2型糖尿病伴抑郁症状患者的脑诱发电位研究

目的了解2型糖尿病伴抑郁症状患者的认知功能及脑诱发电位的变化。方法根据汉密尔顿抑郁量表（HAMD）结果选取50例2型糖尿病合并抑郁症状（研究组）与52例2型糖尿病不合并抑郁症状（对照组）,观察两组脑诱发电位指标。结果两组脑诱发电位中P300未见明显差异（P〉0.05）。病变组脑诱发电位失匹配负波（MMN）、潜伏期较对照组延长,波幅降低（P〈0.01或P〈0.05）。结论MMN是一个敏感反映2型糖尿病患者认知水平损害的发生发展的指标。     

大鼠三叉神经皮层诱发电位的测定

目的：测定正常大鼠三叉神经皮层诱发电位，建立本实验室三叉神经皮层诱发电位正常值数据库。方法：取40只Wistar大鼠，电刺激一侧第3排第2、3根胡须处皮下，在对侧硬膜外记录三叉神经皮层诱发电位。结果：在冠状缝后2．5mm、矢状缝旁5．0mm处硬膜外记录到较一致的，由两个负向波（N1、N2）和一个正向波（P）组成的三叉神经皮层诱发电位。潜伏期为N1（5．25±0．32）ms，P（6．50±0．54）ms，N2（7．62±0．41）ms；波幅为N1（3．75±0．81）μV，P（2．11±0．54）μV，N2（0．62±0．21）μV。结论：该方法测定三叉神经皮层诱发电位，正常值较稳定，为进一步研究病理状态下三叉神经皮层诱发电位变化提供了一定的实验依据。     

实验性动脉血压下降及治疗过程体感皮层诱发电位的动态变化

目的：观察动脉血压下降至失血性休克及治疗后家兔大脑皮层诱发电位的变化，了解缺血缺氧纠正后神经系统电活动的变化。方法：（1）记录放血前诱发电位及放血后血压50～60mmHg（6．65～7．98kPa）时的皮层诱发电位，测量皮层诱发电位潜伏期正波值、负波值的幅度及峰峰值的幅度和时程。（2）给予扩容补液治疗（补充所失血量及等量生理盐水和654—21mg／kg）半小时后血压恢复到80～100mmHg时，测定皮层诱发电位的潜伏期正波值、负波值的幅度及峰峰值的幅度和时程，并进行组间比较。结果：放血前后与治疗组皮层诱发电位差异均有统计学意义（P〈0．05）。结论：实验性动脉血压下降过程中随着血压下降皮层诱发电位正波、负波、峰峰值幅度均呈现下降趋势，其潜伏期、峰峰时程延长；当血压低于70mmHg（9．31kPa）进行扩容时，诱发电位不能恢复到放血前的水平。该变化规律为临床对休克的治疗和有效监测提供了实验依据。     

2型糖尿病合并急性脑梗死的脑干听觉诱发电位研究

目的：探讨2型糖尿病合并急性脑梗死患者脑干听觉诱发电位（BAEP）的临床特点。方法：选择急性脑梗死患者154例,其中2型糖尿病合并急性脑梗死患者（DMCI）74例和非糖尿病急性脑梗死患者（NDMCI）80例,全部患者发病72 h内行BAEP检查,观察BAEP的异常变化及对BAEP的PL、IPL进行比较。结果：DMCI组与NDMCI组患者BAEP异常率分别为81.2%和63.8%,差异有统计学意义（P〈0.05）,DMCI组BAEP异常Ⅲ级病例比NDMCI组显著增多（P〈0.01）,DMCI组患者BAEP主波潜伏期和波间期均比NDMCI组患者明显延长（P〈0.05）。结论：DMCI患者存在脑干听觉诱发电位异常,BAEP可作为观察脑梗死患者脑功能的客观指标。     

2型糖尿病患者脑部皮层及皮层下奖赏环路研究

目的探索2型糖尿病患者皮层及皮层下奖赏环路体积变化,以及胰岛素治疗对奖赏环路的影响。方法对16名2型糖尿病患者及16名健康志愿者进行脑形态学分析,其中11名2型糖尿病患者进行基线(胰岛素治疗前)及随访水平(胰岛素治疗1年)的体积测量。统计学方法采用协方差分析及配对t检验。结果 2型糖尿病患者左侧岛叶及伏隔核区、右侧海马、壳核及杏仁核体积显著小于对照组。接受胰岛素治疗1年后双侧皮层奖赏系统体积(左侧:33.65±3.66 ml;右侧:33.35±4.25 ml)显著高于基线水平(左侧:31.45±2.90 ml;右侧:31.12±2.97 ml);双侧基底节食物奖赏系统结构体积无显著差异;双侧腹侧间脑体积随访水平(左侧:3.26±0.68 ml;右侧:3.20±0.78 ml)较基线水平(左侧:2.96±0.76 ml;右侧:2.82±0.90 ml)显著增加(P<0.05)。结论 2型糖尿病患者皮层及皮层下奖赏系统结构体积减小,胰岛素治疗可以改善皮层及皮层下奖赏系统结构的损害。     

地塞米松对脓毒血症大鼠脑皮层诱发电位及c-Fos蛋白表达的影响

目的：探讨脓毒血症大鼠皮层脑诱发电位的变化和大脑皮层c-Fos蛋白表达及地塞米松（DXM）的干预效应。方法：健康成年Wistar大鼠88只，随机分为假手术组（对照组）、盲肠结扎穿孔术（CLP）组和DXM（10mg／kg）给药组，观察1、2、4、6、10h时段体感诱发电位的动态变化，并进行大脑皮层c-Fos免疫组织化学方法测定。结果：对照组大鼠引出的皮层诱发电位波是以一个正相波为主的复合波。CLP组在10hP1波的潜伏期较对照组显著延长（P〈O．05），波幅显著降低（P〈0．05）；地塞米松1h给药组P1波潜伏期较CLP1h组显著缩短（P〈0．05），而波幅与CLP 1h组比较无统计学差异。地塞米松10h给药组P1波潜伏期较CLP10h组显著缩短（P〈0．05），波幅显著增大（P〈0．05）。c-Fos对照组有少量表达，在CLP1h开始增加，4h达高峰；在DXM注射后1～2h表达明显增加，并持续至用药后10h。结论：地塞米松对大鼠脓毒血症所引起的诱发电位的变化有所改善。c-Fos可能参与脓毒血症发病中机体对神经元损伤的应激机制，DXM通过上调c-Fos蛋白具有保护神经细胞的作用。     

糖尿病视网膜病变中医证型与视觉电生理的关系

目的：探讨糖尿病视网膜病变中医证型与视觉电生理的关系。方法：将39例78眼确诊为糖尿病视网膜病变患者按照中医辨证分型，进行图形视觉诱发电位和闪光视网膜电图检测。结果：图形视觉诱发电位无糖尿病视网膜病变组、糖尿病视网膜病变中医各证型组的P100潜时延长，与正常人组的比较有显著性差异（P＜0.05）。OPs波的改变基本随单纯期→增殖期的发展而减弱，增殖期趋向于熄灭，其中以血瘀气滞证偏多。结论：DR中医证型对P－VEP的潜时、波幅有不同程度的影响；糖尿病视网膜病变对F－ERG的b波波幅有一定影响，面中医证型各组间的b波无明显差异，血瘀气滞证对OPS波波幅影响较明显。     

运动疗法——健身操在2型糖尿病治疗中的应用与护理体会

目的：探讨运动疗法——健身操在2型糖尿病治疗过程中的效果。方法：选取50例2型糖尿病患者作为研究对象，并随机分为对照组与干预组，干预组患者进行健身操运动。结果：干预组患者行有氧运动后，空腹与餐后2h血糖明显下降，住院时间缩短。结论：在糖尿病基础治疗的同时，运动疗法——健身操对2型糖尿病患者有明显的治疗作用。     

2型糖尿病患者诱发电位及其相关因素分析

目的 :了解 2型糖尿病患者的视觉诱发电位 (VEP)、脑干听觉诱发电位 (BAEP)、体感诱发电位 (SEP)、事件相关电位(ERP)的表现及其与临床参量的关系。方法 :用NicoletVikingTV型肌电图 诱发电位仪对 30例 2型糖尿病患者 (DM组 )及年龄和性别与之匹配的正常人 30例 (对照组 )进行VEP、BAEP、SEP、ERP检测。应用SPSS统计软件分析DM组的诱发电位(EP)表现及其与临床参量 (病程、血糖、血脂、肾功能、血管病变 )的关系。结果 :DM组①VEP异常 2 0例 ,BAEP异常 18例 ,MNSEP异常 2 0例 ,PTNSEP异常 2 2例 ,ERP异常 11例。②VEP的P10 0潜伏期 (PL)明显延长 ,BAEP的左侧Ⅰ波PL、双侧Ⅴ波PL、波幅 (Amp)和各波间期 (IPL)明显异常 ,SEP周围电位N9至皮层电位P2 5 P38的PL、Amp以及ERP中N2、P3a、P3b的PL、Amp都有明显异常 ,与对照组比较P <0 0 5 ,P <0 0 0 1。③EP改变与各临床参量有关。结论 :糖尿病患者VEP、BAEP、SEP、ERP都有不同程度异常 ,其异常程度和病程平行。控制血糖、血脂、保护肾功能、防治血管病变有利于阻止神经病变的发展。     

2型糖尿病伴抑郁症状认知功能及交感神经皮肤反应的临床观察

目的了解2型糖尿病伴抑郁症状患者的认知功能及交感神经皮肤反应（SSR）的变化。方法根据汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）结果选取60例2型糖尿病合并抑郁（病变组）与52例2型糖尿病不合并抑郁（对照组）,观察2组失匹配负波、交感神经皮肤反应。结果病变组脑诱发电位失匹配负波（MMN）以及SSR的潜伏期较对照组延长,波幅降低。结论抑郁进一步加重糖尿病患者认知功能改变,自主神经功能受损加重抑郁症状。     

自发性2型糖尿病小鼠发病早期认知功能的研究

目的通过对自发性2型糖尿病小鼠发病早期认知功能的研究,探讨糖尿病脑病的发病机制。方法利用自发性2型糖尿病动物模型KK-Ay小鼠,动态研究其认知功能的变化,并进行脑组织形态学观察。结果在Morris水迷宫实验中,糖尿病小鼠在发病6周时已出现轻度认知功能障碍,在发病12周时认知功能障碍明显加重,游出时间、游出距离显著长于正常对照鼠(P<0.01)。光镜和电镜都观察到糖尿病小鼠脑组织形态学的变化,以电镜下超微结构的变化为主。发病12周时海马及颞叶神经元固缩、深染,核膜凹陷,核内染色质溶解,核糖体解聚,线粒体退变,内容物呈絮状,未观察到毛细血管基底膜增厚,管腔狭窄等血管病变。结论KK-Ay小鼠可以作为研究糖尿病脑病的一种较好的动物模型;高血糖等代谢因素可引起认知障碍的发生。     

老年2型糖尿病血管并发症与脂代谢关系的探讨

目的 探讨老年2型糖尿病患者血管并发症与血脂、载脂蛋白、脂蛋白（a)之间的关系。方法 将老年2型糖尿病患者分为62例无血管并发症组（Ⅱ组）及58例有血管并发症组（I组），对两组病例进行了血清总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL－C）、低密度脂蛋白胆固醇（LDL－C）、载脂蛋白AI（ApoAI)、载脂蛋白B（ApoB)及脂蛋白（a)[Lp(a)]的测定。结果 I组与Ⅱ组比较：TC、TG、LDL－C、ApoB、Lp(a)水平均显著增高，而HDL－C和ApoAI明显降低。结论 老年2型糖尿病患者由于体内胰岛素相对不足和胰岛素抵抗，使血脂、载脂蛋白、脂蛋白浓度和组成成分发生变化及功能发生异常，从而促进动脉粥样硬化，伴随着血管并发症的发生。因此，临床上对老年2型糖尿病患者进行调脂治疗是减少血管并发症的重要手段之一。     

Association of diabetic maculopathy with diabetic nephropathy--a study

A total number of 100 patients were examined over a period of one year to find out any correlation between diabetic maculopathy and diabetic nephropathy. Twenty-two belonged to insulin dependent diabetes mellitus group and 78 patients were in the non-insulin dependent diabetes mellitus group who were suffering from diabetes over a period of 0-25 years and more. Another group comprising 6 patients were chosen from these 100 patients who were suffering from nephropathy diagnosed clinically and on pathological investigations. Background and proliferative--both types of diabetic retinopathy were found with increased incidence with the persistence of the disease in both types of diabetes mellitus. Nine patients had diabetic maculopathy, out of which 6 patients (66.66%) were suffering from diabetic nephropathy. Proliferative diabetic retinopathy is more common in insulin dependent diabetes mellitus than in non-insulin dependent diabetes mellitus of more than 25 years of duration. Maculopathy is more common in non-insulin dependent diabetes mellitus and there is strong correlation between diabetic maculopathy and diabetic nephropathy.     

参麦降糖饮治疗气阴两虚型2型糖尿病临床研究

目的:观察参麦降糖饮治疗气阴两虚型2型糖尿病的临床疗效.方法:将66例患者随机分为两组,治疗组35例,应用参麦降糖饮治疗对照组33例,口服消渴丸治疗.两组均60 d为1疗程.结果:治疗组有效率为85.8%,对照组为60.6%,两组比较有显著性差异(P＜0.05).结论:参麦降糖饮治疗气阴两虚型糖尿病疗效确切.     

Studies on central nervous system function in diabetes mellitus

Fifty-seven insulin dependent (IDDM) and non-insulin dependent (NIDDM) diabetic patients and 25 controls were studied. Patients with history of strokes, hypoglycaemia, hearing impairment, diabetic retinopathy, etc, were excluded. Clinical examination of central nervous system (CNS) and computerised tomography scan of brain were absolutely normal in all cases. Neuroelectrophysiological tests done were the visual evoked potential (VEP), brainstem auditory evoked response (BAER) and somatosensory evoked potential (SEP). The mean VEP latency was significantly raised in both NIDDM and IDDM compared with controls. The mean BAER and SEP latencies were both significantly raised in NIDDM but not in IDDM. The percentage of cases with abnormally raised CNS latencies were as follows: In NIDDM, VEP-16.7%, BAER-50% and SEP-26.7%; in IDDM, VEP-11.1%, BAER-14.8% and SEP-18.5%. Thus, subclinical CNS dysfunction is common in diabetes mellitus particularly in NIDDM and this can be reliably detected by measuring the CNS latencies, specially VEP.     

盐酸米诺环素软膏辅助治疗Ⅱ型糖尿病牙周炎的临床疗效评价

目的研究盐酸米诺环素软膏辅助糖尿病牙周炎的非手术治疗的临床疗效。方法选择Ⅱ型糖尿病患者25例,进行牙周非手术治疗,比较治疗前及治疗后4周、8周状况,包括牙周袋深度(PD),菌斑指数(PLI),出血指数(BI),附着丧失(AL)。结果患者治疗后的4周和8周,各项指标较基线均有明显改善(P<0.05)。结论盐酸米诺环素软膏短期内控制糖尿病牙周炎症有明显效果。     

PREVALENCE OF MICROALBUMINURIA IN NON-INSULIN-DEPENDENT DIABETES MELLITUS

The prevalence of microalbuminuria was assessed in 50 patients of non-insulin dependent diabetes mellitus. The mean age of patients was 52.1 ± 11.6 years and the duration of diabetes was 8.3 ± 6.8 years. Twenty (40%) patients had microalbuminuria. Microalbuminuria was more common in patients with a longer duration of diabetes (more than 5 years), a poor glycaemic control, and higher systolic blood pressure.KEY WORDS: Microalbuminuria, Diabetes mellitus, Diabetic nephropathy, Chronic renal failure     

非胰岛素依赖型糖尿病患者脑血管受累的TCD检测

目的:经颅多普勒超声(TCD)检测非胰岛素依赖型糖尿病患者脑血管受累情况。方法:采用EME公司TC-2020型经颅多普勒超声仪对非胰岛素依赖型糖尿病(NIDDM)患者组和对照组的颅内血管(ACA、MCA、PCA)进行检测。结果:NIDDM组TCD检测异常率与对照组有显著差异。表明糖尿病患者的脑血管受累明显多于非糖尿病对照组。结论:应用TCD技术能够全面具体反映出糖尿病患者的脑血管受累部位及程度,为临床防治、控制糖尿病并发症的发生提供了较可靠的依据。     

Copper, zinc, and magnesium levels in non-insulin dependent diabetes mellitus

A relationship has been reported between trace elements and diabetes mellitus. This study evaluated the role of such a relationship in 83 patients with non-insulin dependent diabetes mellitus (40 men and 43 women), with a mean duration of diabetes of 3.9 +/- 3.6 years. Patients with nephropathy were excluded. Thirty healthy non-diabetic subjects were studied for comparative analysis. Subjects were subdivided into obese and non-obese. Diabetic subjects were also subdivided into controlled and uncontrolled groups; control was based on fasting blood glucose and serum fructosamine levels. Plasma copper, zinc and magnesium levels were analysed using a GBC 902 double beam atomic absorption spectrophotometer. Plasma zinc and magnesium levels were comparable between diabetic and non-diabetic subjects, while copper levels were significantly elevated (p < 0.01) in diabetic patients. Age, sex, duration and control of diabetes did not influence copper, zinc, or magnesium concentrations. We conclude that zinc and magnesium levels are not altered in diabetes mellitus, but the increased copper levels found in diabetics in our study may merit further investigation of the relationship between copper and non-insulin dependent diabetes mellitus.     

Epidemiological study of prevalence of chlorpropamide alcohol flushing in insulin dependent diabetics, non-insulin dependent diabetics, and non-diabetics

An epidemiological study was carried out to compare the prevalence of facial flushing in non-diabetics, patients with insulin dependent diabetes, and patients with non-insulin dependent diabetes in response to 40 ml sherry taken 12 hours after 250 mg chlorpropamide or placebo, administered double blind in randomised order. A flush after chlorpropamide but not placebo was reported by 6.2% of non-diabetics (17/273), 9.7% of insulin-dependent diabetics (14/145), and 10.5% of non-insulin dependent diabetics (25/239), excluding those receiving long term chlorpropamide treatment. The differences were not significant. This response was unrelated to age, sex, body mass index, and family history of diabetes in all three groups. Patients taking long term chlorpropamide, however, showed a significantly (p less than 0.01) higher prevalence of flushing after both chlorpropamide and placebo (56.3%; 9/16) compared with the rest of the non-insulin dependent diabetics (16.7%; 40/239), the insulin dependent diabetics (6.9%; 10/145), and the non-diabetics (5.9%; 16/273). Patients receiving long term chlorpropamide would be expected to flush with sherry after a placebo tablet because of therapeutic plasma concentrations of the drug. It is concluded that there is no evidence of an increased prevalence of chlorpropamide alcohol flushing in response to the single challenge test in non-insulin dependent diabetics compared with insulin dependent diabetics and non-diabetics except in selected patients taking chlorpropamide long term. This study does not support the hypothesis that the chlorpropamide alcohol flush is a specific marker for a subtype of non-insulin dependent diabetes.