糖尿病患者临床前期左心功能测定与评价

本文通过132例糖尿病患者左心室收缩间期(STI)等方面的检查,比较无临床心脏病表现的糖尿病患者与正常人;有、无高血压的糖尿病患者;两型糖尿病患者的左心室功能。对58例患者进行治疗1年前后、STI变化比较,观察有关无临床心脏病表现的糖尿病患者临床前期左心功能改变,并试探其可能的影响因素。     

T_3占优势Graves病22例临床分析

T_3占优势 Graves 病患者其特征为,由于抗甲状腺药物治疗过程中,血清 T_3持续升高,T_4正常,T)_3/T_4比率(ng/μg)大于20。我们随访22例,接受药物治疗18～28个月,观察2年,16例复发。复发时间乎均停药8.8个月。其中8例复发者作甲状腺次全切除术,术后甲状腺功能恢复正常,血清 T_3/T_4比率均小于20。T_3占优势甲状腺机能亢进患者有较高的血清 TSH 受体抗体活性,与甲状腺 T_4 5′-脱碘酶活性有关.药物治疗缓解率低,以选用手术或同位素治疗为佳.     

复发性嗜铬细胞瘤伴妊娠一例报告

患者女性,27岁,住院号188510,于1977年因阵发性高血压8个月入院。发作时多汗、头痛、心悸,持续数分钟至10余分钟。入院时体检无异常发现,多次24小时尿 VMA 在18.4～24.5mg(正常值<6mg/24h),24小时尿儿茶酚胺分别为236、246μg     

糖尿病人和原发性高甘油三酯血症病人血清载脂蛋白A_1及B水平比较

本文用快速、灵敏的联合免疫火箭电泳法测定正常人、糖尿病和原发性高甘油三酯血症患者血清载脂蛋白A_1和B水平。观察到两组病人血清载脂蛋白A_1水平均显著诋于正常值,而载脂蛋白B水平显著高于正常值。两组病人之间血清载脂蛋白A_1和B水平无显著差异,提示高甘油三酯血症亦是冠状动脉粥样硬化性心脏病的危险因素之一。     

中西医结合治疗糖尿病周围神经病变疗效观察

29例非胰岛素依赖型糖尿病合并周围神经病变患者分成两组:一组为控制血糖组共12例,经8个月严格控制血糖,正中、尺、腓运动神经传导速度和正中、尺感觉神经潜伏期获改善,而且改善的程度与空腹血糖和糖基化血红蛋白降低的程度密切相关;另一组为针灸加控制血糖组共17例,经1与3个月的治疗,分别有82.4%和90.0%的患者神经病变临床症状得到改善,但正中、尺、腓运动神经传导速度和正中、尺感觉神经潜伏期未得到改善。     

甲状腺机能减退症的脂类代谢——附50例分析

本文报道甲减50例(男10例,女40例),年龄16～63岁,病程3个月～20年,其中亚临床型甲减10例,轻型10例,重型30例。伴心绞痛5例,心肌梗塞1例,主动脉硬化8例,眼底动脉硬化16例。甲减伴高胆固醇血症36例,占72％,伴高甘油三酯(TG)血症12例,占24％。重型甲减血清总胆固醇(TC)升高尤为显著,仅重型甲减TG增高而HDL-Ch降低;临床型甲减     

正常志愿者的黎明现象探讨

本文对12名正常志愿者进行了黎明现象的测试,受试者于午夜至6:00～6:30AM保持睡眠状态,0:30～8:00AM每30分钟采血一次,行BG、和insulin、GH、TSH、T_3、T_4、F、E、NE测定。结果示BG平均浓度于5AM后呈轻度上升,7:30 AM达最高值。insulin平均浓度于5:00AM达最低值,以后逐渐上升,7:00AM达最高值。F平均浓度的升高(2AM)早于清晨血糖升高2～3小时.GH平均浓度于0:30～4:00AM几乎为4:00～8:00AM的二倍.E和NE平均浓度于清晨呈有意义的增高,以后者更为明显,可出现在黎明现象前或与之同步。本研究证实在正常人中存在黎明现象,胰岛素的拮抗激素GH、F、E和NE可能参与发生机制。     

垂体瘤按功能分类的再探讨

本文从临床表现,垂体动态功能试验和病理形态 三方面对106例垂体瘤进行研究,对其按功能分类作进一步探讨。材料和方法:106例中92例经手术切除瘤体。根据症状,血清激素水平分组。功能试验包括TRH,灭吐灵兴奋,高糖抑制GH试验。同一瘤块分为二份供电镜,光镜对照检查。     

糖尿病肾病

糖尿病中肾脏病变简称糖尿病肾病。有广义与狭义之分。前者指糖尿病人由于多种因素引起的常见肾脏病,后者指糖尿病中特有的肾脏并发症,本文将重点论述糖尿病者所特有的肾小球硬化症与肾小管病变,虽相似病变亦可偶见于无糖尿病的其他疾病中,但极罕见。患病率糖尿病性肾小球硬化症的患病率各家报道颇不一致。主要由于临床诊断标准不一,也可     

PRE- AND POST-OPERATIVE HYPOTHALAMIC-PITUITARY- THYROIDAL AXIS FUNCTION IN PATIENTS WITH PROLACTINOMA, GROWTH HORMONE TUMOUR AND ACTH TUMOUR

Pre- and postoperative hypothalamic-pituitary-thyroid axis function was studied in 38 patients with pituitary adenomas (PRL, GH and ACTH tumours), of whom 35 were surgically confirmed and three diagnosed by clinical signs, CT scanning and hormone assessments. About ten days after operation, the same study was repeated in 10 patients with prolactinoma and 7 with growth hormone (GH) tumour. The preoperative abnormal serum TSH response to TRH was found in 8/20 patients with prolactinoma, 9/16 with GH tumour, and 2/2 with Cushing's disease due to ACTH microadenoma. The incidence of abnormal TSH response to TRH was not significantly increased in patients with larger adenoma in either PRL or GH tumour group. In 8 cases of prolactinoma, metoclopramide (MCP, 10 mg, P.O.) test was also performed and there was a significant positive correlation between TSH responses to TRH and to MCP. Serum TT3 in the GH tumour group was within normal ranges, but significantly higher than that of the normal and prolactinoma groups. After operation, TT3 was significantly decreased as compared with that before operation and there were marked changes in TSH response to TRH. In conclusion, there were some abnormalities in TSH control in patients with non-TSH pituitary tumour, and in serum TT3 control in patients with GH tumour. The surgical treatment of pituitary adenoma can lead to transient decrease in TSH reserve and serum TT3 level probably resulting from both stress and/or destruction of thyro-trophs by the operation.