肺结核合并糖尿病36例临床分析

目的 :探讨糖尿病对肺结核抗痨疗效的影响。方法 :通过对 36例肺结核患者糖尿病疗效的观察 ,分析肺结核患者病灶、空洞和痰菌变化情况。结果 :在 2 9例糖尿病好转患者中 ,肺结核病灶吸收好转率、空洞缩小或关闭率、痰菌阴转率分别为 96.6%、93 .8%、92 .9% ;7例糖尿病恶化 ,其病灶好转吸收率仅为 14.3% ,无 1例空洞缩小或关闭 ,痰菌持续阳性 ,2例死亡。两组病灶吸收率及痰菌阴转率经统计分析有显著性差异 ( p <0 .0 1)。 结论 :糖尿病与肺结核互有不利影响 ,糖尿病治疗结果对肺结核患者预后有重要影响。因此 ,建议对所有肺结核及糖尿病患者常规进行血糖和胸部x线检查。     

鬼针草提取物对Ⅱ型糖尿病小鼠降血糖作用的研究

目的：研究鬼针草提取物对Ⅱ型糖尿病小鼠的作用。方法：给小鼠尾静脉注射四氧嘧啶(Alloxan)致Ⅱ型糖尿病小鼠，以优降糖为阳性对照药，灌胃7d后，测定小鼠血清葡萄糖等生化指标。结果：鬼针草95％乙醇提取物的EtOAc、n-BuOH萃取物能降低正常小鼠的血糖，并且EtOAc萃取物具有降低四氧嘧啶高血糖小鼠血糖的作用。     

糖尿病患者社区随访的干预效果评价

目的评价糖尿病患者社区综合干预效果。方法 2011年抽取乌鲁木齐市青年路街道办事处新民路西社区确诊的80例糖尿病患者,综合干预1年后进行有关指标效果评价。结果 80例糖尿病患者中,接受为期1年综合干预的67例,综合干预后的糖尿病患者的治疗率、控制率分别提高了1%、17.41%,仅控制率差异有统计学意义(P<0.01)。糖尿病患者的运动参与率提高了14.83%(P<0.05)。吸烟率、饮酒率均有所下降,但均没有统计学意义(P>0.05)。糖尿病患者健康知识知晓率均有所提高,差异有统计学意义(P<0.01或P<0.05),限盐勺、控油壶、计步器使用率分别为65.67%、47.76%、35.82%。结论糖尿病患者社区综合干预成效明显,方法切实可行。     

Insulin sensitivity of protein and glucose metabolism in overweight female adolescents with type 1 diabetes mellitus: positive modulation by physical exercise

Abstract Impairment of insulin sensitivity of glucose metabolism, a prominent feature of type 1 diabetes (DM), is also well documented in adolescence and obesity. Overweight is frequently present during adolescence in females. Spurt in growth is significantly reduced during puberty in females with type 1 DM, while it is normal in males. In this study we assessed the effect of the coexistence of type 1 DM, adolescence, overweight, and their possible interference with growth. Moreover, we evaluated whether dietetic control associated with physical exercise improved insulin sensitivity in adolescence. The study enrolled 11 female adolescents and young adults (aged 18.5±0.6 years), affected by type 1 DM for 8.3±0.9 years, who were overweight (BMI, 27.3±0.8 kg/m²) and receiving conventional insulin therapy (0.78±0.10 U/kg day). We used the euglycemic hyperinsulinemic clamp technique coupled to [²H₂]glucose and [¹³C]leucine infusion. The results show a striking increase in insulin resistance of glucose metabolism: the suppression of endogenous glucose production (EGP) was 59% in comparison to 90%–100% recorded by others at similar insulin levels in subjects at different periods of life. Insulin resistance in type 1 DM overweight adolescents was also present on protein metabolism: the postabsorptive plasma leucine (146.9±10.1 M) and the endogenous leucine flux (ELF, 88.8±4.5 µmol/kg min) were higher than in healthy controls. The suppression of ELF during hyperinsulinemia was defective in diabetic adolescents (27%, p<0.001) with respect to controls (36%). Only three of the 11 overweight diabetic subjects completed the 6-month physical exercise and diet program, and showed improvement of insulin sensitivity at the final evaluation. The EGP suppression by insulin shifted from 41% to 79%; ELF suppression increased from 26% to 34%. All the parameters of glucose metabolism correlated with the weight loss (BMI reduction from 27.8±1.9 to 25.6±1.2 kg/m²). In conclusion, overweight female adolescents with type 1 DM have an impaired insulin action on glucose and protein metabolism. Physical exercise and correct dietary regimen positively influence insulin sensitivity. The present preliminary data are relevant for an improved control of glucose homeostasis and a normal growth in adolescence.     

糖尿病的中医药治疗近况

从中医辨证施治、中成药治疗、中医外治(含针灸、推拿、外敷)及中西医结合治疗4个方面综述了近5年来中医药治疗糖尿病的进展。认为深入研究和使用中医药、从根本上寻找防治糖尿病的新疗法,是当今中国医学界的重大课题。     

120例住院病人糖化血清蛋白检测结果分析

目的:探讨糖化血清蛋白(GSP)检测在鉴别诊断应激性高血糖和糖尿病的价值。方法:随即抽取120住院患者进行糖化血清蛋白检测,并对检测结果进行统计分析。结果:应激性高血糖GSP为(1.71±0.34)mmol/L(n=53),糖尿病患者GSP为(3.24±0.27)mmol/L(n=67)。经t检验,应激性高血糖者与糖尿病患者的GSP具有显著性差异(P<0.05)。结论:GSP可鉴别诊断应激性高血糖和糖尿病,该方法值得临床推广使用。     

"临界"水平心血管病危险因素随访研究

目的 探讨有"临界"水平心血管病危险因素的居民疾病发展变化情况.方法 对某社区共446人的心血管病危险因素的变化情况进行随访观察3年.结果 "临界"高血压(120～139/80～89 mm Hg)、高血糖(6.1～6.9 mmol/L)、高胆固醇血症(5.18～6.19 mmol/L)者分别占居民的45.3%、16.4%、16.1%.3年间高血压、糖尿病和高胆固醇血症的发生率分别为28.7%、9.6%、6.9%,其相对危险性分别是血压、血糖、胆固醇处于正常水平者的3.2倍、11.2倍和4.3倍(P均<0.05).结论 心血管病危险因素血压、血糖、胆固醇处于"临界"水平的居民3年间高血压、糖尿病、高脂血症的发病率较血压、血糖、胆固醇处于正常水平者显著升高;其中"临界"高血压居民的比例最高,其发展为高血压的发生率亦较高.     

Protocolli preventodontici per pazienti diabetici

Objectives

To suggest a treatment protocol for diabetic patients with periodontal disease, and to assess the effectiveness of probiotic bacteria in controlling periodontal pathogens.

Material and methods

Ten patients affected by diabetes and periodontal disease were selected. PCR real time was used for bacterial count in samples collected from periodontal pockets before and after the maintenance therapy, including the administration of probiotic bacteria.

Results

A greater reduction of the bacterial count was observed in patient taking probiotic bacteria comparing the bacterial count before and after the experimental protocol.

Conclusions

The administration of probiotic bacteria, together with the use of toothbrush, dental floss, and specific oral care products, may help to balance bacterial flora. At the end of an active therapy, an appropriate maintenance protocol allows excellent results in diabetic patients as well.     

超重和肥胖对妊娠期糖尿病围产结局的影响

目的探讨超重和肥胖与妊娠期糖尿病患者妊娠结局的关系。方法 2010年1月～2011年12月在我院门诊产检确诊为妊娠期糖尿病患者,根据孕前体重指数(Body Mass Index BMI,kg/m2)分为:正常体重组(BMI 18.5～24.9)、超重组(BMI 25.0～29.9)、肥胖组(BMI≥30)。使用饮食控制或胰岛素治疗控制血糖水平。观察其妊娠并发症及妊娠结局。结果 604例妊娠期糖尿病孕妇中BMI正常体重241例(占39.90%),超重211例(占34.93%),肥胖152例(占25.17%)。超重与肥胖妊娠期糖尿病孕妇经辅助生育技术后妊娠,高龄产妇,巨大儿与急诊剖宫产的发生率显著高于正常组;肥胖组胎膜早破与子痫前期发生率,剖宫产率显著高于超重组及正常组;肥胖组顺产率显著低于正常组,肥胖组早产胎膜早破率显著高于正常组。结论妊娠前肥胖和超重可增加妊娠期糖尿病孕妇不良妊娠结局的风险。加强健康教育,适度控制孕前体重,可预防妊娠期糖尿病并发症,改善妊娠结局。     

甘精胰岛素控制2型糖尿病患者血糖有效性和安全性研究

目的 探讨甘精胰岛素控制2型糖尿病患者血糖的有效性和安全性,验证新的2型糖尿病治疗方案“一个中心、三步曲”.方法 采用多中心的随机、开放性、自身对照研究,对入选的203例2型糖尿病患者给予甘精胰岛素治疗,分为一针方案、一针一药方案、一长多短方案、一长一药多短方案四组,分别为30、106、48、19例,观察患者治疗前后血糖、糖化血红蛋白(HbA1c)、体重等变化.结果 治疗前患者的空腹血糖(FPG)(11.73±4.49) mmol/L,餐后2h血糖(2hPPG)( 16.73±4.96) mmol/L,HbA1c(9.43±2.31)％,治疗后分别为(5.78±0.76) mmol/L、(8.37±1.37) mmol/L、(6.81±0.38)％,均较治疗前显著降低(P＜0.01).治疗前后体重和体质指数比较差异无统计学意义(P＞0.05).四组患者治疗后FPG、2hPPG、HbA1c均较治疗前显著下降,差异有统计学意义(P＜0.01).治疗过程中仅1例患者出现低血糖反应.结论 “—个中心、三步曲”治疗方案,是一种既有效、安全,又方便、经济的2型糖尿病的治疗方案.