甲状腺功能亢进合并糖尿病

甲状腺功能亢进(甲亢)可与糖尿病并存。我院1972～1987年住院的甲亢及糖尿病病例共963例,发现两病兼发者10例,报告如下。 临床资料 一、一般资料 男2例,女8例。年龄9～53岁,30～50岁者6例。甲亢症状先于糖尿病症状者5例,两病症状同时出现者2例,糖尿病症状先出现者3例。两病发病先后间隔2月～10年,平均2.8年。     

甲亢合并糖尿病38例分析

我院2003—05／2006—08共收治甲亢合并糖尿病患者38例，分析如下。 1临床资料 1．1一般资料本组男8例，女30例，年龄20～72岁。首发表现为甲亢19例（50％），糖尿病9例（23．7％），两病发生间隔时间1个月～20a。二者同时发现者10例（26．3％）。有甲亢家族史者4例，有糖尿病家族史者2例。1型糖尿病4例（10．5％），2型糖尿病34例（89．5％），合并酮症者6例。甲亢均为Grave’S病，合并房颤者2例。     

肺结核合并糖尿病46例临床分析

肺结核合并糖尿病在呼吸内科临床工作中较为多见 ,并呈逐年增加之势。本院 1996～ 1998年共收治活动期肺结核患者 52 6例 ,其中合并糖尿病者 4 6例 ,占8.7%。现将其临床特点分析报道如下。1　临床资料1.1　一般资料　 4 6例患者中 ,男性 39例 ,女性 7例 ,年龄 2 6～ 82岁 ,39岁以下 5例 ,4 0～ 4 9岁 8例 ,50～59岁 13例 ,60～ 69岁 10例 ,70岁以上 10例。 50岁以上共 33例 ,占 71.7%。糖尿病先于肺结核者 34例 ,占 73.9% ,肺结核先于糖尿病 2例 ,两病同时发现者10例。 4 6例患者中Ⅰ型糖尿病 4例 ,Ⅱ型糖尿病 4 2例。本组病例肺结核及糖尿…     

甲状腺功能亢进症合并糖尿病11例临床分析

甲状腺功能亢进症(甲亢)合并糖耐量降低常见,但合并糖尿病不多见,本文总结11例,并作临床分析如下。临床资料1.诊断依据:甲亢的诊断依据高代谢率征群,突眼,甲状腺肿大,血清三碘甲状腺原氨酸(T_3)、甲状腺素(T_4)或甲状腺~(131)碘摄取率增高。糖尿病的诊断依据世界卫生组织(WHO)1980年糖尿病专家委员会制订的标准。2.一般资料:1982年1月～1989年12月间我院内分泌专科共确诊甲亢合并糖尿病11例,男1例,女10例,年龄19～66岁。甲亢症状先出现者6例,糖尿病症状先出现者2例,两组症状同时出现者3例。两     

腹腔镜胆囊阑尾联合切除术的临床应用

本院自2005年7月至2007年7月,行腹腔镜胆囊阑尾联合切除术27例,无一例发生并发症,效果满意。现报告如下。1临床资料1.1一般资料本组27例患者中男12例,女15例;年龄26～73岁,平均46岁。全部患者中有胆囊结石者21例,急性发作15例,胆囊息肉6例。其中,合并糖尿病7例,高血压、冠心病3例。有慢性阑尾炎病史21例,急性单纯阑尾炎5     

2型糖尿病合并脑梗死与糖化血红蛋白、血脂的关系探讨

糖尿病是动脉硬化性脑梗死的主要危险因素之一,且其发生、病情及预后主要与血糖水平有关。1　临床资料1.1　一般资料　1991年1月至1999年1月收治的2型糖尿病并脑梗死43例为脑梗死者组,同期住院的2型糖尿病未合并糖尿病脑梗死者48例为对照组。脑梗死组:男20例,女23例,年龄53～76岁,平均(62.4±4.9)岁。病程为3个月至20年,平均病程(7.1±1.6)年,合并高血压23例。对照组:男29例,女19例,年龄55～73岁,平均(68.1±5.3)岁。病程1个月至18年,平均病程(5.7±1.6)年,合并高血压21例。病前大部分经依据WHO标准诊断为非胰岛素依赖型糖尿病,即2型糖尿…     

肺结核合并糖尿病26例临床分析

糖尿病与结核病常常合并存在,相互间有不良影响,互为因果关系,在肺科临床工作中较为常见,如能及时诊断并积极治疗,其预后仍会获得较好的效果。现将我院1988年8月至1998年7月期间收治的819例肺结核患者中合并糖尿病的26例进行临床分析。1 临床资料1.1 一般资料 26例中,男17例,女9例,年龄25～?4岁,50岁以上19例。根据中华医学会1998年结核病分类法,26例均为继发型肺结核。Ⅰ型糖尿病1例,Ⅱ型糖尿病24例,糖耐量异常1例。两病并发时糖尿病病情分型:轻型1例;中型12例;重型4例。糖尿病先于肺结核者13例,肺结核先于糖尿病者5例,两病同时发现者8例。合并煤工尘肺4例。     

糖尿病性周围神经病的临床分析

糖尿病性周围神经病（diabeticperipheralneuropathies,DPN）过去认为主要见于病程长及糖尿病控制差者。近年来观察到不少病例神经系统症状先于糖尿病症状发生。本文对1997年3月～1998年8月宣武医院确诊的80例DPN临床特征进行分析。1资料与方法1．1一般资料本组80例中男48例,女32例;年龄19～78岁,平均51．2岁。既往糖尿病病程0～35年。符合WHO糖尿病诊断标准。其中Ⅰ型糖尿病3例,Ⅱ型糖尿病77例;DPN病程1天～10年。80例均以糖尿病为原发病,在糖尿病被诊断时或糖尿病病程中合并单发或多发末梢或依林经等周围神经病变,并排除其它…     

辨证分型、针药并用治疗中风48例分析

临床资料 1一般资料 2002年10月-2004年1月,本院病房收治48例中风病人,男27例,女21例;年龄48～81岁,平均62.65岁;脑出血28例,脑梗死20例;合并高血压者25例,合并糖尿病3例,同时合并高血压、糖尿病3例,合并冠心病4例(其中房颤3例).     

糖尿病合并甲状腺功能亢进39例诊治分析

目的探讨糖尿病并甲状腺功能亢进（甲亢）患者的临床特点和诊疗方法。方法对39例糖尿病并甲亢患者的临床特点进行回顾性分析。结果首发表现为糖尿病者9例,甲亢21例,二者同时发现者9例。综合治疗后,症状明显好转,空腹及餐后血糖均得到较好控制,血清游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺素（TSH）均恢复正常。6例合并酮症者均痊愈。结论加强对糖尿病并甲亢病例的充分认识,及早诊断,综合治疗后均能收到较好的疗效。     

CB1-06: Benefits of Early Versus Later Hypertension Treatment and Control on Cardiovascular Outcomes in Those with Diabetes: Clinical and Research Implications

Background/Aims The benefits of early hypertension (HT) control in patients with diabetes (DM) may vary by degree of BP control achieved in the year after HT onset. Methods Retrospective cohort study, of 13,480 DM who met study criteria for new onset HT based on blood pressure (BP) measurements, ICD-9 HT diagnose, and pharmacy data. Multivariate logistic and proportional hazard regression models were used to model the impact of BP control in first year and baseline comorbidity on subsequent occurrence of stroke or acute myocardial infarction, with adjustment for demographic factors, comorbidities, and diabetes severity. Results During a mean of 37 months of follow-up time the rate of major CV events in those whose mean BP in the 12 months after HT onset was < 130/80 mm Hg, 130-139/80-89 mm Hg, and > 140/90 mm Hg was 4.9, 5.1, and 7.8 major CV events per 1000 person years respectively. CV events rates did not differ significantly for those above or below 130/80 mm Hg, but were significantly lower in those <140/90 mm Hg compared to those who >= 140/90 mm Hg at the end of the first year after HT onset (p=.0002). In multivariate models, BP control was a significant predictor of stroke, but not of myocardial infarction. Discussion Prompt control of HT within one year of onset significantly reduced likelihood of subsequent stroke. Benefits of BP control were not significantly modified by baseline comorbidities or severity of diabetes.     

CB1-04: Benefits of Early Versus Later Hypertension Treatment and Control on Cardiovascular Outcomes in Those with Diabetes: Clinical and Research Implications

Background/Aims The benefits of early hypertension (HT) control in patients with diabetes (DM) may vary by degree of BP control achieved in the year after HT onset. Methods Retrospective cohort study, of 13,480 DM who met study criteria for new onset HT based on blood pressure (BP) measurements, ICD-9 HT diagnose, and pharmacy data. Multivariate logistic and proportional hazard regression models were used to model the impact of BP control in first year and baseline comorbidity on subsequent occurrence of stroke or acute myocardial infarction, with adjustment for demographic factors, comorbidities, and diabetes severity. Results During a mean of 37 months of follow-up time the rate of major CV events in those whose mean BP in the 12 months after HT onset was < 130/80 mm Hg, 130-139/80-89 mm Hg, and > 140/90 mm Hg was 4.9, 5.1, and 7.8 major CV events per 1000 person years respectively. CV events rates did not differ significantly for those above or below 130/80 mm Hg, but were significantly lower in those <140/90 mm Hg compared to those who >= 140/90 mm Hg at the end of the first year after HT onset (p=.0002). In multivariate models, BP control was a significant predictor of stroke, but not of myocardial infarction. Discussion Prompt control of HT within one year of onset significantly reduced likelihood of subsequent stroke. Benefits of BP control were not significantly modified by baseline comorbidities or severity of diabetes.     

Cardiovascular reflexes, vibration thresholds and electroneurography parameters of the peroneal and sural nerves in type I diabetics

In 26 type I diabetics ranging in age from 18 to 65 years with a duration of illness of between 1 and 34 years the following investigations were performed: 1. case history and questionnaire; 2. neurological examination; 3. determination of the vibration threshold; 4. electroneurography of the peroneal nerve and the sural nerve; 5. determination of the cardiovascular reflexes; 6. medical examination and additional findings; 7. ophthalmological investigation. 21 patients showed evidence of sensorimotor polyneuropathy (SM-PNP), the average age of this group (41 years) being 10 years higher than in the group without SM-PNP (31 years). The values of HbA1c were pathological in 17 of 21 cases with SM-PNP, and 2 of 5 cases without SM-PNP. Retinopathy was found rarely in both groups. 13 patients showed evidence of autonomic neuropathy (ANP). The mean duration of illness (15.4 years) and the average age of patients (36.5 years) in this group was distinctly higher than in the group without ANP (mean duration of illness: 8.9 years, mean age: 31.9 years). 12 patients with ANP and 7 patients without ANP had abnormally high HbA1c levels. Diabetic SM-PNP was most frequently (in 19 of 21 cases) diagnosed by electroneurographical investigation of the peroneal nerve. In the diagnosis of diabetic ANP the anamnesis (8 positive findings) and the determination of the heart rate variation during deep breathing (7 positive findings) are complementary. Among the 13 patients with ANP, 12 also had SM-PNP, whereas among the 21 patients with SM-PNP only 12 showed evidence of concomitant ANP.     

尿动力学检查对糖尿病患者膀胱功能的评价

目的：探讨尿动力学检查在糖尿病患者膀胱功能障碍诊断的意义。方法：对伴有下尿路症状的糖尿病患者34例，按糖尿病病史分为早期组（〈8a）与进展期组（〉10a），分别进行尿动力学测定，获取膀胱初始容量、最大膀胱容量、最大尿流率、残余尿、逼尿肌压力等参数作相关分析。结果：34例均完成尿动力学测定，尿动力学表现异常占30例（88．2％）；早期组与进展期组相比，最大尿流率明显下降（P〈0．01），初始尿意容量、残余尿、最大膀胱容量明显增高（P〈0．01），逼尿肌收缩力亦下降（P〈0．01）。结论：尿流动力学检查是对DCP进行客观评价的最重要的手段；早期的糖尿病患者予以治疗干预，对预防膀胱功能恶化有重要的意义。     

脑梗死非溶栓治疗出血性转化的MR分型与预后相关性研究

目的：①建立脑梗死非溶栓治疗出血性转化（HT）的磁共振（MR）分型方法；②验证其与预后的相关性。材料和方法：回顾性分析421例MR弥散加权（DWI）检查有高信号病灶的非溶栓治疗的急性脑梗死病例，依据自定MR分型方法对其中的31例HT进行分型，并与3个月后神经功能修订的Rankin量表（mRs）评分进行相关性研究，对伴或不伴有HT的脑梗死患者的预后相关性进行单因素分析，并进行χ2检验，两组间比较用ｔ检验。结果：421个病例中，31例（7.4%）发生HT，其中Ⅰ级10人（2.34%），Ⅱ级4人（0.95%），Ⅲ级17人（4.0%）。3个月后神经功能mRs评分，165人（39.2%）出现神经功能减退（mRs 3~5）或死亡，其中35人（8.3%）死亡；发生HT的31人中，有21人（67.7%）出现神经功能减退或死亡。Ⅱ级、Ⅲ级与预后不良明显相关。结论：7.4%非溶栓治疗的急性脑梗死病例发生HT，脑干或小脑HT、大面积梗死HT与预后不良显著相关，急性脑梗死HT的MR分型与预后有良好的相关性。     

超声诊断桥本甲状腺炎合并结节样病变56例分析

【目的】探讨桥本甲状腺炎（HT）合并结节样病变的超声声像特征、鉴别诊断及误诊原因。【方法】分析56例经手术病理证实的桥本甲状腺炎合并结节样病变的超声声像特征。【结果】56例HT合并结节样病变中,病理证实：32例单纯HT结节（单发或多发）,15例HT合并乳头状癌,7例HT合并滤泡性腺瘤,2例HT合并结节性甲状腺肿。超声检查诊断单纯HT结节（单发或多发）26例,甲状腺癌7例,腺瘤5例,结节性甲状腺肿2例,与病理相符,诊断准确率71．4％（40／56）。误诊16例,其中5例单纯HT结节、7例甲状腺癌及2例腺瘤误诊为结节性甲状腺肿,2例单纯HT结节误诊为腺瘤,误诊率为28．6％。甲状腺癌与单纯性HT结节,在结节形态不规则、边界不清晰、内部伴钙化声像表现上有显著差异。【结论】对HT甲状腺结节的超声诊断应以结节外腺体回声情况及腺体血供情况并结合血清学甲状腺抗体的检测进行全面分析和判断;对于结节形态不规则、边界不清晰、伴有钙化灶者要警惕．合并有恶变的可能。     

小腿骨筋膜室综合征的诊治与延误分析

目的总结小腿损伤并骨筋膜室综合征早期诊治方法,分析诊治延误原因。方法本组小腿损伤并骨筋膜室综合征患者33例,其中男性25例,女性8例,年龄8～66岁,平均29．7岁,密切观察临床症状和体征,及时应用whiteside针刺测压装置监测,多普勒超声血流探测仪或彩超检查确诊后即时切开减压21例,保守治疗后减压12例。结果及时减压组优良率约90．48％（19／21）,保守后减压组优良率约41．67％（5／12）,随访6个月至7年,平均3．3年,其中1例后期形成慢性窦道骨髓炎,2例骨不连接再次植骨加内固定而治愈,4例截肢后安装义肢,足下垂、轻度膝、踝关节僵硬4例：26例血液循环及下肢功能恢复良好。结论早期诊断、严密观察病情、及时切开减压是治疗骨筋膜室综合征的重要措施。     

Oxidative stress, the functional activity of beta-cells, and the content of tumor necrosis factor alpha in patients with type II diabetes mellitus

The purpose of the study was to investigate the effects of dietotherapy on oxidative stress (OS) condition, the fl-cell functional activity (BCFA), insulin resistance index (IRI), and the serum tumor necrosis factor alpha (alpha-TNF) level in patients with type 2 diabetes mellitus (DM 2). The subjects, 30 patients with DM 2 (9 men, 21 women), aged 42 to 70 (mean age 58.77 +/- 8.86 years), were examined. The duration of DM 2 in the subjects was from 1 month to 5 years. OS parameters, IRI and BCFA, as well as serum alpha-TNF were measured before the study and after 3 months of observation. The tests performed after the end of the study showed that hydrocarbonate exchange remained compensated, and IRI and BCFA were moderately lowered in DM 2 patients on dietotherapy. There was an insignificant elevation of serum alpha-TNF, while the condition of hydrocarbonate exchange had bettered. Changes in OS parameters in patients on dietotherapy evidence that the reserve activity of anti-oxidative system enzymes decreases. Thus, the compensation of hydrocarbonate exchange in DM 2 patients on dietotherapy retains, which is accompanied by a decrease in IRI and BCFA, while serum alpha-TNFincreases insignificantly, and reserved anti-oxidative system enzyme activity decreases moderately.     

肝素治疗慢性特发性血小板减少性紫癜的初步疗效观察

应用小剂量肝素治疗１４例慢性特发性血小板减少性紫癜症患者。１４例患者均为难治性者，其中男５例，女９例，年龄１９～７６岁（平均４７岁）。病程６个月～２０年（平均６．３年）。所有患者在肝素应用前均经泼尼松及多种免疫抑制剂正规治疗无效，泼尼松应用剂量在肝素治疗期间均减至１０ｍｇ／ｄ。肝素应用方法为腹部脐周皮下注射１２５０Ｕ／次，２次／ｄ。肝素治疗后，显效１例（７％）；良效６例（４３％）；进步３例（２１％）；无效４例（２９％）。总有效率为７１％。１０例有效病例血小板上升达高峰所需时间为１０～２３天（平均１８天）。肝素治疗前后，凝血功能、肝和肾功能、尿常规、心电图检查等均无变化。     

高血压患者血清肝细胞生长因子水平及相关因素分析

目的 观察高血压患者血清肝细胞生长因子(HGF)水平.方法 选取高血压患者30例,2型糖尿病合并高血压患者30例,正常对照者30例,分别测定血清HGF、空腹血糖(FBG)、餐后血糖(2hPG)、糖化血红蛋白(HbA1c)、TC、TG以及收缩压(SBP)、舒张压(DBP)、BMI、腰围(W)等.结果 血清HGF在高血压组[(413.87±90.87)ng/L]及2型糖尿病合并高血压组[(413.72±98.72)ng/L]均高于正常对照组[(120.45±25.11)ng/L](P均＜0.05),高血压组与2型糖尿病合并高血压组差异无统计学意义(P＞0.05);血清HGF与FBG、SBP呈正相关(r值分别为2.273、5.353,P均＜0.05).结论 高血压患者及2型糖尿病合并高血压患者血清HGF水平均增高,其水平可能反映血管内皮功能不全的严重程度.