脑梗死合并代谢综合征患者的临床特征

目的 旨在分析脑梗死合并代谢综合征患者的临床特征及与脑血管病变程度的相关性.方法 脑梗死患者585例按NCEP-ATPⅢ诊断标准分为代谢综合征组和非代谢综合征组.回顾性地比较两组患者临床特征,分析代谢综合征与脑血管病变程度的相关性.结果 脑梗死患者585例中有290例(49.6%)合并代谢综合征.代谢综合征组的体质量指数、腰围、动脉血压、总胆固醇、三酰甘油、尿酸、空腹血糖、餐后2 h血糖、糖化血红蛋白均显著高于无代谢综合征组;而高密度脂蛋白胆固醇水平显著低于后者;前者结构性影像(CT)大灶梗死和多灶梗死发生率和重型神经功能缺损积分均显著高于后者.相关分析显示,脑血管病变程度与患者腰围、动脉血压、总胆固醇、三酰甘油、糖化血红蛋白、空腹血糖及餐后2 h血糖水平呈明显正相关(P＜0.05),与高密度脂蛋白胆固醇呈负相关(P＜0.01).结论 脑梗死合并代谢综合征患者使动脉粥样硬化危险因子更加聚集,脑血管病变程度更加严重,应进行全面脑血管危险因素防治,以改善预后.     

2型糖尿病合并脑梗死56例临床分析

目的探讨2型糖尿患者合并脑梗死的特点。方法113例脑梗死患者分为治疗组56例,为糖尿病合并脑梗死患者,对照组57例为非糖尿病的脑梗死患者,两组患者入院后均采用综合治疗措施,控制血压、扩血管、降低颅内压、抗血小板聚集,改善循环,营养神经及对症治疗。同时治疗组通过饮食控制,口服降糖药或胰岛素治疗,将空腹血糖控制在6—8mmol／L,餐后2h血糖控制在10mmol／L以下。两组患者均测定血压（BP）、空腹血糖（FBG）、餐后血糖（PBG）、糖化血红蛋白（HbA1c）、血清总胆固醇（TCH）、三酰甘油（TG）、高密度脂蛋白（HDL）及低密度脂蛋白（LDL）对比并分析其与病情、预后的关系。结果2型糖尿病合并脑梗死患者组的脑神经损伤程度高于与非糖尿病脑梗死患者组（P〈0．05）。2型糖尿病合并脑梗死患者组血压、血糖水平、餐后血糖、糖化血红蛋白、血脂均高于非糖尿病脑梗死患者组（P〈0．05）。2型糖尿病合并脑梗死患者组的治疗效果低于非糖尿病脑梗死患者组,病死率高于非糖尿病脑梗死患者（P〈0．05）。结论糖尿病合并脑梗死致残率高,糖尿病为急性脑血管病重要的独立危险因素,严格控制血糖、控制血压和纠正血脂是预防糖尿病合并脑梗死的重要手段。     

代谢综合征患者C-反应蛋白与心血管病危险因素关系

目的 了解代谢综合征病人C反应蛋白与心血管病危险因素之间的关系.方法 回顾分析代谢综合征175例,根据C反应蛋白水平分为高C反应蛋白组和正常C反应蛋白组.检测两组体质量指数、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、总胆固醇、甘油三酯、空腹血糖、餐后2小时血糖、糖化血红蛋白、收缩压和舒张压.结果 高C反应蛋白组的体质量指数、低密度脂蛋白胆固醇、总胆固醇、甘油三酯、空腹血糖、餐后2小时血糖、糖化血红蛋白、收缩压、舒张压均显著高于正常C反应蛋白组,而高密度脂蛋白胆固醇水平显著低于后者（P＜0.01）;C反应蛋白水平与体质量指数、甘油三酯、低密度脂蛋白胆固醇、糖化血红蛋白、舒张压、空腹血糖及餐后2小时血糖水平呈正相关（P＜0.05）,与高密度脂蛋白胆固醇呈负相关（P＜0.05）.结论 代谢综合征病人中C反应蛋白升高者往往伴随多种代谢紊乱加重,心血管病的危险因素亦随之加重,故对此类病人更要加强防治措施.     

尿液pH值与代谢综合征的相关性研究

目的:探讨中老年人群尿液pH水平与代谢综合征的相关性。方法:对上海市嘉定社区2 322名40岁以上居民进行问卷调查和体格检查,空腹采血检测肝功能、肾功能、血糖、血脂及胰岛素,收集晨尿检测尿pH值。采用多元线性回归分析代谢综合征与尿液pH值的相关性,Logistic回归分析代谢综合征和低尿液pH水平的相对风险度。代谢综合征采用按亚洲人特点改良的美国国家胆固醇教育计划成人治疗组第3次报告诊断标准。结果:与正常人群相比,代谢综合征患者腰围、体质量指数、血压、空腹血糖、糖化血红蛋白、低密度脂蛋白胆固醇、三酰甘油等指标偏高(P     

2型糖尿病合并代谢综合征患者心外膜脂肪特点

目的探讨2型糖尿病合并代谢综合征患者心外膜脂肪特点。方法选择2型糖尿病患者120人为研究对象,测量身高、体重、腰围、臀围和血压,抽空腹血测量血糖、糖化血红蛋白、甘油三酯和高密度脂蛋白胆固醇,利用双能X线测量身体脂肪和肌肉,超声心动图测量心外膜脂肪。Logistic多元回归分析用于评价心外膜脂肪和各变量的联系程度。结果合并代谢综合征的糖尿病患者腰围、腰臀比、甘油三酯、全身脂肪、男性型脂肪、心外膜脂肪、高血压和冠心病患病率均高于未合并代谢综合征者,腰围、甘油三酯和男性型脂肪是心外膜脂肪增加的独立危险因素,而高密度脂蛋白胆固醇属于独立保护因素。结论 2型糖尿病合并代谢综合征者的心外膜脂肪较未合并代谢综合征者增多,且其厚度与腰围、甘油三酯、男性型脂肪和高密度脂蛋白胆固醇密切相关。     

非酒精性脂肪肝合并代谢综合征各组分及其聚集与心脑血管病的相关分析

目的分析非酒精性脂肪肝(NAFLD)合并代谢综合征(MS)各组分及其聚集情况与心脑血管病的关系。方法对门诊就诊和健康体检成年人2 478例按是否合并NAFLD分为对照组和NAFLD组。分析NAFLD合并MS各组分及其聚集情况,NAFLD并心脑血管病与MS组分、聚集数相关性。结果 NAFLD组体质量指数、腰围、血压、空腹血糖、胆固醇、三酰甘油、低密度脂蛋白、丙氨酸氨基转移酶均显著高于对照组,高密度脂蛋白则低于对照组。NAFLD组肥胖、高血压、高三酰甘油血症、低高密度脂蛋白血症、高血糖和代谢综合征分别为51.80%,32.76%,37.22%,39.28%,24.53%,45.97%,显著高于对照组。NAFLD组合并心脑血管病较无NAFLD组显著增高,NAFLD合并心脑血管病与MS组分、聚集数显著相关。结论 NAFLD患者有明显的代谢综合征组分集聚,合并心脑血管病显著增高;随着MS组分聚集数增多,有并发心脑血管病变危险性增大的趋势。     

浅谈糖化血红蛋白与血糖、血脂之间的关系

目的分析2型糖尿病患者糖化血红蛋白、空腹血糖、餐后2h血糖、血脂间的关系。方法随机选择2014年3月到2015年3月我院内分泌科住院2型糖尿病患者120例作为观察组,选择同期来本院健康体检者120例作为对照组,检测并对比其糖化血红蛋白、空腹血糖、餐后2h血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇与低密度脂蛋白胆固醇等各项指标。结果对观察组患者及对照组健康者各项指标检测结果进行对比,发现观察组糖化血红蛋白、空腹血糖、餐后2h血糖、甘油三酯、总胆固醇、低密度脂蛋白胆固醇显著高于对照组健康者(P0.05),高密度脂蛋白胆固醇显著低于对照组健康者(P0.05);糖化血红蛋白与空腹血糖、餐后2h血糖呈显著正相关,与甘油三酯、总胆固醇、低密度脂蛋白胆固醇有平行上升趋势,与高密度脂蛋白胆固醇呈负相关。结论糖化血红蛋白与血糖、血脂的联合检测,对糖尿病的预防、诊断以及并发症防治有至关重要的意义。     

2型糖尿病患者糖化血红蛋白与空腹血糖、血脂检测的关系

目的 分析2型糖尿病患者糖化血红蛋白与空腹血糖、血脂的关系.方法 将2020年1月—2021年5月该院诊治的43例2型糖尿病患者设为观察组,另外将同期的40名体检正常者设为对照组,两组对象均接受空腹血糖和糖化血红蛋白、血脂(总胆固醇、载脂蛋白B、低密度脂蛋白胆固醇、三酰甘油、载脂蛋白A1、高密度脂蛋白胆固醇)检测,对比...     

柏艾胶囊治疗代谢综合征合并高血压的临床研究

目的观察柏艾胶囊治疗代谢综合征合并高血压的临床疗效。方法将74例代谢综合征合并高血压病人随机分为治疗组(34例)与对照组(40例)。两组病人均给予基础治疗,治疗组在基础治疗的同时加用柏艾胶囊,每次3粒,每天2次,早、晚饭后0.5～1 h服用。对照组在基础治疗的同时加用安慰剂胶囊,每次3粒,每天2次,早、晚饭后0.5～1 h服用。4周为1个疗程,共治疗12周(3个疗程)。观察两组治疗前后血压、稳态模型胰岛素抵抗指数(HOMA-IR)、血糖、血脂、形体学指标的变化。结果治疗后,治疗组24 h舒张压、24 h平均动脉压、白昼舒张压及白昼平均动脉压均较治疗前降低(P0.05),治疗组治疗后白昼收缩压与对照组比较,差异有统计学意义(P0.05)。治疗后治疗组餐后2 h血糖和HOMA-IR均较治疗前下降(P0.05),空腹血糖、糖化血红蛋白、空腹胰岛素呈下降趋势,但差异无统计学意义。治疗后治疗组三酰甘油较治疗前下降,高密度脂蛋白胆固醇较治疗前升高,差异均有统计学意义(P0.05)。治疗后,治疗组体重、体质指数和腰围较治疗前降低(P0.05)。结论柏艾胶囊可有效改善代谢综合征合并高血压病人血压、血糖、血脂及形体学指标。     

新诊断糖尿病合并代谢性炎症综合征与糖尿病周围神经病变影响因素探讨

目的 分析新诊断糖尿病合并代谢性炎症综合征（metabolic inflammatory syndrome,MIS）与糖尿病周围神经病变（diabetic peripheral neuropathy,DPN）的影响因素。方法 将2022年4—8月江门市人民医院内分泌科经糖耐量试验筛选的新诊断糖尿病患者129例纳为研究对象,根据患者是否合并MIS,将患者分为非MIS组（69例）和MIS组（60例）,通过查阅病历收集患者的各项资料,探讨新诊断糖尿病合并MIS与DPN的影响因素。结果 MIS组DPN发生率61.67%(37例)高于非MIS组10.14%(7例),差异有统计学意义（P<0.05）;两组性别、年龄、总胆固醇、低密度脂蛋白胆固醇、尿酸水平对比,差异无统计学意义（P>0.05）,MIS组患者BMI、腰围、腰臀比、空腹C肽、餐后2 hC肽、空腹血糖、餐后2 h血糖、舒张压、收缩压、三酰甘油、糖化血红蛋白、C反应蛋白水平均高于非MIS组,高密度脂蛋白胆固醇低于非MIS组,差异有统计学意义（P<0.05）。经过多因素Logistic回归分析,DPN的发生与腰围、收缩压、糖...     

A patient with rectal ulcer with severe stenosis presenting with perforated peritonitis

We report a patient with rectal ulcer with severe stenosis, who underwent urgent surgical treatment for perforated peritonitis. The 54-year-old man suddenly developed cramping abdominal pain and fever while hospitalized, with signs of peritoneal irritation. An emergency laparotomy was performed, and severe stenosis of the rectum and a perforated lesion on the oral side approximately 10 cm distant from the stenosis were found, with massive abdominal purulent fluid. He was treated by rectosigmoid colon resection with transverse colon loop colostomy. Histopathologically, the stenosis was caused by ulceration extending to all muscular layers of the rectum, with inflammatory changes. Benign rectal stenosis is so rare that differential diagnosis from malignancy may be difficult when there are inflammatory changes in the surrounding tissues. However, it is necessary to keep in mind the likelihood of this disease in differentiation from rectal cancer. Received: December 21, 1998 / Accepted: May 28, 1999     

肿瘤病人弓形虫感染分析

在肿瘤的发生和发展进程中 ,多伴有免疫功能低下或缺陷 ,从而极易遭受各种感染。弓形虫是机会感染因子 ,当患者免疫功能受损时 ,易于感染 ,还会使隐性感染激活 ,引起低热不退、淋巴结肿和脑神经系统的反应 ,此现象尚未引起临床医师的重视。近年来 ,我们对 4 0 9例肿瘤病人进行了弓形虫感染及弓形虫病的分析观察 ,报告如下 :1　材料与方法1 1　材料　 30 4例病人血清取自江西省肿瘤医院住院或门诊病人 ,随机抽样后低温保存待检 ,10 5例取自其他医院送检样品 ,有急性症状者随到随检 ,以便及时做病原学检测。1 2　弓形虫病诊断方法1 2 1　免疫…     

Evaluation of atrial vulnerability with transoesophageal stimulation in patients with atrioventricular junctional: Comparison with patients with ventricular pre-excitation and with normal subjects

The aim of our work was to evaluate the inducibility of atrialfibrillation in a group of patients with atrioventricular junctionalreentrant tachycardia and to compare it with that of patientswith a Kent-type ventricular pre-excitation (Wolff-Parkinson-Whitesyndrome) and a control group. One hundred and twenty-five subjects were separated into groups.Group 1 comprised 49 Wolff-Parkinson-White patients, with amean age of 26.4, range 10.66 years; group 2, 51 patients withatrioventricular junctional reentrant tachycardia inducibleby transoesophageal atrial stimulation andlor clinically documented,with a mean age of 43.4, range 16–78 years; group 3, 25control subjects with a mean age of2.64, range 13–76 years. Each subject underwent atrial transoesophageal stimulation withthe following protocol: programmed atrial stimulation with 1and 2 stimuli during atrial pacing of 100. min^–1 and 150.min^–1; atrial stimulation for 10 s at a rate of 200–300–400–500–600.min^–1 with intervals of 10 s between stimulations, fivesuccessive ‘ramp-up’ atrial stimulations for 9 swith the rate increasing from 100 to 800. min^–1 with intervalsof 10 s between stimulations. The end point was the completionof the protocol or induction of sustained atrial fibrillation(>1 min). The chi-square test was used for statistical analysis. Our resultsshowed that in group 1 atrial fibrillation was induced in 27149patients (55.1%); this was sustained in 13149 (26.5%) and non-sustainedin 14149 (28.5%); in group 2, atrial fibrillation was inducedin 22151 patients (43.0%); it was sustained in 7151 (13.7%)and non-sustained in 15151 (29.4%); in group 3, sustained atrialfibrillation was not induced in any subject and in only onesubject was a non-sustained atrial fibrillation (4 s) induced. The chi-square test showed that group 2 vs group 1 were non-significant,while group 2 vs group 3 and group 1 vs group 3 were significant(P<0.003 and P<0.0007, respectively). Therefore group 2 patients showed a greater atrial vulnerabilityin comparison to the control subjects and a similar vulnerabilityto group 1 patients. It is possible that the greater atrialvulnerability in the patients of group 2 was due to the doublenodal pathway.     

Infection with Rhodococcus equi in a patient with sarcoidosis treated with corticosteroids

A 51-year-old female farmer was diagnosed as having sarcoidosis. During 4 years of observation, slow radiological progression was observed. Cough then developed, necessitating treatment with corticosteroids. After 28 months of continuous treatment with prednisolone in low doses (5-7.5 mg daily), she suffered fever episodes, recurrent haemoptyses, general malaise and loss of weight. A chest roentgenogram showed a left upper lobe infiltrate, which progressed and finally cavitated, and rib destruction. Despite efforts, including a thoracotomy, 22 months passed before a diagnosis could be made. Blood and sputum cultures and cultures from the destroyed rib showed growth of Rhodococcus equi, a common soil organism which can cause infections in foals and other animals. Treatment with rifampicin and erythromycin was successful. R. equi has been reported to cause infection in patients with neoplastic disease and/or immunosuppression, but the disease might be more common than is suggested by the sparse case reports in the literature, owing to lack of familiarity with the organism, which will tend to be overlooked as a contaminant.     

Treating patients with lupus with B-cell depletion

A new era in the treatment of systemic lupus erythematosus has dawned with the increasing introduction of monoclonal antibodies and other approaches, that target the key molecules involved in the pathogenesis of the disease. At present the ability to block the CD20 molecule on those B cells that carry this marker has proved the most effective way to treat patients resistant to conventional immunosuppressive drugs. However, these studies have all been open label and the results of double blind controlled studies are eagerly awaited.