2型糖尿病肾病患者基质金属蛋白酶-2水平变化及其临床意义

目的:研究2型糖尿病(2-DM)肾病患者血浆基质金属蛋白酶2(MMP-2)水平变化及其临床意义.方法:根据尿白蛋白排泄率(UAER),将87例糖尿病患者分为2-DM无肾病组28例(UAER＜20 μg/min)、2-DM微量蛋白尿组30例(UAER:20～200μg/min)和2-DM 临床蛋白尿组29例(UAER≥200μg/min),用ELISA法测定血浆MMP-2的水平.另设正常对照组20例.结果:2-DM患者血浆MMP-2水平明显低于正常对照组(P＜0.01).结论:持续高血糖可使血浆MMP-2水平下降,其改变早于微量蛋白尿的出现,MMP-2可能参与了糖尿病肾病的发生、发展.     

甲状腺危象合并糖尿病酮症酸中毒一例

患者女,17岁,因怕热、心悸、多尿、多饮伴消瘦10个月余、昏迷4 h于2005年1月29日急诊入院.5个月前外院检测游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)均明显升高,促甲状腺激素(TSH)明显降低,诊断为"甲状腺功能亢进(甲亢)",给予放射性131I治疗;3个月前予甲巯咪唑及普萘洛尔治疗,服药不规则,症状无明显改善.     

2型糖尿病患者应用二甲双胍治疗前后血浆胃促生长素及YY肽水平

目的 观察二甲双胍治疗对新诊断2型糖尿病患者血浆胃促生长素、YY肽(PYY)水平的影响,探讨二甲双胍对2型糖尿病患者体重影响个体差异性的机制.方法 采用前瞻性巢式病例对照研究作为研究设计方案.64例新诊断2型糖尿病患者应用二甲双胍治疗12周,根据治疗后体重的变化情况,分为体重减轻组及体重未减轻组,治疗前后测定空腹血浆胃促生长素、PYY水平及相关代谢指标.结果 2型糖尿病患者经二甲双胍治疗后空腹血浆胃促生长素水平均较治疗前明显下降[(10.71 +2.68对11.81±3.19)ng/ml,P＜0.05],空腹血浆PYY水平均较治疗前明显升高[(136.86±39.14对128.42±37.31)pg/ml,P＜0.05].治疗后有43.7％的2型糖尿病患者出现体重明显下降.体重减轻组在治疗后空腹血浆胃促生长素水平下降16.6％,降幅高于体重未减轻组的6.2％(P＜0.05);体重减轻组在治疗后空腹血浆PYY水平升高10.8％,升幅高于体重未减轻组的3.5％(P＜0.05).结论 2型糖尿病患者二甲双胍治疗后体重明显减轻者较体重基本保持不变者,空腹血浆胃促生长素水平降低更显著,空腹血浆PYY水平升高更显著,具体机制还有待进一步研究.     

降糖药物对新发2型糖尿病患者胫前动脉弹性影响的初步探讨

目的 探讨降糖药物对新发2型糖尿病患者胫前动脉弹性的影响.方法 随机选取新发2型糖尿病患者100例,分为对照组50例和病例组50例.计算胫前动脉的应变-血压指数(SBPI),所有患者服用降糖药物6个月后再次计算胫前动脉的SBPI,并进行组间和组内对比分析.结果 对照组胫前动脉SBPI治疗后高于治疗前(P<0.05).病例组胫前动脉SBPI治疗前后比较差异无统计学意义(P>0.05).病例组胫前动脉SBPI在治疗前和治疗后均低于对照组(P<0.05).结论 降糖药物对不合并血管并发症的新发2型糖尿病患者胫前动脉弹性有较好的保护作用.

Abstract：

Objective To investigate the effects in elasticity of anterior tibial artery in new patients with type 2 diabetes caused by medicines of reducing blood sugar. Methods One hundred patients with type 2 diabetes were involved. The patients were divided into control group(50 cases) and case group(50 cases) according the vascular complications (including macroangiopathy and microangiopathy). Maxmum of circumferential strain(CSmax) of anterior tibial artery was acquired through strain and strain rate imaging. Local blood pressure which included local systolic blood pressure(LSBP) and local diastolic blood pressure (LDBP) of anterior tibial artery was measured at the same time. Strain-blood pressure index(SBPI) of anterior tibial artery was calculated, SBPI = CSmax/[(LSBP - LDBP)/LDBP] × 100%. It took six months for each patient to take medicines of reducing blood sugar. Then SBPI of anterior tibial artery was calculated again. Parameters were compared inter- and intra-groups. Results SBPI of anterior tibial artery after therapy was higher than that before therapy in control group( P<0. 05). There was no significant difference between SBPI of anterior tibial artery before therapy and that after therapy in case group( P >0. 05). SBPI of anterior tibial artery in case group was lower than that in control whatever before and after therapy( P < 0. 05). Conclusions The protection of medicines of reducing blood sugar on elasticity of anterior tibial artery in new diabetic patients without vascular complications was better.