不同血糖水平患者血液流变学改变的临床意义

目的 探讨不同血糖水平患者血液流变学各项指标变化的临床意义.方法 通过检测30例确诊糖尿病患者、30例确诊糖耐量异常患者与30名正常人的血液流变学6项指标,分析其特点及临床意义.结果 糖尿病患者的全血高切黏度、全血低切黏度、血浆黏度、血纤维蛋白原4项指标与正常对照组比较,有明显增高(P<0.05).而红细胞压积及红细胞沉降率与正常对照组比较无明显变化(P>0.05).结论糖尿病患者多伴有血液流变学的改变,且这种改变从糖耐量异常时即已发生,所以早期进行血液流变学检测,对预防糖尿病和控制其并发症的发生有重要意义.     

2型糖尿病患者HbAlc与血脂、血液流变学的关系分析

目的分析2型糖尿病患者HbAlc与血脂、血液流变学的相关性。方法将我院自2011年1月至2013年12月收治166例2型糖尿病患者作为观察组,另将76例正常健康体检者为对照组,采集两组患者清晨空腹静脉血液,检测血脂、血液流变学的有关指标,并对观察组的HbAlc与血脂、血液流变学进行相关性分析。结果观察组的HbA1c、TG、TC、LDL-C、ApoB、全血高切黏度、全血低切黏度以及血浆黏度均显著高与对照组,,而HDL-C、ApoA1均明显较低对照组,差异具有统计学意义（P〈0.05）;观察组的HbA1c与HDL-C及ApoA1呈明显负相关,而与其他指标均呈正相关（P〈0.01）。结论治疗2型糖尿病时,应对血脂、血液流变学进行动态监测,将控制血糖与治疗脂质代谢紊乱和血液流变学异常结合起来,降低心脑血管并发症的发生几率,从而提高患者的生活质量。     

糖尿病患者血液流变学结果的分析

采用R80锥/板自动血液流变仪,检测86例糖尿病患者的血流变,血糖,甘油三脂及胆固醇.80名健康对照组.结果糖尿病患者的血液流变学指标除红细胞比积无显著差异外,其余均呈血糖依赖性的高于正常对照组,结论糖尿病患者血液流变学指标呈血糖依赖性改变.     

丹红注射液与复方丹参注射液对初诊老年重型2型糖尿病患者血液流变学的影响

目的观察丹红注射液对初诊老年重型2型糖尿病患者血液流变学的影响。方法将60例初诊老年重型2型糖尿病患者随机分成A、B两组,在严格控制血糖的基础上,分别给予丹红注射液和复方丹参注射液静滴,比较两组治疗前后血液流变学指标的变化情况。结果A、B两组各自治疗前后相比,血液流变学指标中除红细胞压积外均明显改善（P〈0.05或0.01）,两组治疗后相比全血还原黏度和红细胞电泳指数有统计学差异（P〈0.05）。结论2型糖尿病患者在控制血糖的同时应予以改善循环治疗;丹红注射液与复方丹参注射液对老年重型2型糖尿病患者的血液流变学指标均有明显改善作用,丹红注射液的疗效优于复方丹参注射液。     

106例非酒精性脂肪肝患者血液流变学分析

目的探讨非酒精性脂肪肝患者血液流变学的变化。方法在106例非酒精性脂肪肝患者和50例正常对照人群,检测血液流变学指标。结果非酒精性脂肪肝患者全血比黏度、血浆黏度、红细胞聚集指数、红细胞压积、体重指数、血糖、谷氨酰胺转肽酶、血清总胆固醇和甘油三酯均比正常人群升高。结论肥胖症、糖尿病、高脂血症都是非酒精性脂肪肝的危险因素。     

糖尿病患者血液流变学结果的分析

采用R80锥／板自动血液流变仪，检测86例糖尿病患者的血流变，血糖，甘油三脂及胆固醇。80名健康对照组。结果：糖尿病患者的血液流变学指标除红细胞比积无显著差异外，其余均呈血糖依赖性的高于正常对照组，结论：糖尿病患者血液流变学指标呈血糖依赖性改变。     

糖尿病患者红细胞膜磷脂成分与血液流变学的改变

应用高效液相色谱法分析了４０例Ⅱ型糖尿病患者红细胞膜磷脂成分与血液流变学的有关指标及血糖、血脂水平。结果显示，糖尿病患者红细胞膜磷脂成分有改变，并且全血粘度及血浆粘度增高，红细胞变形指数增高，红细胞过度聚集，纤维蛋白原增高。以上变化与血糖、血脂水平及糖尿病视网膜病变存在相关性。多元逐步回归分析提示糖尿病红细胞膜磷脂成分的改变是影响血液流变学变化的重要因素。     

肺癌患者血液流变学检测分析

目的探讨肺癌患者血液流变学指标的变化及临床意义。方法对86例肺癌病人血液流变学指标进行检测分析。结果肺癌患者全血黏度、血浆黏度、血沉、红细胞压积、红细胞刚性指数、红细胞聚集指数、纤维蛋白原的水平较健康对照组有明显增高,有统计学意义(P0.01)。结论肺癌患者存在明显高凝状态,血液流变学指标可以作为了解肺癌发生和发展的重要指标。     

蚓激酶对糖尿病患者血液流变学、血糖及血脂的影响

目的了解蚓激酶对糖尿病患者的血液流变学、血糖和血脂的影响,以及对糖尿病并发症的防治作用。方法对76例2型糖尿病患者在血糖控制到FPG〈8mmol/L,2hPG〈11mmol/L后,随机分为蚓激酶组40例,对照组36例。蚓激酶组用蚓激酶60万单位口服,日3次,共8周。比较两组治疗前后血液流变学、血糖和血脂的差异。结果蚓激酶组的全血黏度、血浆比黏度、血浆纤维蛋白原浓度、血小板聚集率和甘油三酯均明显降低（P〈0.01）,两组空腹及餐后血糖下降无差异（P〉0.05）。结论蚓激酶对糖尿病患者的血脂,血液流变学指标均有不同程度的改善。     

糖尿病致眼肌麻痹病因及治疗分析

目的分析糖尿病致眼肌麻痹的病因及治疗体会。方法回顾性分析该院2004年1月—2014年6月收治的30例糖尿病性眼肌麻痹患者的临床资料,对其进行控制血糖、改善血液循环、营养神经等治疗。结果治疗3~20周,所有患者均治愈,复发2例,再次综合治疗8周后痊愈;治疗过程中可知,血糖水平与治疗时间呈正相关。结论糖尿病性眼肌麻痹治疗的关键是控制血糖水平。     

The influence of plasma glucose upon pulsatile ocular blood flow in subjects with Type II diabetes mellitus

Abstract Aims/hypothesis. This study investigated the influence of plasma glucose upon pulsatile ocular blood flow in subjects with Type II (non-insulin-dependent) diabetes mellitus. Methods. A total of 19 subjects with Type II diabetes and 8 normal control subjects undertook a meal tolerance test after an overnight fast. The pulsatile ocular blood flow, using the Ocular Blood Flow Tonometer, and plasma glucose concentrations were taken at times 0 min, 90 min and 240 min. Blood pressure and glycated haemoglobin concentrations, in the subjects with diabetes, were also measured at time 0 min. Pulsatile ocular blood flow and plasma glucose were also measured at times 0 and 90 min in 5 subjects with Type II diabetes mellitus who remained fasting. Results. It was found that the subjects with diabetes who undertook the meal tolerance test showed a significant increase in both plasma glucose concentrations and pulsatile ocular blood flow from time 0–90 min, followed by a decrease from 90 min to the end of the session at 240 min. (p < 0.001 in each case). Regression analysis showed a significant correlation between the change in pulsatile ocular blood flow and the change in plasma glucose concentration (r = 0.671, p = 0.001). Control subjects showed no significant change in either plasma glucose or pulsatile ocular blood flow during the meal tolerance test. Subjects with diabetes mellitus who remained fasting also showed no significant change in pulsatile ocular blood flow or plasma glucose concentrations. No correlation was found between glycated haemoglobin concentrations or blood pressure and pulsatile ocular blood flow. Conclusion/interpretation. Pulsatile ocular blood flow is influenced by changes in plasma glucose concentrations in Type II diabetes mellitus, indicating that uncontrolled hyperglycaemia might result in a higher pulsatile ocular blood flow than might otherwise be expected. [Diabetologia (2001) 44: 700–705] Received: 7 November 2000 and in revised form: 6 February 2001     

On line continuous monitoring of subcutaneous tissue glucose in men by combining portable glucosensor with microdialysis

Summary For the normalisation of blood glucose levels in diabetic patients by feedback controlled insulin delivery, a self-manageable and reliable method for continuous glucose estimation is still not available. By combining a commercially available needle type dialysis probe (molecular cutoff 20,000 Da) with a sensitive glucose sensor, we obtained a device for continuous glucose measurement in dialysate. This device was tested in healthy volunteers during a 75-g oral glucose tolerance test and in Type 2 (non-insulin-dependent) diabetic patients. Venous glucose and subcutaneous sensor signal were followed for 300 min (ten healthy subjects), 21 h (three healthy subjects) or 9 h (seven Type 2 diabetic patients). The recovery of the microdialysis was interindividually different, but after calibration, glucose levels in the dialysate and subcutaneous glucose sensor signal correlated well (r = 0.84–0.95). Under the assumption of a physiologic and technical delay between intravenous and subcutaneous glucose, correlation coefficient between intravenous glucose and subcutaneous sensor signal ranged from 0.60 to 0.93. We conclude that changes in blood glucose could be monitored in the subcutaneous tissue by the microdialysis technique in a continuous on line manner.     

Comparison of lymphomononuclear cell energy metabolism between healthy, impaired glucose intolerance and type 2 diabetes mellitus patients

Diabetes mellitus (DM) is a complex disease that affects many systems. The most important cells of the immune system are lymphomononuclear (LMN) cells. Here, we aimed to evaluate the energy metabolism of LMN cells in patients with diabetes and impaired glucose tolerance. We measured LMN cell energy metabolism in patients with type 2 diabetes mellitus, impaired glucose tolerance (IGT) and healthy subjects. Cells were freshly isolated from peripheral blood and the subgroups were determined by flow cytometric method. Lactate production and glycogen utilization were significantly increased in the LMN cells of patients with type 2 DM and IGT when compared with healthy volunteers. No statistical difference was observed between the patients with type 2 DM and IGT. There was a significant correlation between fasting plasma glucose and lactate production in LMN cells. LMN cells changed their energy pathway in a diabetic state and preferred anaerobic glycolysis. Prediabetic range also affected energy metabolism in LMN cells. This abnormal energy production might cause dysfunction in LMN cells and the immune system in diabetic and prediabetic patients. In conclusion, we concluded that impaired glucose metabolism could change energy metabolism.     

糖尿病并发冠心病血浆内皮素及心钠肽含量变化及其临床价值

目的测定2型糖尿病（T2DM）并发冠心病（CHD）病人血浆血管内皮素（ET）、心钠素（ANP）含量，探讨其在本病发生与发展中的作用和对临床诊断的价值。方法选择64例糖尿病（DM）病人，其中并发CHD组32例，未并发CHD组32例，以放射免疫分析（Rn）法检测血浆ET、ANP水平，进行分析，并与30名健康体检者作比较。结果DM并发CHD组血浆ET、ANP含量显著高于未并发CHD的DM组及正常健康人组（P〈0．01）；DM无并发CHD组血浆ET、ANP含量显著高于正常对照组（P〈0．05）。影响因素除与本身有无并发CHD外，尚与病程、年龄有关。结论DM并发CHD病人血浆KF、ANP变化可能参与了本病的发病过程。可作为判断病情程度及疗效评价的指标。     

Neurohumoral factors in hypertensive patients with and without left ventricular hypertrophy

Increased pressure load and neurohumoral activation are main factors involved in pathomechanism of left ventricular hypertrophy (LVH) in hypertension (HT). To gain insight into the involvement of neurohumoral factors responsible for cardiac hypertrophy, plasma level of aldosterone (Aldo), plasma renin activity (PRA), insulin-like growth factor-1 (IGF-1), pro-endothelin-1 (pro-ET) and atrial natriuretic peptide (ANP) were measured in HT patients (pts) and compared between pts with and without LVH. Also relationships between neurohormones and LV mass index (LVMI), mean blood pressure (MBP) were assessed separately in HT pts with and without LVH. 121 HT patients (pts) of age 17-79 (mean 48 +/- 15.3) were divided into three groups: 1-53 pts with mild HT, 2-44 pts with moderate HT and 3-24 pts with severe HT. Each of the group was divided into pts with and without LVH further all HT pts were divided into two groups; with and without LVH. Control group consisted of 39 healthy normotensives. LV mass was assessed echocardiographically and plasma levels of IGF-1, PRA, Aldo, pro-ET, and ANP were measured by radioimmunoassay in each pts and controls. LVH was found in 35.8% pts with mild HT, in 68.18% pts with moderate HT and in 100% pts with severe HT. The level of all measured neurohormones were significantly higher in pts with LVH compared to pts without LVH (p < 0.001). In pts with LVH there was significant correlation between LVMI and IGF-1, PRA, Aldo, pro-ET-1 and ANP, contrary to pts without LVH in which such correlations was not found. In pts with LVH there was also significant correlation between MBP and IGF-1, PRA, ANP and pro-ET-1. Increased plasma level of PRA, Aldo, IGF-1, pro-ET-1 and ANP in HT pts with LVH and significant correlation between measured neurohormones and LVMI suggests their contribution to LVH in HT pts. Significant correlation between LVMI, MBP and IGF-1 level, PRA and ANP indicate interplay between hemodynamic and neuroendocrine factors in pathomechanism of LVH.     

脑瘫患儿应用脐血间质干细胞的临床安全性研究

目的评价人脐血间质干细胞临床应用于脑瘫患儿的安全性。方法脐血间质干细胞鞘内和静脉注射治疗44例脑瘫患儿,对治疗前、治疗后脑瘫患儿的血常规、肝肾功能、电解质、血清酶学、血清免疫蛋白及补体、T细胞亚群进行对比研究。结果患儿的血常规、肝肾功能、电解质、细胞与体液免疫各项指标治疗前后的检测结果无统计学意义(P>0.05)。结论脐血源神经干细胞的临床应用是安全可行的。     

肥胖2型糖尿病肾病患者动态血糖分析

目的探讨肥胖2型糖尿病（T2DM）肾病患者的动态血糖特点。方法80例肥胖T2DM患者根据24h尿白蛋白排泄率（24hUAER）分为糖尿病肾病（DN）组和单纯2型糖尿病（T2DM）组,每组40例;另选健康体检者15名组成正常对照（NC）组。动态血糖监测系统（CGMS）监测三组72h血糖变化,并进行对比分析。结果DN组血糖波动系数（BGFC）、日内血糖波动最大幅度、2hPG均明显大于T2DM组及NC组（P均〈0．05）,DN组BGFC与24hUAER正相关（r=0．356、P〈0．05）。结论血糖波动与肥胖2型糖尿病肾病相关。     

Minor haemoglobin fractions in uraemic and in diabetic patients

Using a high resolution automated chromatographic method, the levels of the different minor haemoglobins Hb A1a, A1b, and A1c were measured in 20 healthy controls, in 20 patients with chronic renal failure, in 20 uraemic patients on intermittent haemodialysis, and in 20 insulin-dependent diabetic patients. In uraemic non haemodialysed patients, the levels of the three minor fractions were increased significantly. The two fractions Hb A1b and A1c were normalised subsequent to haemodialysis, whereas the level of Hb A1a was higher in the haemodialysed than in the uraemic non haemodialysed group. In both groups of uraemic patients, no correlation was found between the minor Hb fractions and the corresponding serum creatinine, uric acid, urea, phosphorus, bicarbonate and blood glucose levels. In diabetic patients, the three minor fractions were increased. As expected, Hb A1c and glucose concentrations were tightly correlated. No correlation was found between blood glucose levels and Hb A1a, whereas a correlation existed between blood glucose levels and Hb A1b. It is concluded that the increase of minor haemoglobin fractions in renal failure does not only reflect the glucose intolerance. Renal failure itself causes an increase of the three minor fractions. Overall assay of the minor haemoglobin components (Hb A1) may lead to misinterpretation in case of diabetic patients with chronic renal failure.     

尿转铁蛋白排泄率测定对糖尿病肾病早期诊断的意义

应用免疫速率散射比浊法测定５２例健康人和７６例无临床蛋白尿的糖尿病患者２小时尿微量白蛋白（Ａｌｂ）和微量转铁蛋白（ＴＲＦ）的排泄率（ＡＥＲ和ＴＥＲ）。结果：１．糖尿病组ＡＥＲ和ＴＥＲ均明显高于正常对照组（Ｐ＜０．０１）。２．在糖尿病组中，３２．９％的患者ＡＥＲ升高，４３．４％的患者ＴＥＲ升高，两者有显著性差异（Ｐ＜０．０１）。ＴＥＲ和ＡＥＲ呈明显正相关（ｒ＝０．９３，Ｐ＜０．０１）。３．在ＡＥＲ升高和ＴＥＲ升高糖尿病组中，其血压分别稍高于ＡＥＲ正常糖尿病组和ＴＥＲ正常糖尿病组，差异有显著性意义（Ｐ＜０．０５），而空腹血糖水平无此变化（Ｐ＞０．０５）。与无视网膜病变组相比，有视网膜病变组ＡＥＲ、ＴＥＲ升高的阳性率增加，两者有显著性差异（Ｐ＜０．０５）。提示：ＴＥＲ做为糖尿病肾病早期诊断指标，可能与ＡＥＲ具有相同的意义，甚至较其敏感。     

A novel method for continuous online glucose monitoring in humans: the comparative microdialysis technique

The aim of this study was to prove the feasibility of continuous subcutaneous glucose monitoring in humans using the comparative microdialysis technique (CMT). The performance of the CMT was determined by comparing tissue glucose values with venous or capillary blood glucose values in healthy volunteers and type 1 diabetic subjects. The CMT is a microdialysis-based system for continuous online glucose monitoring in humans. This technique does not require calibration by the patient. Physiological saline with glucose (5.5 mM) is pumped in a stop-flow mode through a microdialysis probe inserted into the abdominal s.c. tissue. Tissue glucose concentration is calculated by comparing the dialysate and perfusate glucose concentrations. The time delay due to the measurement process is 9 min. We tested the CMT on six healthy volunteers and six type 1 diabetic patients for 24 h in our clinical setting. Comparisons were made to HemoCue analyzer (Angelholm, Sweden) capillary blood glucose measurements (healthy volunteers) and to venous blood glucose concentration determined with a Hitachi analyzer (diabetic patients). The mean absolute relative error of the CMT glucose values from the blood glucose values was 17.8+/-15.5% (n = 167) for the healthy volunteers and 11.0+/-10.8% (n = 425) for the diabetic patients. The mean difference was 0.42+/-1.06 mM (healthy volunteers) and -0.17+/-1.22 mM (diabetic patients). Error grid analysis for the values obtained in diabetic patients demonstrated that 99% of CMT glucose values were within clinically acceptable regions (regions A and B of the Clarke Error Grid). The study results show that the CMT is an accurate technique for continuous online glucose monitoring.