肾功能正常的2型糖尿病患者血肌酐与乳酸水平相关

目的 探讨肾功能正常的2型糖尿病患者的血肌酐与血乳酸水平的关系以及应用二甲双胍后对血乳酸的影响.方法 选择肾功能正常的住院2型糖尿病患者723例,其中应用二甲双胍者(用药组)275例,未用双胍类者(对照组)448例.用酶电极法测定血乳酸水平,同时榆测空腹血糖、胰岛素、HbA1C尿素氮、肌酐和丙氨酸转氨酶(ALT)等水平.结果 (1)用药组的平均血乳酸水平高于对照组[(1.33±0.57 vs 1.17±0.47)mmol/L,P<0.01];高乳酸血症的发生率显著高于对照组(9.45% vs 4.91%,P<0.01),但均末达到酸中毒的水平.(2)相关性分析结果显示,血乳酸水平与血肌酐、尿素氮、ALT、体重指数(BMI)呈明显正相关.在校正ALT和BMI后,肌酐仍与血乳酸呈正相关(r=0.345,P<0.01).(3)按肌酐水平进行分层后,血乳酸水平随着血肌酐水平升高而增加,肌酐>90 μmol/L后显著增高;受试者工作特征(ROC)曲线分析表明预测血乳酸水平增高的肌酐截点是95.35 μmol/L.结论 肾功能正常的2型糖尿病患者应用二甲双胍虽具有较好的安全性,但仍有极少数患者可出现乳酸水平的轻度升高.血肌酐>95.35μmol/L者发生高乳酸血症的风险增加.     

嘉定区安亭镇糖尿病及糖调节受损的患病率调查

目的了解安亭镇糖尿病及糖调节受损的患病现况。方法于2008年6月-2008年7月采取整群分层抽样的方法,对安亭镇3个社区20～74岁的1906名居民进行糖尿病（DM）及糖调节受损（IGR）患病率调查。使用问卷调查收集一般人口学资料,疾病家族史、既往疾病史,包括既往糖尿病史等资料。对已知糖尿病患者进行馒头餐试验,对既往无糖尿病史者进行葡萄糖耐量试验。按照世界卫生组织1999年糖尿病诊断标准对糖耐量状态进行判断。结果1906例调查者中,DM患病率为7．9％,其中新发DM55人;IGR为13．0％。糖尿病及糖调节受损患病随着年龄的增长而增高（P〈0．001）,男性糖尿病患病率为9．8％,女性5．6％,性别差异有统计学意义。结论上海嘉定区安亭镇DM患病率接近全国平均水平,IGR患病率较高,有相当的DM患者未能被及时发现。     

上海社区糖尿病前期及糖尿病人群视网膜病变患病率及相关危险因素分析

Objective To determine the prevalence and risk factors of diabetic retinopathy (DR) in the Diabetes Mellitus (DM) and impaired glucose regulation (IGR) population in Shanghai Community. Methods DR screening after the epidemiologic study of metabolic syndrome in Huayang and Canyang Community , Shanghai was conducted among 1300 patients with DM or IGR during June 2005 and March 2006, Digital non-mydriatic fundus photography was performed for each eye in all subjects. Other factors, including diabetes related history, BMI, WHR, fasting plasma glucose, HbAlc, serum lipid and blood pressure were also assessed. 642 patients,312 males and 330 females, aged 65 ± 13, with complete data were enrolled into the analysis. Results The prevalence of DR was 19. 9% in the diabetic population, and the prevalence of mild, moderate, severe non-proliferative retinopathy and proliferative retinopathy was 12. 0%, 5. 1%, 2. 3% and 0. 5%, respectively; the prevalence of DR in IGR reached 8. 0%. Logistic regression analysis revealed that HbA1c level and diabetes duration were both independently associated with diabetic retinopathy. Conclusion The prevalence of DR was high in both DM and IGR population. Bad blood glucose control and long diabetes duration both increased occurrence of DR.     

上海社区糖尿病前期及糖尿病人群视网膜病变患病率及相关危险因素分析

Objective To determine the prevalence and risk factors of diabetic retinopathy (DR) in the Diabetes Mellitus (DM) and impaired glucose regulation (IGR) population in Shanghai Community. Methods DR screening after the epidemiologic study of metabolic syndrome in Huayang and Canyang Community , Shanghai was conducted among 1300 patients with DM or IGR during June 2005 and March 2006, Digital non-mydriatic fundus photography was performed for each eye in all subjects. Other factors, including diabetes related history, BMI, WHR, fasting plasma glucose, HbAlc, serum lipid and blood pressure were also assessed. 642 patients,312 males and 330 females, aged 65 ± 13, with complete data were enrolled into the analysis. Results The prevalence of DR was 19. 9% in the diabetic population, and the prevalence of mild, moderate, severe non-proliferative retinopathy and proliferative retinopathy was 12. 0%, 5. 1%, 2. 3% and 0. 5%, respectively; the prevalence of DR in IGR reached 8. 0%. Logistic regression analysis revealed that HbA1c level and diabetes duration were both independently associated with diabetic retinopathy. Conclusion The prevalence of DR was high in both DM and IGR population. Bad blood glucose control and long diabetes duration both increased occurrence of DR.     

音叉联合尼龙丝检查在糖尿病周围神经病变筛查中的价值

目的探索128 Hz音叉检查、10 g尼龙丝检查及其联合检查在糖尿病周围神经病变(DPN)筛查中的适用性。方法对233例2型糖尿病患者进行神经传导速度(NCV)检查、密歇根神经病变筛选法(MNSI评分)、128 Hz音叉检查、10 g尼龙丝检查及10 g尼龙丝联合128 Hz音叉检查。以NCV检查作为"金标准",计算各种方法诊断DPN的敏感性、特异性、阳性预测值、阴性预测值、准确度及一致性。结果MNSI评分>2分、128 Hz音叉检查≥0.5分、10 g尼龙丝检查≥1分和10 g尼龙丝检查≥1分联合128 Hz音叉检查≥0.5分与NCV诊断DPN的一致性κ值分别为0.69、0.55、0.33及0.57。结论128 Hz音叉联合10 g尼龙丝检查有望DPN早期筛查中得以推广,其推广次序依次是MNSI评分、128 Hz音叉联合10 g尼龙丝检查、128 Hz音叉检查和10 g尼龙丝检查。     

云南省基诺族成年人糖尿病的患病率及其相关因素

目的 了解基诺族成年人糖尿病患病现况。方法 2012年2-4月对云南省基诺族18～75岁成年人进行问卷调查及基于口服葡萄糖耐量试验的糖尿病患病率调查,共5577人完成问卷、体格检查和血样本检测,所有数据纳入分析。以1999年世界卫生组织糖尿病诊断标准确定糖尿病、糖调节异常。以2010年全国人口性别年龄构成为标准人口,使用直接法计算标化率。结果 基诺族总人群[5577例,（40.113.2）岁]、男性[2649例,18～75岁,平均（39.913.6）岁]、女性[2928例,18～75岁,平均（40.212.9）岁]的糖尿病标化率分别为6.8%、9.4%和4.1%。在新诊断糖尿病患者中,单纯空腹血糖7.0 mmol/L的占38.4%,单纯2 h血糖11.1 mmol/L的占39.8%,二者均升高的占21.8%。总人群、男性、女性的糖尿病前期标化率分别为19.6%、21.9%和17.5%。糖尿病前期患者中单纯空腹血糖受损的占42.6%,单纯糖耐量受损的占43.8%,空腹和餐后均受损的占13.6%。男性、增龄、高血压、血脂异常、中心性肥胖、饮酒均为糖尿病及糖尿病前期的独立危险因素。结论 男性的糖尿病及糖尿病前期患病率明显超过女性。基诺族成年人空腹血糖异常的比例较高。     

上海社区糖尿病前期及糖尿病人群视网膜病变患病率及相关危险因素分析

Objective To determine the prevalence and risk factors of diabetic retinopathy (DR) in the Diabetes Mellitus (DM) and impaired glucose regulation (IGR) population in Shanghai Community. Methods DR screening after the epidemiologic study of metabolic syndrome in Huayang and Canyang Community , Shanghai was conducted among 1300 patients with DM or IGR during June 2005 and March 2006, Digital non-mydriatic fundus photography was performed for each eye in all subjects. Other factors, including diabetes related history, BMI, WHR, fasting plasma glucose, HbAlc, serum lipid and blood pressure were also assessed. 642 patients,312 males and 330 females, aged 65 ± 13, with complete data were enrolled into the analysis. Results The prevalence of DR was 19. 9% in the diabetic population, and the prevalence of mild, moderate, severe non-proliferative retinopathy and proliferative retinopathy was 12. 0%, 5. 1%, 2. 3% and 0. 5%, respectively; the prevalence of DR in IGR reached 8. 0%. Logistic regression analysis revealed that HbA1c level and diabetes duration were both independently associated with diabetic retinopathy. Conclusion The prevalence of DR was high in both DM and IGR population. Bad blood glucose control and long diabetes duration both increased occurrence of DR.     

应用Excel VBA将医院检验报告快速构建成数据库

目的 使用Excel VBA(visual basic for application)将数据和注解混排的医院检验报告转变成可直接统计分析的数据库.方法 在Excel中创建工程文件"上海社区流调实验室数据库整理.xls",包括作为Microsoft Excel对象模块的工作表和模块代码窗口中的VBA程序.工作表包括①预先构建好的数据库框架工作表,名称为"上海社区流调实验室数据整理",准备存放导入的数据;②三张存放相应医院检验报告资料的工作表,依次命名为"生化室检查项目"、"尿蛋白"和"尿常规",为新建数据库的资料来源.编译、调试及运行VBA程序,进行数据的导出和导入.结果 "生化室检查项目"、"尿蛋白"和"尿常规"工作表中的数据被导出到"上海社区流调实验室数据整理"工作表中,数据库构建完成.结论 使用Excel VBA能快速将数据和注解混排的医院检验报告资料快速输出到已构建好的数据库中.     

门诊2型糖尿病患者中高血压存在情况及其危险因素初析

多危险因素干预试验(MRFIT)12年数据资料证实，高血压是糖尿病死亡的一个独立危险因子。在糖尿病心血管并发症中，高血压不仅发生率高，而且是糖尿病患者心血管事件和微血管病变的一个主要危险因素。本文旨在了解门诊2型糖尿病患者中高血压的构成情况、血压控制情况，并初步探讨2型糖尿病易合并高血压的可能危险因素。     

饮食习惯与2型糖尿病合并肾病的关系

目的：评估饮食习惯在2型糖尿病（NIDDM）合并糖尿病肾病（DN）中的作用。方法：回顾性条件了按年龄、性别、种族、居住地匹配的两组NIDDM患者，一组为非蛋白尿组（＜300mg/d,n=106)，一组为蛋白尿组（≥500mg/d,n=106)。资料处理使用条件logistic，回归分析。结果：单因素结果分析显示：患糖尿病（DM）后日平均蔬菜摄入量与DN有统计学关联，OR＝1．87，95％CI为1．14－3．06；而患DM后的碳水化合物、水果、油脂、蛋白质类等的摄入情况未显示与NIDDM合并DN有统计学联系。用可能的混杂因素调整后上述关联依然存在。结论：对于NIDDM患者来说，蔬菜日平均摄入量的减少可增加NIDDM患者合并DN的危险性。