新疆汉族、维吾尔族和哈萨克族儿童糖尿病患病率调查及相关因素分析

目的 了解新疆汉族、维吾尔(维)族、哈萨克(哈)族儿童糖尿病患病率及其危险因素.方法 通过整群随机抽样方法,抽取喀什、和田和福海3个地区为研究现场,随机抽取年龄0～17岁汉、维和哈族儿童5283人作为研究对象,以问卷收集资料并进行体格及实验室检查.空腹血糖受损(IFG)和糖尿病诊断标准按2007年中国糖尿病防治指南,统计不同民族、年龄、性别组人群糖尿病患病率及分析危险因素.结果 IFG总检出率为0.5％,糖尿病总患病率为0.1％,按2000年全国人口普查年龄构成标化后分别为0.68％和0.09％.超重和肥胖为新疆儿童糖尿病危险因素,OR值分别为2.844和3.963.结论 新疆汉、维和哈族儿童糖尿病和IFG年龄标化患病率低于北京(2004年)和全国5～17岁儿童青少年水平.     

Consistency of ocular coherence tomography fast macular thickness mapping in diabetic diffuse macular edema

OBJECTIVES: To investigate optical coherence tomography consistency on foveal thickness, foveal volume, and macular volume measurements in patients with and without diffuse diabetic macular edema. INTRODUCTION: Optical coherence tomography represents an objective technique that provides cross-sectional tomographs of retinal structure in vivo. However, it is expected that poor fixation ability, as seen in diabetic macular edema, could alter its results. Several authors have discussed the reproducibility of optical coherence tomography, but only a few have addressed the topic with respect to diabetic maculopathy. METHODS: The study recruited diabetic patients without clinically evident retinopathy (control group) and with diffuse macular edema (case group). Only one eye of each patient was evaluated. Five consecutive fast macular scans were taken using Ocular Coherence Tomography 3; the 6 mm macular map was chosen. The consistency in measurements of foveal thickness, foveal volume, and total macular volume for both groups was evaluated using the Pearson's coefficient of variation. The T-test for independent samples was used in order to compare measurements of both groups. RESULTS: Each group consisted of 20 patients. All measurements had a coefficient of variation less than 10%. The most consistent parameter for both groups was the total macular volume. DISCUSSION: Consistency in measurement is a mainstay of any test. A test is unreliable if its measurements can not be correctly repeated. We found a good index of consistency, even considering patients with an unstable gaze. CONCLUSIONS: Optical coherence tomography is a consistent method for diabetic subjects with diffuse macular edema.     

农村社区糖尿病患者膳食和运动现状调查

目的了解农村社区管理糖尿病患者膳食和运动现状，提高患者血糖控制水平。方法采用现况调查方法对某农村社区管理的62名糖尿病患者进行问卷调查和体格检查。结果管理患者蔬菜摄入量只达到推荐下限的50％，膳食纤维仅达到19％，而食用油摄入量达到推荐上限的189％，32％患者胆固醇摄入超标；65％患者膳食总热量超过推荐量，34％患者脂肪供能比超标；患者主动性运动锻炼率19．35％，运动锻炼达标率仅3．23％。结论农村社区管理糖尿病患者膳食运动状况有待改善，应强化行为干预提高患者的血糖控制水平。     

血清晚期氧化蛋白产物与2型糖尿病患者动脉粥样硬化的关系

目的 探讨血清晚期氧化蛋白产物与2型糖尿病患者动脉粥样硬化性大血管并发症的关系.方法选择90例2型糖尿病患者和60例健康对照者,用酶联免疫吸附法及分光光度法分别检测血清基质细胞衍生因子1α生及晚期氧化蛋白产物水平,采用高分辨超声测定大动脉内膜中膜厚度.结果 2型糖尿病患者血清晚期氧化蛋白产物和基质细胞衍生因子1α水平明显高于健康对照者(P<0.05或P<0.01),2型糖尿病患者高晚期氧化蛋白产物组基质细胞衍生因子1α、空腹血糖、糖化血红蛋白及血清甘油三酯水平和体质指数与正常晚期氧化蛋白产物组比较显著升高(P<0.05),2型糖尿病患者中动脉粥样硬化组晚期氧化蛋白产物及基质细胞衍生因子1α水平明显高于非动脉粥样硬化组(P<0.01或P<0.05).单因素相关分析显示,血清晚期氧化蛋白产物水平与基质细胞衍生因子1α呈正相关(r=0.295,P=0.03),与空腹血糖、糖化血红蛋白、甘油三酯及体质指数呈正相关(r=0.286,P=0.03;r=0.310,P=0.01;r=0.461,P=0.001;r=0.257,P=0.04).结论 2型糖尿病患者蛋白氧化损伤增强,血清晚期氧化蛋白产物增加促进血管内皮细胞基质细胞衍生因子1α表达,晚期氧化蛋白产物增加可能与2型糖尿病动脉粥样硬化相关.     

护理干预对腰椎间盘突出症伴糖尿病患者的影响

目的：探讨护理干预对腰椎间盘突出症伴糖尿病患者围手术期的影响。方法：将2005年1月～2008年1月我科收治的腰椎间盘突出症伴糖尿病患者80例随机分成实验组和对照组各40例,对照组行常规围手术期护理,实验组在此基础上增加精心的护理干预。比较两组患者血糖控制情况、住院时间、切口甲级愈合率及患者满意率情况。结果：实验组术前、术后血糖低于对照组（P〈O．01）;总住院时间短于对照组（P〈0．01）;切口甲级愈合率及患者满意度均高于对照组（P〈O．05,P〈0．01）。结论：护理干预有利于患者血糖控制,降低手术风险,缩短住院时间,提高切口甲级愈合率及患者满意率,促进患者早日康复。     

沙棘原花青素对6月龄糖尿病大鼠周围神经病变的保护作用及其机制

目的探讨沙棘原花青素对6月龄糖尿病(DM)大鼠坐骨神经功能、醛糖还原酶活性及抗自由基能力的影响。方法以腹腔注射链脲佐菌素(STZ)制备SD大鼠糖尿病模型,随机分为DM模型组,沙棘原花青素大、中、小3个剂量组,并以正常组做对照。4周后检测各组大鼠血清、坐骨神经、脑组织中醛糖还原酶(AR)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)活性和脂质过氧化物丙二醛(MDA)的含量,并用BL-420F生物机能实验系统测定大鼠坐骨神经传导速度。结果与糖尿病模型组比较,沙棘原花青素各组大鼠血清、坐骨神经、脑组织中醛糖还原酶活性和MDA含量明显降低,而SOD、GSH-Px活性以及坐骨神经传导速度明显增加。结论沙棘原花青素对糖尿病大鼠周围神经病变具有保护作用,可能与抑制多元醇代谢通路增强和减轻自由基损伤有关。     

1型糖尿病一级亲属胰岛自身抗体筛查与胰岛β细胞功能研究

419名1型糖尿病患者一级亲属进行葡萄糖耐量试验,采用放射配体法检测谷氨酸脱羧酶抗体(GADA)、酪氨酸磷酸酶抗体(IA-2A)与胰岛素自身抗体(IAA),检出率分别为7.16%、1.43%与1.26%.其中11名抗体阳性一级亲属(Ab+组)、14名抗体阴性一级亲属(Ab-组)与39名对照者分别于5～7 d内进行IVGTT与那格列奈-葡萄糖耐量试验(OGTT).Ab+组第一时相胰岛素分泌[FPIR(4.80±0.24对5.25±0.66)mU/L]、10 min内胰岛素曲线下面积AUC0-10[(6.18±0.30对6.61±0.63)mU·min-1·L-1]与胰岛素净增值/血糖净增值比值[ΔI30/ΔG30(2.75±0.37对3.61±1.05)mU/mmol]低于对照组(均P＜0.05).Ab+组1 min胰岛素释放低于Ab-组[(3.80±0.30对4.52±0.70)mU/L,P＜0.05].Ab-组稳态模型评估的胰岛素抵抗指数(HOMA-IR)高于正常对照组(2.92±1.04对1.96±1.22,P＜0.05).提示本组1型糖尿病一级亲属胰岛自身抗体检出率与欧美白种人接近.胰岛自身抗体阳性一级亲属可能存在一定程度的胰岛β细胞功能减退,抗体阴性一级亲属可能存在一定程度的胰岛素抵抗.

Abstract：

Oral glucose tolerance test(OGTT)was performed in 419 first-degree relatives(FDRs)of type 1 diabetes mellitus. GADA, IA-2A, and IAA were determined by radioligand assay, and the positive rates were 7.16%, 1.43%, and 1.26%, respectively. Intravenous glucose tolerance test(IVGTT)and nateglinide-OGTT were performed in 39 controls, 11 first-degree relatives with positive autoantibody(Ab+group), 14 ones with negative autoantibody(Ab-group)during 5-7 days.The first-phase insulin release(FPIR), area under insulin release during 0-10 min [AUC0-10] of IVGTT and the value of(ΔI30/ΔG30)of nateglinide-OGTT in Ab+group were lower than those of control and(2.75±0.37 vs 3.61±1.05)mU/mmol, all P＜0.05]. The 1st min insulin release in Ab+group was lower than that of Ab-group [(3.80±0.30 vs 4.52±0.70)mU/L, P＜0.05]. The HOMA-IR was higher in Ab-group than that in control group(2.92±1.04 vs 1.96±1.22, P＜0.05). The results suggest that the positivity rates of autoantibodies in FDRs of type 1 diabetes mellitus are very close to those of Caucasian. There exist insulin secretion defects in FDRs with positive autoantibody while insulin resistance in FDRs with negative autoantibody.     

中医“治未病”在糖尿病防治中的应用

从中医学的"治未病"理论,中医学"治未病"在糖尿病前期中的应用(饮食、适度运动、监控高危人群),中医学"治未病"在糖尿病及其并发症中的应用,阐述了中医"治未病"在糖尿病防治中的作用。     

132例糖尿病酮症酸中毒和昏迷临床分析

132例糖尿病酮症酸中毒和昏迷,占同期生院糖尿病人的36％,死亡率14.4％。指出糖尿病酮症酸中毒,在我国目前仍较常见,应引起警惕和重视。对发病诱因和防治问题进行了探讨。