银屑病患者血脂水平分析

目的研究银屑病患者脂代谢紊乱情况,分析不同类型银屑病患者血脂变化特点。方法将332例银屑病患者按临床表现分为脓疱型、寻常型及红皮病型,比较各组间的血脂水平。结果与对照组比较,银屑病组总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(ApoA1)水平较低,差异有统计学意义(P0.05),脂蛋白[Lp(a)]水平较高,差异有统计学意义(P0.05);脓疱型银屑病型与寻常型、红皮病型相比,血清TC、HDL-C、LDL-C及ApoA1均较低,差异有统计学意义(P0.05)。结论银屑病患者体内存在脂代谢紊乱,且其紊乱严重情况可能与疾病类型有关。     

158例2型糖尿病患者血脂与血尿酸代谢异常关系分析

目的：探讨2型糖尿病患者血脂与血尿酸代谢的关系;方法：对158例2型糖尿病患者（观察组及101例正常对照组）进行血清总胆固醇（TC）、甘油三脂（TG）、高密度脂蛋白（HDL—C）、低密度脂蛋白（LDL-C）、载脂蛋白A（APoA）、载脂蛋白B（APoB）、血尿酸（UA）测定;结果：观察组TG、APoB、UA明显高于对照组,观察组HDL-C、APoA明显低于对照组。结论：2型糖尿病患者易发生脂代谢异常,而血脂、血糖、血尿酸异常的共存是该病发生的危险因素,也是心脑血管疾病的危险因素。因此,及时纠正血脂、血尿酸代谢异常对2型糖尿病的治疗就显得十分重要。     

血脂测定在糖尿病中的临床意义

目的 观察糖尿病患者和正常人对照组血脂(甘油三酯、胆固醇)。方法 通过自动生化分析仪检测。结果 糖尿病患者血脂增高人数比例明显大于正常人对照组．而血脂增高将导致血液粘度增加．从而发生动脉硬化，提示注意纠正高血脂。     

糖尿病2型患者血脂的治疗

长期以来，人们对于糖尿病的认识仅局限于糖代谢的紊乱，其治疗措施亦侧重于血糖的控制。2001年，班廷奖得主McGarry教授在美国糖尿病协会年会（ADA）上提出脂代谢障碍为2型糖尿病及其并发症的原发病理生理改变，2型糖尿病中糖代谢紊乱的根源为脂代谢异常。他甚至提出将2型糖尿病称为“糖脂病”。由此脂代谢异常与糖尿病的关系引起学术界的广泛关注。     

糖尿病患者血脂的观察

糖尿病患者除有糖代谢紊乱,还有明显的脂代谢异常,糖尿病患者较正常人群动脉硬化的发病率高、患者年龄轻、病情进展快、冠心病和脑血管意外的患病率较非糖尿病患者高2～3倍,是近年来糖尿病患者主要死因。为探讨血脂与糖尿病的关系和对糖尿病血管并发症的影响,我们观察了50例糖尿病患者的血脂水平,并与33名健康人做对照,报告如下。     

尿毒症血液透析患者血脂变化及临床意义

目的通过对40例尿毒症患者进行肾透析,评价肾透析后患者发生冠心病危险性有效的血液生化指标。方法采用费森尤斯4008S型血液透析机,费森尤斯F14透析器,并用碳酸氢盐透析液透析,反渗水处理,患者每周透析2～3次,每次3～4h,以肝素抗凝,首剂量2 000U,以1 200U/h维持至透析前30min。结果尿毒症患者首次透析前血脂水平与正常组比较:三酰甘油(TG)水平升高(P<0.01),极低密度脂蛋白胆固醇(VLDL-C)、低密度脂蛋白胆固醇(LDL-C)水平升高(P<0.05),高密度脂蛋白胆固醇(HDL-C)降低。尿毒症患者透析前后血脂比较TG高于透析前,差异有统计学意义(P<0.01),LDL-C、VLDL-C高于透析前,差异有统计学意义(P<0.05),HDL-C则低于透析前,差异有统计学意义(P<0.01)。结论透析前患者具有IV型高脂血症特点,TG、TC(总胆固醇)、VLDL-C、LDL-C升高,HDL-C降低,其中高TG血症,高VLDL-C血症最为突出。透析后血脂异常加重,TG、VLDL-C、LDL-C进一步升高,HDL-C降低。     

糖尿病肾病患者检测血脂的价值

目的：探讨不同病程的糖尿病肾病（diabetic nephropathy，DN）患者血脂检测的价值。方法：测定95例糖尿病患者和50例健康体检者血甘油三脂（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL—C）、高密度脂蛋白胆固醇（HDL—C）水平。结果：正常白蛋白组血脂各项与正常对照组比较差异无显著性（P〉0．05）；微量白蛋白组TG、LDL—C明显高于正常对照组及正常白蛋白组（P〈0．05），血HDL—C明显低于正常对照组及正常白蛋白组（P〈0．05）；大量自蛋白组TG、LDL—C明显高于正常对照组及正常白蛋白组（P〈0．01），血HDL—C明显低于正常对照组及正常白蛋白组（P〈0．01），血TC明显高于正常对照组及正常白蛋白组（P〈0．05），糖尿病肾病组血脂水平随糖尿病肾病程度加重而升高。结论：糖尿病肾病脂代谢紊乱程度明显高于非糖尿病肾病，且随病程迁延而加重。     

2型糖尿病及其前期患者胰岛素抵抗与血脂代谢紊乱关系研究

目的探讨2型糖尿病(T2DM)及其前期患者胰岛素抵抗与血脂代谢紊乱之间的相关性。方法对比分析43例T2DM患者,48例糖尿病前期患者(包括21例空腹血糖受损患者,27例糖耐量减低患者)的口服葡萄糖耐量试验(OGTT)、胰岛素释放试验(IRT)、血脂的测定结果。结果 T2DM组的空腹血糖(FBG)、餐后2h血糖(2h PG)、甘油三脂(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、胰岛素抵抗指数1(HOMA1-IR)显著高于糖尿病前期组(P<0.05),高密度脂蛋白胆固醇(HDL-C)显著低于糖尿病前期组(P<0.05)。Pearson相关分析显示HOMA1-IR与FBG、2h PG、TG、TC、LDL-C呈正相关(P<0.05),与HDL-C呈负相关(P<0.05)。结论 T2DM及其前期患者胰岛素抵抗与血脂代谢紊乱的关系密切。     

糖尿病患者血脂变化的临床观察

目的 探讨血脂和糖尿病之间的关系.方法 将55例糖尿病患者设为观察组,另设健康体检者63例为正常对照组.检测两组受试者空腹血糖(FBG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、总胆固醇(TC)等指标,分析血脂与糖尿病之间的关系.结果 与对照组相比,观察组患者LDL-C、TG、TC明显升高(P＜0.05),而高密度脂蛋白胆固醇明显降低(P＜0.05).结论 血脂和糖尿病之间存在确切的关系,糖尿病患者低密度脂蛋白胆固醇、三酰甘油和总胆固醇水平升高,而高密度脂蛋白胆固醇水平降低.     

Neck Mobility in Different Headache Disorders

The main purpose of this study was to assess neck mobility (by Cybex equipment) in different headache disordered and, in particular, cervicogenic headache, and to compare; these findings with those in controls. A total of 51 control subjects and 90 headache patients were investigated, whereof 28 patients suffered from common migraine (migraine without aura), 34 from tension-type headache (H episodic and 25 chronic), and 28 patients from cervicogenic headache. One-way ANOVA and post hoc Bonferroni analysis showed significant differences between those with cervicogenic headache and the other groups for rotation ( P <0.001) and flexion/extension ( P <0.001), but not for lateral neck movement ( P =NS). There were no significant differences between migraine patients, tension-type headache patients, and controls. In all four groups, there was a significant positive correlation between active and passive neck movement for rotation ( P <0.001), flexion/extension ( P <0.001), and lateral neck movement ( P <0.001). Repeated measures analysis of variance (ANOVA) showed no significant day-to-day differences in 10 control subjects. In the control group (n=51), there was a significant negative correlation between age and neck movement. For rotation. Pearson's correlation coefficient was: r =-0.71 ( P <0.001), for flexion/extension r =-0.71 ( P <0.001), and for lateral neck movement r =-0.67 ( P <0.001). No significant sex difference was found as for any of the neck movements. Pain at the time of investigation did not seem to influence neck mobility. Cervicogenic headache has been recognized as a pair syndrome by the International Association for the Study of Pain (IASP). Since reduced neck mobility is one of the major criteria for this diagnosis, it emphasizes the need for systematic, objective neck mobility measurements in the individual patient to substantiate the diagnosis. The technique is simple and proved reliable.     

脑卒中患者睡眠障碍特点研究

目的观察脑卒中患者睡眠障碍的特点。方法应用专业量表对350例脑卒中患者的睡眠状况进行评估及统计分析。结果脑卒中患者睡眠障碍主要表现为入睡困难、早醒、睡眠维持障碍、睡眠结构紊乱、日间过度睡眠、发作性睡病等;女性患者的睡眠障碍发生率高于男性(P<0.05)。结论脑卒中患者的睡眠障碍发生率显著高于一般人群;女性脑卒中患者睡眠障碍总体发生率高于男性患者;女性患者入睡困难、早醒、睡眠维持障碍、睡眠结构紊乱的发生率高于男性患者;男性患者日间过度睡眠、发作性睡病及其他类型的发生率高于女性患者。     

Dyslipidemia in HIV patients

Thanks to antiretroviral therapy, people with human immunodeficiency virus (HIV) infection are living longer, but as they do, non-HIV medical problems become more relevant. In particular, dyslipidemia, an important reversible risk factor for cardiovascular disease, has been linked to HIV infection and its treatment. Although controversy remains as to whether people with HIV infections will develop premature coronary heart disease, it seems prudent to manage dyslipidemia in these patients just as we do in our HIV-negative patients. Interactions between lipid-lowering drugs and antiretroviral drugs require special attention.     

Dyslipidemia in metabolic syndrome

The prevalence of obesity has become increasingly common worldwide, in particular western countries. Obesity, together with insulin resistance, leads to metabolic syndrome in which other coronary risk factors including hyperlipidemia and hypertension cluster in one individual. Hyperlipidemia in metabolic syndrome is characterized increased triglyceride(TG), decreased HDL-C, and small dense LDL, called dyslipidemic triad. Dyslipidemia is attributable to increased flux of free fatty acids to the liver, which promotes TG synthesis, thus VLDL production. Increased VLDL, together with decreased lipoprotein lipase activity due to insulin resistance, causes accumulation of TG-rich lipoproteins, including proatherogenic remnants. Further, increased activities of cholesteryl ester transfer protein and hepatic triglyceride lipase results in low HDL-C and small dense LDL. Initial treatment should be directed to modify life style(weight loss and increased physical activity). Then, pharmacological intervention should be considered when the initial treatment is not fully successful. Fibrate derivatives are considered to be ideal to correct dyslipidemic triad. In addition, potent statins(HMG-CoA reductase inhibitor) can be alternative in metabolic syndrome subjects with elevated LDL-C levels.     

联合分析8种精神障碍药物的治疗方法与阿米替林治疗精神障碍的稳定性研究

目的为了完善临床常规性8种神经障碍疾病治疗药物的用药方法与用药效果,探究阿米替林药物对神经障碍疾病治疗效果的稳定性。方法根据我院2010年8月~2013年8月所治疗过的精神障碍疾病患者,共160人,按照抽签方式将其分为两组,A组患者使用常规性8种精神障碍治疗药物,B组患者单纯性使用阿米替林药物,经过一段相同时间的治疗后,分别研究每组药物的治疗效果。结果 A组患者通过使用常规性8种药物的不同组合使用治疗,患者抑郁、精神分裂症状、呕吐、意识不清、狂躁症、失眠、焦虑等精神障碍情况出现不同程度好转,药物治疗的有效率为93.75%。阿米替林对抑郁症、狂躁症、焦虑症患者的控制能力较强,药物主要体现极强的镇定作用。药效较为稳定,但对患者肝功能会造成一定的损伤,对癫痫、伴有心梗、三环药物有过敏史的患者不能使用。药物的用药有效率为96.25%。结论联合使用常规性精神障碍治疗药物对比单纯性用药临床效果体现明显,药物起效时间短,药物之间无冲突,患者控制情况理想。阿米替林仍然是临床精神障碍疾病的常规性镇定药物,其稳定性较强,但用药具有一定的限制,合理使用药物才能达到最佳的治疗效果。     

3种常见住院精神病自测健康状况比较

目的探讨住院精神分裂症、躁狂发作、抑郁发作患者自测健康状况。方法采用自编一般情况问卷、自测健康状况评定量表(SRHMS)对304例住院精神分裂症患者、112例躁狂发作患者、98例抑郁发作患者及120名健康志愿者(对照组)进行评定。结果精神分裂症组、抑郁发作组SRHMS总分及各子量表分均低于对照组(P0.05)。躁狂发作组仅社会健康子量表分低于对照组(P<0.05)。抑郁发作组SRHMS总分及各子量表分明显低于精神分裂症与躁狂发作组(P<0.01),而精神分裂症组SRHMS总分、生理及心理子量表分低于躁狂发作组(P<0.05)。结论精神分裂症、躁狂发作及抑郁发作患者均存在不同程度的健康不良,抑郁发作患者不良健康状况最为严重。     

Dyslipidemia in the critically ill

Total and HDL cholesterol levels fall at the onset of acute illness and the cholesterol levels normalize as the patient recovers. Hypocholesterolemia may predispose the critically ill patient to sepsis and adrenal failure. Early enteral nutrition and tight glycemic control accelerate the recovery of the cholesterol levels.     

New Directions in Managing Dyslipidemia

Statin therapy has long been the mainstay of dyslipidemia management due to superior reduction in morbidity and mortality from cardiovascular disease. However, many patients who take statins fail to meet low-density lipoprotein-cholesterol targets, have recurrent atherosclerotic cardiovascular disease, or are statin intolerant. Recent updates give guidance on prevention of atherosclerotic cardiovascular disease in all patients, including those for whom statin therapy is contraindicated or insufficient. Other classes of medications, such as ezetimibe and proprotein convertase subtilisin/kexin type 9 inhibitors, can lower low-density lipoprotein cholesterol and may also improve cardiovascular outcomes. This report explores dyslipidemia management guidelines, reviews the use of ezetimibe and proprotein convertase subtilisin/kexin type 9 inhibitors, and provides recommendations for nurse practitioners.     

妊娠期糖代谢异常对妊娠结局的影响

我院2006-01～2006—12共分娩2836例，其中糖代谢异常167例，发生率5．89％。现分析如下。 1对象和方法 1．1对象初产妇142例，经产妇25例，年龄20～41岁，其中≥30岁83例（49．70％），孕周32^＋3～43周。GDM及GIGT按乐杰的诊断标准。孕前体重指数（BMI）≥24为肥胖。     

Dyslipidemia in type 2 diabetes

Type 2 diabetes mellitus is associated with a cluster of lipid abnormalities:elevated plasma triglycerides, reduced high-density lipoprotein cholesterol, and smaller and denser low-density lipoproteins,which have been associated with an increased risk of cardiovascular disease. Insulin resistance may contribute to dyslipidemia associated with type 2 diabetes by increasing hepatic secretion of large,triglyceride-rich very low-density lipoprotein particles and by impairing the clearance of lipoprotein particles from plasma. Lifestyle interventions may be effective in improving the diabetic dyslipidemia syndrome. For patients who do not respond to lifestyle changes, pharmacologic therapies (lipid-lowering medications and anti-diabetic agents) are available. Clinical trials demonstrate that the use of such pharmaceutics to treat diabetic dyslipidemia concomitantly reduces the risk of coronary artery disease.