持续皮下胰岛素输注和胰岛素每日多点注射治疗2型糖尿病的成本效果分析

Objective To observe the cost-effectiveness of using continuous subcutaneous insulin infusion (CS Ⅱ) and multi-point daily insulin injections (MDI) in controlling blood sugar in the newly hospitalized type 2 diabetes patients. Methods Retrospective analysis on 86 cases taking CS Ⅱ and 103 cases using MDI on a 'blood sugar control program' among the newly hospitalized patients with type 2 diabetes. The period for observation was 2 weeks, using cost-effectiveness analysis methods to evaluate the two treatment programs. Results After two weeks of treatment, the effectiveness in the control of blood sugar in CS Ⅱ group was similar to the MDI group, with no significant difference(P<0.05) and the adverse reactions were similar. Costs in the CS Ⅱ program (Yuan/person) was less than in the MDI program (1478.34 vs. 1620.46), with significant differences (P< 0.05). The cost-effectiveness ratios (C/E) were 15.07 in the CS Ⅱ group, and 16.34 in the MDI group, with no significant difference (P>0.05). In order to further reduce the cost of CS Ⅱ group as a reference, the incremental cost-effectiveness ratio (△C/ △E)ofthe MDI group was 129.20. Conclusion Costs-effective of the CS Ⅱ program was better than the MDI one in treating the newly hospitalized patients with type 2 diabetes, suggesting that CS Ⅱ program might be a better choice for hospitals to carry on an intensive insulin therapy program.     

持续皮下胰岛素输注和胰岛素每日多点注射治疗2型糖尿病的成本效果分析

Objective To observe the cost-effectiveness of using continuous subcutaneous insulin infusion (CS Ⅱ) and multi-point daily insulin injections (MDI) in controlling blood sugar in the newly hospitalized type 2 diabetes patients. Methods Retrospective analysis on 86 cases taking CS Ⅱ and 103 cases using MDI on a 'blood sugar control program' among the newly hospitalized patients with type 2 diabetes. The period for observation was 2 weeks, using cost-effectiveness analysis methods to evaluate the two treatment programs. Results After two weeks of treatment, the effectiveness in the control of blood sugar in CS Ⅱ group was similar to the MDI group, with no significant difference(P<0.05) and the adverse reactions were similar. Costs in the CS Ⅱ program (Yuan/person) was less than in the MDI program (1478.34 vs. 1620.46), with significant differences (P< 0.05). The cost-effectiveness ratios (C/E) were 15.07 in the CS Ⅱ group, and 16.34 in the MDI group, with no significant difference (P>0.05). In order to further reduce the cost of CS Ⅱ group as a reference, the incremental cost-effectiveness ratio (△C/ △E)ofthe MDI group was 129.20. Conclusion Costs-effective of the CS Ⅱ program was better than the MDI one in treating the newly hospitalized patients with type 2 diabetes, suggesting that CS Ⅱ program might be a better choice for hospitals to carry on an intensive insulin therapy program.     

2型糖尿病患者腹型肥胖程度与结石患病风险的相关性分析

探究2型糖尿病患者腹型肥胖程度与胆囊结石、泌尿系结石患病率的相关性。选取2016年1月至2018年12月在中山大学附属第三医院内分泌与代谢病学科住院的2477例2型糖尿病(T2DM)患者。每例受试者均接受体格检查、生化检测、腹部B超检查。总人群按照腰臀比的四分位数分为4组,使用方差分析各组间基线资料差异。χ2检验分析各组间胆囊结石及泌尿系结石患病率的差异,Logistic回归分析法分析2型糖尿病患者结石患病的危险因素。结果显示,在胆囊结石组中,随着腰臀比四分位数的增加,患病率由2.4%(15/625)增加至12.5%(77/618)。胆囊结石患病率多因素Logistic回归分析表明,在胆囊结石组,T2DM患者中位于腰臀比第4四分位数的患者相比第1四分位数的患者,其患胆囊结石的风险显著增加(OR=3.78,95%CI 1.16~12.30,P=0.027)。在肾结石组,随着腰臀比四分位数的增加,患病率由2.4%增加至6.8%。在校正除体质指数外其他可能混杂因素后,T2DM患者中位于腰臀比第4四分位数的患者相比第1四分位数的患者,其患肾结石风险显著增加(OR=5.34,95%CI 1.14~25.01,P=0.033)。但进一步校正体质指数后,其结果无统计学意义(P>0.05)。说明,T2DM患者腹型肥胖程度与胆囊结石患病风险增加存在显著相关。     

2型糖尿病患者一次顿服或分两次服用2 mg格列美脲的疗效比较

126例2型糖尿病患者1：1随机分组，每日服用格列美脲2mg（1次服用或分2次服用）。测空腹和三餐后2h血糖，计算它们的极差和标准差；检测HbA1c。结果显示两种服用方式降糖效力相当，但一次服用血糖波动较小。     

角色互换模拟教学方法在病历书写教学中的应用

病历书写教学是物理诊断学教学的重点和难点,中山大学附属第三医院诊断学教研室采用角色互换模拟教学方法对临床医学专业和预防医学专业的部分学生进行病历书写教学.结果 显示,角色互换模拟教学方法重点突出,能够弥补学生临床知识不足和充分利用课外时间,显著提高学生病历书写水平,并具有培养学生换位思考、严格遵守时间规定和增加师生交流等优点.     

老年2型糖尿病合并非酒精性脂肪肝与下肢动脉疾病的关系

目的探讨老年2型糖尿病（T2DM）合并非酒精性脂肪肝的发生与下肢动脉疾病（LEAD）的关系。方法对89例老年2型糖尿病患者,根据有无合并非酒精性脂肪肝分为合并脂肪肝组和非脂肪肝组。对这些患者进行体格检查、生化检查及下肢动脉彩色多普勒超声检查。结果老年2型糖尿病合并脂肪肝组BMI、WHR、FINS、HOMA—IR、LDL—C、TG较非脂肪肝组升高（P〈0．05）。两组间LEAD发生率无显著性差异,但合并脂肪肝组重度及极重度LEAD发生率较高。结论老年2型糖尿病合并脂肪肝组更易出现血脂异常、胰岛素抵抗及较严重下肢动脉疾病。     

借助网络技术对见习进行链式管理的探讨

目的:探讨用网络技术对见习进行链式管理的效果.方法:对2017年至2019年216位学生和10位带教老师进行链式管理;2014年至2016年212位学生和11位带教老师作为对照.结果:采用链式管理后,缺勤率下降;见习、小讲课和教学查房迟到减少;课前预习增多;作业按时完成率提高;带教老师小讲课和教学查房分数提高,教师完成...     

Klinefelter综合征并糖脂代谢异常一例

Klinefelter综合征是一种以性腺发育异常、性功能减退为主要表现的性染色体异常疾病.该综合征可合并糖尿病、糖耐量异常或代谢综合征,国内仅有少量报道.现将我们收治的1例患者报道如下: Klinefelter综合征是一种以性腺发育异常、性功能减退为主要表现的性染色体异常疾病.该综合征可合并糖尿病、糖耐量异常或代谢综合征,国内仅有少量报道.现将我们收治的1例患者报道如下: 1 病例简介     

新诊断2型糖尿病患者血糖波动与胰岛细胞功能的关系

目的：探讨新诊断2型糖尿病患者血糖波动与胰岛细胞功能的关系。方法分析51例新诊断2型糖尿病患者的临床资料,血糖波动采用OGTT 1 h与OGTT 0 h差值（GLU1）、OGTT 2 h与OGTT 0 h差值（GLU2）表示。胰岛细胞功能采用空腹血清胰岛素、空腹血清C肽、稳态模式评估法的胰岛素分泌指数（HOMA-β）及胰岛素抵抗指数（HOMA-IR）表示。分析患者血糖波动情况,即GLU1、GLU2与空腹血清胰岛素、空腹血清C肽、HOMA-β、HOMA-IR的相关性。结果该组患者的GLU1为（7.84±2.31）mmol/L,GLU2为（7.4±2.7）mmol/L,空腹血清胰岛素为（13.8±6.0）mU/L,空腹血清C肽为（0.85±0.26）nmol/L,HOMA-β的对数值为4.10±0.64,HOMA-IR的对数值为1.43±0.54。GLU1、GLU2与空腹血清胰岛素、空腹血清C肽、HOMA-IR的对数无相关性（P均＞0.05）,但与HOMA-β的对数值呈负相关（r值分别为-0.344、-0.498,P均＜0.05）。结论新诊断2型糖尿病患者血糖波动可能与胰岛素分泌缺陷密切相关。     

2型糖尿病下肢血管病变与血清胱抑素C的关系

目的研究2型糖尿病(T2DM)合并下肢血管病变患者的临床特点及其与血清胱抑素C(CysC)的关系。方法将103例住院T2DM患者根据有无合并下肢血管病变分为合并下肢血管病变组和无下肢血管病变组,记录患者身高、体重、腰围、臀围,进行空腹血糖(FBG)、血总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、血清肌酐(Scr)、血清胱抑素C(CysC)、空腹胰岛素(FINS)测定,计算体重指数(BMI)、腰臀比(WHR)、胰岛素抵抗指数(HOMA-IR)。结果 2型糖尿病合并下肢血管病变组BMI、WHR、FINS、HOMA-IR、LDL-C、CysC较无下肢血管病变组升高(P<0.05),而FBG、TC、HDL-C、TG两组差别无统计学意义(P>0.05)。结论 2型糖尿病合并下肢血管病变组更易出现血脂异常及胰岛素抵抗。2型糖尿病合并下肢血管病变组胱抑素C水平较高。