甘精胰岛素300 U/ml与100 U/ml治疗中国2型糖尿病患者疗效和安全性的比较

目的比较甘精胰岛素300 U/ml(Gla-300)与100 U/ml(Gla-100)治疗非胰岛素类降糖药血糖控制不佳中国T2DM患者的疗效和安全性。方法本研究为EDITION AP(NCT02855684)中国亚组分析,在这项开放标签、随机对照的临床试验中,非Ins类降糖药物血糖控制不佳的474例中国T2DM患者按2:1比例随机予Gla-300(n=315)或Gla-100(n=159)治疗,观察两组26周时的疗效和安全性指标。结果两组自基线至治疗26周时HbA1c降幅的最小二乘均值差为0.05%,达到非劣效性评估终点。26周治疗期间,Gla-300组发生至少1次重度和/或证实夜间低血糖患者比例低于Gla-100组(31.5%vs 42.0%,P=0.03)。两组其余疗效和安全性指标差异无统计学意义。结论Gla-300治疗26周降低HbA1c效果与Gla-100相似,发生夜间低血糖风险更低。     

2型糖尿病肾病患者血清生长分化因子-15的表达及其临床意义

目的：探讨2型糖尿病肾病患者血清生长分化因子-15(GDF-15)的表达情况及临床意义。方法选择2011年12月至2015年2月在我院内分泌科进行治疗的2型糖尿病患者520例,根据尿白蛋白的含量水平分为正常白蛋白尿组(n=192)和微量白蛋白尿组(n=185)以及大量白蛋白尿组(n=143),应用酶联免疫吸附法(ELISA)检测并比较每组患者的血清GDF-15水平。结果正常白蛋白尿组患者血清GDF-15为(704.5±82.5) pg/ml,微量白蛋白尿组患者为(864.0±85.4) pg/ml,大量白蛋白尿组患者为(1773.9±113.5) pg/ml。正常白蛋白尿组和微量白蛋白尿组患者的血清GDF-15水平明显低于大量白蛋白尿组,差异均具有统计学意义(P<0.05);微量白蛋白尿组的血清GDF-15水平明显高于正常白蛋白尿组,差异具有统计学意义(P<0.05)。多元线形回归分析显示,微量白蛋白(mAlb)与白蛋白(Alb)呈负相关,与GDF-15呈正相关（P<0.05）。结论2型糖尿病肾病患者在临床的不同时刻血清GDF-15也会发生变化,患者血清GDF-15的高表达对病情的诊断和预后评价具有重要价值。     

格列美脲对人胰岛素和非促泌剂联用效果不佳的2型糖尿病患者疗效观察

在临床工作中，可以遇到一些使用人胰岛素同时联合2种或以上非促泌剂治疗而血糖控制不佳的患者，传统的治疗方法是继续增加胰岛素及口服药用量，近期国内有学者报道应用格列美脲联合胰岛素治疗单用胰岛素控制血糖不佳的患者效果明显。笔者对2型糖尿病患者加用格列美脲后可以明显降低血糖和糖化血红蛋白（HbA1c），减少胰岛素用量，报告如下。     

2型糖尿病患者NO、ET、GMP-140水平测定的临床意义

糖尿病肾病（DN）是2型糖尿病（DM）微血管并发症之一。其发生机理可能与内皮损伤及血小板功能异常有关。一氧化氮（NO）与内皮素（ET）在发挥内皮细胞功能中起着重要作用，而血小板-α颗粒膜蛋白（GMP-140）含量反映血小板活化程度及血栓形成倾向。通过测定2型糖尿病患者血清中的NO、ET及GMP-140的含量，分析3者对糖尿病肾病早期的影响及临床意义。     

糖尿病并发尿路感染的临床与病原学分析

对84例经清洁中段尿细菌培养阳性，细菌计数≥10^3／ml，确诊为UTI的DM病人的临床特点与病原菌进行分析。结果84例DM并UTI病人中有典型膀胱刺激征者32例，占38％（32／84）。其余52例为ASP，占61．9％（52／84），UTI的致病菌以革兰氏阴性杆菌为主，占83．3％。大肠埃希氏菌为优势菌株，占60．7％，其次为变形杆菌9．5％，枸橼酸杆菌8．3％，球菌占11．9％。其中表皮葡萄球菌占4．8％。金葡萄球菌占3．5％，酵母菌占4．8％。大肠埃希菌对氨苄青霉素、庆大霉素、环丙沙星、左氧氟沙星的耐药率较高。结论：DM合并UTI者，以ASP为多见，以革兰氏阴性杆菌为主，耐药率高。     

正常人骨动力学的初步研究

正常人骨动力学参数在我国还是空白,本文对6名不同年龄正常人骨动力学的几个基本参数进行了初步测量和研究,借以了解正常人骨动力学特点,及其对一些代谢性骨病的诊断意义。     

2型糖尿病肾病患者血小板α-颗粒膜蛋白和血浆内皮素的变化

2型糖尿病肾病(DN)是2型糖尿病微血管病变的并发症之一,临床常以尿微量白蛋白排泄(UAE)作为DN早期诊断的特异性指标。近年来许多研究表明,血小板功能异常及内皮细胞产生的内皮素(ET)增多在糖尿病微血管病变的发生、发展中起重要作用。我们通过测定α-颗粒膜蛋白(GMP-0140),血浆内皮素(ET)水平的变化观察α型糖尿病(NIDDM)患者内皮细胞,血小板功能变化,及它们与UAE之间的关系,探讨DN的发病机理。     

男性骨质疏松患者股骨头松质骨微结构区域差异的研究

Objective The aim of this study was to investigate the femoral head trabecular heterogeneity in Chinese male patients with osteoporotic fracture and their effects on osteoporotie fracture.Methods Human femoral heads were obtained from 11 male osteoporotie fracture (OP) patients ranged from 51 to 82 years old [average age (65±9 ) years old], and 7 male trauma ( TM ) patients ranged from 46 to 75 years old [average age (61±11 ) years old] who underwent total hip arthroplasty within two hours after either osteoporotic or trauma hip fracture.The OP was defined as having a fragility fracture.After laying femoral head as living body position and locating mark, nine trabecular specimens were obtained from femoral heads, each of 6 mm × 6 mm× 7 mm.The cortical shell was not included in each specimen.One cube was selected as the primary compressive trabecular region and the other 8 specimens as non-primary compressive trabecular region.These cubes were scanned using high-resolution microcomputed tomography scanner (μCT).After scanning, the data of total cubes, primary compressive trabecular region and noncompressive trabecular region were used for analysis by t test.Results In OP group volumetric bone mineral deosity(vBMD) [( 182.15±66.00) mg/mm3 vs (223.97±70.92) mg/mm3, t =3.041], tissue bone mineral density (tBMD) [(538.76±64.72) mg/mm3 vs (580.01±63.86 ) mg/mm3, t = 3.160],bone volume fraction (TV/BV) [(0.22 ± 0.06) % vs (0.26 ± 0.07 ) %, t = 2.821], trabecular thickness (Tb.Th.) [( 161.07 ±42.75 ) μm vs ( 205.47 ± 74.44 ) μm, t = 3.233] were significantly decreased while bone surface/bone volume ( BS/BV ) [( 13.75 ± 2.55 ) mm-1 vs ( 12.28 ± 2.70 ) mm-1, t =-2.777] was significantly increased in the non-primary compressive trabecular region than that in the primary compressive trabecular region ( P < 0.05 ).vBMD [( 182.15 ± 66.00) mg/mm3 vs ( 248.05 ±105.48) mg/mm3, t = - 3.598], tBMD [(538.76 ± 64.72) mg/mm3 vs ( 570.54 ± 100.32) mg/mm3,t=-2.108],TV/BV [(0.22±0.06) % vs (0.28±0.12) %, t= -3.466], Tb.Th.[(161.07±42.75) μm vs (200.31 ±96.63) μm, t= -2.866], trabecular number (Tb.N.)[(1.46±0.23)/mm3 vs ( 1.57 ± 0.29)/mm3, t = - 2.396] were significantly decreased while trabecular separation ( Tb.Sp.) [(780.82 ± 144.85 )μm vs ( 653.09 ± 119.64) μm, t = 5.470], degree of anisotropy (DA) ( 1.57±0.20 vs 1.47±0.18, t = 2.930 ) were significantly increased in OP than in TM in the non-compressive trabecular region( P < 0.05 ).No significant differents were found between OP and TM for any of the parameters measured in the primary compressive trabecular region.Tb.Th.[(199.37±68.22)μm vs (176.33 ±71.21 )μm, t = 2.060,P < 0.05] were significantly increased in the primary compressive trabecular region than that in the non-primary compressive trabecular region and no significant differences were found in the other parameters in the all 18 specimens.Conclusions The femoral head trabeculae had a heterogenic distribution in OP.Bone loss in OP primarily takes place in non-compressive trabecular region.Femoral neck fracture cannot be prevented though the bone microstructure do not loss in the primary compressive trabecular region.Tb.Th.in the femoral head could be an interesting parameter which is closely related to the femoral neck fracture.     

2型糖尿病患者中性粒细胞和淋巴细胞比值与胰岛β细胞分泌功能的相关性

目的:研究血糖控制不佳的2型糖尿病(T2DM)患者中性粒细胞和淋巴细胞比值(NLR)与胰岛β细胞分泌功能的相关性.方法:回顾分析某院内分泌科住院血糖控制不佳的T2DM患者106例作为研究对象,符合每日应用胰岛素≥30 U,糖化血红蛋白(HbA1c)≥8％,根据糖化血红蛋白水平将其分为3组,T2DM-A组(8％≤HbA1...     

胎胰组织培养及移植治疗Ⅰ型糖尿病的临床研究

本文报告我院建立了人胎胰组织培养方法,并应用短期培养的人胚胎胰岛组织为20例Ⅰ型糖尿病患者施行了胰岛移植。移植部位均为小网膜腔内。移植最长时间26个月,最短时间4个月,总有效率90%。平均胰岛素每日用量比移植前明显减少50%以上,同时空腹血糖等参数明显下降,血清 C 肽值增长2～4倍。移植前后均未服免疫抑制剂,移植物保持良好的功能,未发生排斥现象。