and all of them had plasma glucose concentrations of 200 mg/dl or greater 2 hours after lunch. Mean age (59.1 +/- 10.2 yrs) and cholesterol concentration after prednisolone treatment (226.8 +/- 36.4 mg/dl) in the SDM group were significantly higher than those values in the non-SDM group (41.3 +/- 18.0 yrs and 188.1 +/- 27.2 mg/dl, respectively, p<0.01). CONCLUSIONS: A close relationship among postprandial hyperglycemia, advanced age, and hypercholesterolemia is a characteristic of SDM in patients with neurologic diseases. Therefore, monitoring the plasma glucose concentration 2 hours after lunch may be useful to detect SDM in these patients.     

SD大鼠1型糖尿病动物模型的建立

目的探讨制作理想糖尿病动物模型的方法。方法采用空腹腹腔一次性注射65 mg/kg链脲佐菌素的方法,建立SD大鼠1型糖尿病模型。结果造模1周后测血糖均高于16.7 mmol/L。持续观察8周,血糖值始终在建模初期高血糖水平上波动,未见到复转,并出现典型的"三多一少"症状,胰腺符合糖尿病成模动物胰腺病理变化。结论采用空腹腹腔一次性注射65 mg/kg链脲佐菌素的方法复制出1型糖尿病模型,具有造模方法简便、用药量小、药物毒性较低、胰岛B细胞损害特异性高等优点,可应用于糖尿病及其并发症研究的各个领域。