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1.
目的探讨在糖尿病诊断中应用空腹血糖(FPG),糖化血清白蛋白(GA)及糖化血红蛋白(HbA_1c)三者联合检测的临床意义。方法对70例糖尿病患者和56例健康体检者进行FPG、HbA_1c及GA的测定,再用SPSS17.0对结果进行计量资料统计学分析。结果糖尿病患者较正常对照组的空腹血糖、糖化血清白蛋白、糖化血红蛋白水平明显要高(P<0.05),且糖尿病组空腹血糖与糖化血清白蛋白和糖化血红蛋白呈正相关,3组结果相比较,差异有统计学意义(P<0.05)。结论空腹血糖、糖化血红蛋白和糖化血清白蛋白三者联合检测对早期诊断糖尿病,判断治疗效果,对控制和减少糖尿病并发症的发生、发展有重要意义。  相似文献   

2.
目的探讨HbA_1c与OGTT对糖尿病的诊断价值。方法将96例疑似糖尿病(DM)患者进行OGTT和HbA_1c测定,对比两种检测方法对糖尿病的诊断价值。结果 HbA_1c糖尿病检出率79.5%(70/88),OGTT糖尿病检出率77.3%(68/88);HbA_1c+OGTT糖尿病检出率97.7%(86/88);HbA_1c≥6.5%检出率为79.5%,FPG≥7.0 mmol/L检出率为76.1%,2hPG≥11.1 mmol/L检出率为79.5%,FPG≥7.0 mmol/L或HbA_1c≥6.5%检出率为85.2%,2hPG≥11.1 mmol/L或HbA_1c≥6.5%检出率为90.9%。比较可知HbA_1c+OGTT糖尿病检出率最高。结论 HbA_1c与OGTT在糖尿病诊断中均具有一定的价值,二者单用检测糖尿病会出现漏诊和误诊的情况,两种方法结合使用,可有效提高糖尿病的明确诊断率。  相似文献   

3.
目的探讨二甲双胍与格列齐特联合治疗2型糖尿病的临床疗效。方法随机将2017年1月至2018年7月本院收治的110例2型糖尿病患者分到对照组(n=55例)和观察组(n=55例),对照组患者予以格列齐特治疗,观察组患者予以二甲双胍与格列齐特联合治疗,对比分析两组患者的空腹血糖(FPG)水平、餐后2 h血糖(2hPG)水平、糖化血红蛋白(HbA1c)水平、空腹胰岛素(FINS)水平及低血糖反应情况。结果治疗后,观察组及对照组的FPG、2hPG、HbA_1c、FINS均明显低于治疗前,P <0.05;且观察组的FINS明显低于对照组,P <0.05;但治疗后,观察组及对照组FPG、2hPG、HbA1c比较,P> 0.05。观察组低血糖反应1例(1.81%),对照组低血压反应5例(9.09%),两组比较,P <0.05。结论二甲双胍与格列齐特联合治疗2型糖尿病在控制血糖方面与单用格列齐特治疗相似,但在减少低血糖反应、改善胰岛素抵抗方面具有一定的优势。  相似文献   

4.
目的 探讨甘精胰岛素联用格列美脲片治疗磺脲类药物继发性失效的2型糖尿病患者的疗效及安全性.方法 60例口服磺脲类降糖药血糖控制不理想的2型糖尿病患者随机分为甘精胰岛素治疗组(GL组)和中性鱼精蛋白锌胰岛素(NPH)组,予睡前皮下注射胰岛素联合口服格列美脲治疗12周,观察12周前后空腹血糖、餐后2h血糖、糖化血红蛋白、空腹C肽、餐后C肽的变化.结果 GL组治疗后FPG(6.3±1.4)mmol/L,2hPG(8.7±1.4)mmol/L,HbAlc(6.7±0.61%;NPH组治疗后FPG(6.4±1.0)mol/L,2hPG(8.8 4±1.2)mmol/L,HbAlc(6.6±0.7)%,较治疗前差异有极显著性(P<0.01);但GL组的低血糖事件明显少于NPH组(P<0.05).且GL组治疗后C肽水平明显升高.结论 甘精胰岛素联用格列美脲片治疗2型糖尿病的方案安全有效,简便易行,能减少低血糖事件的发生,且可能改善胰岛功能.  相似文献   

5.
目的了解控制达标的2型糖尿病患者用药情况,为临床合理用药提供参考。方法对334例糖化血红蛋白(HbA_(lc))≤6.5%的2型糖尿病患者行空腹血糖、C肽测定,同时调查糖尿病药物用药情况,对药物的分布及频率进行分析。结果 334例HbA_(lc)达标的患者中,使用频率最高的药物是糖苷酶抑制剂(49.7%)。全部患者中有56.6%(189/334)进行了联合用药。最常见的联合用药方案是:预混胰岛素+糖苷酶抑制剂(10.5%)及磺脲类+糖苷酶抑制剂(9.9%)。根据使用胰岛素与否,行多元回归分析发现:使用胰岛素与糖尿病病程正相关,与空腹C肽水平成负相关(均P<0.01)。结论 HbA_(lc)控制达标的患者多数需要联合用药。糖尿病病程越长,C肽水平越低,越需要使用胰岛素。  相似文献   

6.
目的 探讨甘精胰岛素联用格列美脲片治疗磺脲类药物继发性失效的2型糖尿病患者的疗效及安全性.方法 60例口服磺脲类降糖药血糖控制不理想的2型糖尿病患者随机分为甘精胰岛素治疗组(GL组)和中性鱼精蛋白锌胰岛素(NPH)组,予睡前皮下注射胰岛素联合口服格列美脲治疗12周,观察12周前后空腹血糖、餐后2h血糖、糖化血红蛋白、空腹C肽、餐后C肽的变化.结果 GL组治疗后FPG(6.3±1.4)mmol/L,2hPG(8.7±1.4)mmol/L,HbAlc(6.7±0.61%;NPH组治疗后FPG(6.4±1.0)mol/L,2hPG(8.8 4±1.2)mmol/L,HbAlc(6.6±0.7)%,较治疗前差异有极显著性(P<0.01);但GL组的低血糖事件明显少于NPH组(P<0.05).且GL组治疗后C肽水平明显升高.结论 甘精胰岛素联用格列美脲片治疗2型糖尿病的方案安全有效,简便易行,能减少低血糖事件的发生,且可能改善胰岛功能.  相似文献   

7.
目的 探讨分析空腹血糖(FPG)、口服葡萄糖耐量试验2 h血糖(OGTT 2 hPG)与糖化血红蛋白(HbA1c)在糖尿病筛查中的应用价值.方法 选择就诊的627例糖尿病危险人群作为研究对象,所有研究对象均检测FPG、OGTT 2 hPG、HbA1c,并对检测阳性率进行比较.结果 627例研究对象中,单独应用FPG检出疑似糖尿病119例,单独应用OGTT 2 hPG检出疑似糖尿病166例,单独应用HbA1c检出疑似糖尿病142例,同时查FPG、2 hPG及HbA1c检出疑似糖尿病236例,单独使用三种检测方法检出率并不高,且三者差异无统计学意义(P>0.05),但将三项指标联合使用可明显提高检出率,极大提高了检测的敏感性.应用FPG结合OGTT 2 hPG诊断糖尿病79例,应用FPG结合HbA1c诊断糖尿病73例,差异无统计学意义(P>0.05).结论 应用FPG结合HbA1c诊断糖尿病值得在临床上进一步推广和使用.  相似文献   

8.
扈峻峰 《海峡药学》2013,25(5):115-116
目的观察阿卡波糖联合地特胰岛素治疗2型糖尿病的临床疗效。方法 150例2型糖尿病患者随机分为联合组和对照组,分别采用口服阿卡波糖+皮下注射地特胰岛素和单纯口服阿卡波糖治疗,疗程3个月。观察两组糖化血红蛋白(HbA1c)、空腹血糖(FPG)餐后2h血糖(2hPG),评价两组血糖达标率和低血糖发生率。结果两组治疗后FPG、2hPG和HbA1c都明显降低,与治疗前比较差异均具有统计学意义(P<0.05),两组治疗后FPG、2hPG和HbA1c比较差异有统计学意义(P<0.05)。联合组血糖达标率为80.56%,高于对照组的51.28%,差异有统计学意义(P<0.05)。两组低血糖发生率分别为6.94%和20.51%,差异有统计学意义(P<0.05)。结论阿卡波糖联合地特胰岛素治疗2型糖尿病能明显降低血糖,提高血糖达标率,并且低血糖发生率低,适合临床推广使用。  相似文献   

9.
目的:探讨强化血糖控制对社区早期糖尿病肾病患者的干预效果。方法:将160例社区早期糖尿病肾病患者随机分为强化组和对照组,强化组糖化血红蛋白控制在≤6.0%,对照组糖化血红蛋白≤7.0%,观察两组患者干预前后空腹血糖、糖化血红蛋白、血脂、血压及尿微量白蛋白/肌酐比值的变化。结果:两组经干预后血脂、血压均有所改善;空腹血糖、糖化血红蛋白、尿微量白蛋白/肌酐比值下降,强化组尿微量白蛋白/肌酐下降较对照组明显(P<0.05)。结论:控制早期糖尿病肾病患者饮食、血糖、血压及血脂水平能够降低尿微量白蛋白/肌酐比值,严格的血糖控制有利于延缓早期糖尿病肾病的发生发展。  相似文献   

10.
目的观门冬胰岛素30联合阿卡波糖和精蛋白生物合成人胰岛素(预混30R)联合阿卡波糖治疗经口服降糖药血糖控制不佳的老年2型糖尿病的疗效。方法将60例患者分为两组,各30例。观察组使用门冬胰岛素30联合阿卡波糖,对照组使用精蛋白生物合成人胰岛素(预混30R)联合阿卡波糖。观察治疗前后两组患者空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1C)、胰岛素用量及低血糖发生率。结果两组患者治疗12周后,FPG,2hPG,HbA1C均明显降低;FPG,2hPG观察组明显优于对照组(P<0.05);HbA1C观察组优于对照组,但差异无统计学意义;观察组患者胰岛素用量少于对照组,但差异无统计学意义(P>0.05);观察组低血糖反应发生率为13.33%,显著低于对照组的46.67%(P<0.05)。结论两组治疗方案均可有效控制血糖控制不佳的老年2型糖尿病患者的血糖水平,但门冬胰岛素30联合阿卡波糖对FPG,2hPG,HbA1C控制更理想、降糖效果明显、胰岛素用量少、低血糖发生率低的优点,且比较安全,临床使用方便,依从性好。  相似文献   

11.
目的 评价糖化白蛋白(GA)在糖尿病(DM)患者诊治中的临床价值.方法 选取30例DM住院患者,每天检测7个时间点的血糖(BG)值,并于入院后0,1,2周,同时检测GA值和糖化血红蛋白(HbA1c)值,研究GA与平均血糖的相关性及对比HbAlc对血糖变化的敏感性;同期选取115名健康体检者,测定其GA值及其影响因素.结果 糖尿病患者的GA与HbA1c、平均血糖(MBG)及空腹平均血糖(MFBG)呈显著正相关;而与餐后2 h平均血糖(2hPBG)无显著相关性;GA、HbA1c均在2周的治疗过程中逐渐下降,GA下降趋势更明显,GA/HbA1c比值逐渐下降.结论 CA能较好的反映DM患者过去2周的平均血糖水平,GA较HbA1C敏感而较血糖稳定.  相似文献   

12.
目的 评价低蛋白饮食对糖尿病肾病的治疗效果.方法 选取2015年3月-2017年1月解放军白求恩国际和平医院收治的糖尿病肾病64例,随机分为研究组及对照组,每组32例.2组均进行常规饮食指导,研究组在此基础上给予优质低蛋白饮食,治疗周期为3个月.观察并比较2组治疗前后体重指数(BMI)、平均动脉压(MAP)、血红蛋白(Hb)、白蛋白(ALB)、尿素(BUN)、肌酐(Cr)、尿酸、肾小球滤过率(GFR)、24 h尿白蛋白、糖化血红蛋白(HbAlc)、空腹血糖(FPG)、餐后2h血糖(2 h PG)、血清甘油三酯(TG)、血清总胆固醇(TC)水平.结果 研究组BMI、MAP、Hb、ALB、BUN、Cr、尿酸、GFR、24 h尿白蛋白、HbAlc、FPG、2hPG、TG、TC均优于治疗前及对照组(P<0.05).结论 优质低蛋白饮食可改善GFR,减轻肾小球硬化,提高血清ALB水平,延缓肾功能损伤.  相似文献   

13.
Glycated haemoglobin (HbA1c) concentrations can be falsely lowered in circumstances when red blood cell (RBC) survival is reduced, e.g. in patients with chronic kidney disease (CKD). Glycated albumin (GA) has been suggested as an alternative marker of glycaemic control in these patients since it is independent of the RBC life span. The primary aim of this work was to develop a pharmacokinetic model that describes the time course of GA. The secondary aim was to assess the performance of GA as marker for glycaemic control in comparison to HbA1c based on simulations. For the second aim, three different scenarios were considered in the simulations: 1) assessment of the effect of large intra-day fluctuations in mean blood glucose on GA concentrations, 2) initiation of antidiabetic treatment on the GA profile, and 3) a hypothetical phase II study for a new antidiabetic compound. The GA model, as well as a previously developed HbA1c model described literature data well. GA concentrations appear to be stable even in the presence of high intra-day fluctuations in mean blood glucose concentrations. Simulation of a decrease in mean blood glucose concentrations resulted in a faster change in GA compared to HbA1c. GA also provided a time to 90?% power of the effect of a hypothetical antidiabetic drug that was 16?days shorter than when using HbA1c. These results indicate that GA could be used as alternative marker to assess blood glucose control in diabetic patients with CKD and also to follow an individual patient over time.  相似文献   

14.
波动性高血糖状态与糖尿病血管病变的关系   总被引:1,自引:0,他引:1  
目的探讨2型糖尿病患者波动性高血糖状态对糖尿病慢性并发症的影响。方法169例糖化血红蛋白(HbA,c)相近2型糖尿病患者分为两组:慢性持续性高血糖组(Ⅰ组,78例)、慢性波动性高血糖组(Ⅱ组,91例)。测定患者的空腹血糖(FBG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL)、空腹胰岛素(FINS)、餐后2h胰岛素(2hINS)、空腹C肽、餐后2hC肽、24h尿白蛋白定量(UAER),并分析其糖尿病慢性并发症的发生情况。结果Ⅱ组2hPG显著高于Ⅰ组(P〈0.01),餐后2h胰岛素与餐后2hC肽水平显著低于Ⅰ组(P〈0.01)。Ⅱ组糖尿病慢性并发症发生率显著高于Ⅰ组(P〈0.01)。结论2型糖尿病在波动性高血糖状态下慢性并发症明显增加。  相似文献   

15.
目的探讨血清糖化白蛋白(GA)水平及其他代谢产物与糖尿病(DM)及糖尿病肾病(DN)的相关性及其临床意义。方法 50例糖尿病患者作为糖尿病组, 50例糖尿病肾病患者作为糖尿病肾病组,50例健康人作为健康对照组,将100例糖尿病组和糖尿病肾病组患者根据尿微量白蛋白水平不同分为尿微正常组(58例)及尿微增高组(42例)。检测并比较各组间的空腹血糖(GLU)、血尿素氮(BUN)、肌酐(Cr)、甘油三酯(TG)、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)、糖化血红蛋白(HbA1c)、GA水平。结果健康对照组、糖尿病组和糖尿病肾病组的TC、LDL-C水平两两比较,差异均无统计学意义(P>0.05)。健康对照组的HDL-C(1.52±0.47)mmol/L高于糖尿病组的(1.17±0.54)mmol/L及糖尿病肾病组的(1.09±0.52)mmol/L,差异均具有统计学意义(P<0.05);糖尿病组及糖尿病肾病组的HDL-C水平比较,差异无统计学意义(P>0.05)。糖尿病组和糖尿病肾病组的GLU、BUN、Cr、TG、HbA1c、GA水平均高于健康对照组,糖尿病肾病组的GLU、BUN、Cr、TG、HbA1c、GA水平均高于糖尿病组,差异均具有统计学意义(P<0.05)。尿微正常组和尿微增高组的TC、LDL-C水平比较,差异均无统计学意义(P>0.05)。尿微增高组的GLU、BUN、Cr、TG、HbA1c、GA水平均高于尿微正常组, HDL-C水平低于尿微正常组,差异均具有统计学意义(P<0.05)。结论 GA可为糖尿病及糖尿病肾病的诊断及治疗提供重要的临床依据。  相似文献   

16.
1. The aim of the present study was to assess the validity of glycated albumin (GA) and fasting plasma glucose (FPG) as a screening tool for the early detection of diabetes in Chinese subjects. 2. A total of 1971 outpatient subjects underwent a 75 g oral glucose tolerance test (OGTT) and GA measurement. The receiver operating characteristic curve (ROC) was plotted to examine the sensitivity, specificity, and positive and negative predictive values of GA and FPG in detecting undiagnosed diabetes at the different cut‐off levels. 3. The prevalence of impaired glucose regulation and diabetes was 27.40% and 38.30%. For these diabetic individuals, 4.64% had isolated fasting hyperglycemia, 50.86% had isolated postprandial hyperglycemia and 44.50% had both. Using ROC analysis, a GA of 17.1% gave an optimal sensitivity of 76.82% (95% confidence interval: 73.64–79.79%) and specificity of 76.89% (74.42–79.23%) for the diagnosis of diabetes. Likewise, a FPG of 6.1 mmol/L gave an optimal sensitivity of 80.93% (77.94–83.67%) and specificity of 85.94% (83.86–87.84%). If subjects met both criteria, they were regarded as having diabetes; the positive predictive value of the combined criteria, FPG ≥ 6.1 mmol/L and GA ≥ 17.1%, was relatively high (84.79% (81.62–87.60%)), and this would have avoided 76% of the OGTT in our survey. 4. In conclusion, a GA value of 17.1%, an optimal cut‐off in Chinese subjects, identified a high proportion of potential diabetic individuals. Simultaneous measurement of FPG and GA would enhance the sensitivity of diabetes screening in our population and avoid 76% of OGTT.  相似文献   

17.
金兴权  王丽萍 《中国医药》2011,6(4):413-414
目的 探讨2型糖尿病肾病患者血清C肽水平变化的意义.方法 选取住院2型糖尿病患者120例,按尿白蛋白排泄率大小分成3组,正常白蛋白尿组34例,微量白蛋白尿组40例,临床白蛋白尿组46例,同时设血糖正常健康组30例.测各组空腹血糖、糖化血红蛋白(HbA1c)、空腹血清C肽(FCP),并进行比较分析.结果 微量白蛋白尿组和临床白蛋白尿组患者血清C肽与正常健康组比较,差异有统计学意义[(1.27±0.5)μg/L和(0.32±0.16)μg/L比(2.39±0.22)μg/L,P<0.01];血清C肽水平与尿白蛋白排泄率呈负相关(r=-0.745,P<0.01).结论 血清C肽水平的下降可能参与2型糖尿病肾病发生发展.
Abstract:
Objective To investigate the change of serum C-peptide level in type 2 diabetic nephrosis patients. Methods We recruited 120 patients with type 2 diabetes. The level of fasting plasma glucose (FBG), glycated hemoglobin (HbA1c), fasting C-peptide (FCP) and urinary albumin excretion rate (UAER) were measured.According to UAER, 120 patients were divided into Group Ⅰ: normal albuminuria group, 34 patients; Group Ⅱ:microalbuminuria group, 40 patients; Group Ⅲ: clinical albuminuria, 46 patients. At same time, we selected 30 healthy people as control group. Results The level of C-peptide decreased significantly in Group Ⅱ and Group Ⅲ compared with that of control group (P <0.01 ). The difference of C-peptide level between Group Ⅱ, Group Ⅳ and Group Ⅰ was statistically significant (P < 0.01 ). The level of C-Peptide and urinary albumin excretion rate was negatively correlated (R = -0. 745 ,P < 0. 01 ). Conclusion The decline of serum C-pcptide may be involved in the development of type 2 diabetic nephropathy.  相似文献   

18.
目的:探讨2型糖尿病(DM)患者血糖控制欠佳时脂蛋白(a)[Lp(a)]的水平及其与糖化血红蛋白(HbA 1c)的关系。方法:采用免疫胶乳凝集抑制法检测HbA 1c,采用免疫比浊法对30例HbA 1c高于正常的2型糖尿病患者和30例正常对照者的脂蛋白(a)进行测定。结果:2型DM糖化血红蛋白(GHb)升高组和正常对照组的血浆Lp(a)分布均呈偏态;2型DM GHb升高组Lp(a)显著高于正常对照组(P<0.01);根据HbA 1c水平将2型DM GHb升高组分成三组,三组间脂蛋白(a)的差异无统计学意义(P>0.05);2型DM GHb升高组Lp(a)与HbA 1c无相关性(P>0.05)。结论:2型糖尿病患者血糖控制欠佳时脂蛋白(a)的水平与糖化血红蛋白的水平无关。  相似文献   

19.
目的比较短期甘精胰岛素联合诺和灵R或二甲双胍强化治疗的疗效及对初诊的2型糖尿病患者(T2DM)胰岛β细胞功能的影响。方法对40例初诊的T2DM患者分别给予(A)甘精胰岛素与诺和灵R强化治疗,(B)二甲双胍加甘精胰岛素睡前皮下注射,4周后分析比较治疗前后FPG,2hPG、HbA1c、C肽、胰岛素释放试验的变化。结果治疗后两组FPG、2hPG、HbA1c均显著降低,差异有统计学意义(P〈0.01);A组空腹及服糖后各时间点C肽与胰岛素水平均较治疗前有不同程度的升高,差异有统计学意义(P〈0.01)。结论短期甘精胰岛素联合诺和灵R或二甲双胍治疗均有助于控制血糖,甘精胰岛素与诺和灵R联用还可明显改善初诊T2DM患者胰岛β细胞功能。  相似文献   

20.
The effect of a herbomineral formulation (HMF) on early diabetic nephropathy was investigated. Diabetes was induced in Wistar rats by administering streptozotocin (55 mg/kg, intraperitoneally). The occurrence of early diabetic nephropathy in rats was revealed by high plasma glucose and depleted liver glycogen, decreased glucose uptake by peripheral tissue, impaired renal function, increased antioxidants and lipid peroxidation in kidney. These changes were accompanied by elevated malondialdehyde, glutathione and superoxide dismutase activity in kidney. Furthermore, increased total urine volume, urinary albumin excretion rate, urinary albumin to creatinine ratio, increased relative kidney weight, decreased glomerular filtration rate (GFR) and urinary creatinine were also observed in diabetic nephropathy rats. HMF treatment significantly lowered blood glucose, glycosylated hemoglobin, creatinine, blood urea nitrogen, triglycerides, total cholesterol, serum albumin level, total urine volume, urinary albumin excretion rate, urinary albumin to creatinine ratio and relative kidney weight, and increased urinary creatinine and GFR. Altered levels of antioxidants, viz. lipid peroxidation, glutathione and superoxide dismutase (SOD), in kidney of diabetic nephropathy rats were restored. Histopathological findings indicated dense mesangial matrix in the glomeruli of diabetic nephropathy rats, which may be due to over-activation of matrix metalloproteinases and was reduced following HMF treatment. Our experimental findings clearly demonstrate that HMF has an ability to prevent the progression of early diabetic nephropathy. Such protective effect of HMF might be due to the presence of flavonoids (catechin, quercetin, rutin) and triterpene saponins (oleanolic acid and gymnemic acid) which are known to possess potent antioxidant properties.  相似文献   

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