高血压和Ⅱ型糖尿病患者血清瘦素水平分析

目的 研究中老年高血压和Ⅱ型糖尿病患者的血清瘦素（Leptin）水平，以及内皮素（ET）、胰岛素（Ins）对血清瘦素水平的影响。方法 采用放射免疫法测定201例高血压病与166例Ⅱ型糖尿病患者的血清瘦素水平，观察其与性别、年龄、体重指数（BMI）、脂肪百分比（％Fat）、空腹血糖（FBS）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL－C）、低密度脂蛋白胆固醇（LDL－C）、甘油三脂（TG）、内皮素（ET）、血浆胰岛素（Ins）等指标的关系。结果 高血压和Ⅱ型糖尿病患者BMI、Fat、FBS、HDL－C和TG等五项指标差异显著；多元线性相关结果显示，瘦素与ET呈负相关，与BMI、Fat呈正相关；在逐步回归分析中，HDL－C和ET最后进入方程。结论 高血压和Ⅱ型糖尿病患者的血清瘦素水平无显著差异，影响血清瘦素水平的因素，除BMI和Fat外，主要为血浆内皮素，与血浆胰岛水平无关。     

糖尿病并高血压血清瘦素水平分析

选择122例2型糖尿病患者,分为合并高血压组和血压正常组,各组又分别为肥胖组和非肥胖组,测定其体重指数(BMI)、空腹血糖和胰岛素、糖化血红蛋白(GhbA1C)及血清瘦素水平.结果示2型糖尿病患者血清瘦素水平与体重指数、空腹胰岛素水平成正相关关系(P＜0.01),与血压无明显相关性(P＞0.05);但在合并高血压组血清瘦素水平与糖化血红蛋白成负相关关系(P＜0.05).     

糖尿病并高血压血清瘦素水平分析

选择122例2型糖尿病患,分为合并高血压组和血压正常组,各组又分别为肥胖组和非肥胖组,测定其体重指数（BMI）、空腹血糖和胰岛、糖化血红蛋白（GhbA1C)及血清瘦素水平。结果示2型糖尿病患血清瘦素水平与体重指数、空腹胰岛素水平成正相关关系（P＜0．01）,与血压无明显相关性（P＞0．05）;但在合并高血压组血清瘦素水平与糖化血红蛋白成负相关关系（P＜0．05）。     

2型糖尿病患者血瘦素水平与高血压的相关性研究

选择122例2型糖尿病患者,分为合并高血压组和血压正常组,各组又分别分为肥胖和非肥胖亚组.测定其体重指数(BMI)、空腹血糖(FBG)和胰岛素、糖化血红蛋白(HbA1c)及血清瘦素水平,并作相关性分析.结果显示,2型糖尿病患者高血压组与非高血压组间血清瘦素水平无差异(P＞0.05);血清瘦素水平与BMI、空腹胰岛素呈正相关关系(P＜0.01),与血压无明显相关性(P＞0.05);但在合并高血压组,血清瘦素水平与HbA1c呈负相关关系(P＜0.05).提示2型糖尿病患者的血清瘦素水平与血压无明显相关性,但合并高血压患者长时间血糖控制不良可能会导致血清瘦素水平的下降.     

2型糖尿病患者血清瘦素及可溶性瘦素受体检测分析

对60例2例型糖尿病（T2DM）患者和46例正常对照的研究显示，T2DM患者血清瘦素水平高于正常对照组，可溶性瘦素受体水平低于对照组。     

不同药物对糖尿病瘦素水平影响

将53例初诊Ⅱ型糖尿病人随机分为美吡达治疗组(A组)及二甲双胍治疗组(B组),分别于治疗前后测体重指数(BMI)、平均动脉压(MBP)、腰臀比(WHR)、瘦素(LP)、空腹胰岛素(FINS)、空腹血糖(FPG).结果显示A组治疗后LP、FINS显著高于治疗前及B组(P<0.05);而B组治疗前后对比LP、FINS无显著性差异(P>0.05);LP与FINS、BMI、MBP、性别呈显著性正相关(P<0.05～0.001).提示随着INS水平升高LP浓度相应升高,LP与INS、BMI、性别等密切相关.     

Ⅱ型糖尿病并发高血压患者血浆内皮素水平的改变

目的探讨内皮素在Ⅱ型糖尿病并发高血压或血压正常患者的意义。方法用放射免疫法测定８９例糖尿病患者（其中２８例并有高血压，６１例血压正常）的内皮素水平，并和非糖尿病对照组比较。结果糖尿病并高血压患者血浆内皮素水平较不并有高血压糖尿病和正常对照组高。糖尿病血压正常组亦比正常对照组高。结论糖尿病患者的血浆内皮素含量增高，不论其是否并发高血压。     

瘦素与2型糖尿病

瘦素是肥胖基因的编码产物，它具有调节能量代谢和食物摄入，抑制脂肪合成的作用，与多种内分泌激素之间存在相互关系，瘦素与胰岛素之间存在双向负反馈作用，在肥胖者体内存在高瘦素血症、瘦素抵抗和２型糖尿病中的胰岛素抵抗相并行。因此，瘦素可能参与胰岛素抵抗和２型糖尿病的发生。     

Ⅱ型糖尿病伴高血压患者胰岛素,胰高血糖素水平

配对观察６８例Ⅱ型糖尿病伴高血压和无高血压和无高血压患者ＯＧＴＴ中的血糖，胰岛素、Ｃ肽、胰高血糖素等指标。结果显示伴高血压组患者、胰岛素、胰高血糖素在各时相、Ｃ肽在空腹１２０ｍｉｎ，１８０ｍｉｎ均明显高于无高血压组，而血糖／胰糖素各时相则低于无高血压组。     

2型糖尿病患者血清Leptin水平的研究

用放免法测定２６例２型糖尿病（ＤＭ）患者的血清Ｌｅｐｔｉｎ,胰岛素,用葡萄糖氯化酸疼法测定空腹而溏（ＦＢＧ）,测量体重,计算体重指数（ＤＭＩ）,并测定了２２例患者口服葡萄糖耐量试验（ＯＧＴＴ）２小时后Ｌｅｐｔｉｎ水平,以及１３例男性患者的血清睾酮,并与２６例正常人进行对照。结果显示,２型ＤＭ组与对照组比较,血清Ｌｅｐｔｉｎ无显著差异（Ｐ〉０．０５）,女性是男性的２．３倍,服葡萄糖２小时后Ｌｅｐｔｉ     

老年2型糖尿病患者血清瘦素浓度与甘油三酯水平的关系

目的　探讨老年糖尿病人血清瘦素浓度与甘油三酯水平的关系。方法　测定 10 0例老年糖尿病患者血清瘦素浓度与甘油三酯的水平 ,分析二者之间的关系。结果　老年糖尿病患者随甘油三酯水平升高血清瘦素浓度升高 (P <0 0 5 ) ,在相同甘油三酯水平 ,女性患者血清瘦素浓度高于男性患者 (P <0 0 5 )。结论　老年糖尿病患者血清瘦素浓度与甘油三酯水平有关。     

Treatment of Type 2 Diabetes in the Elderly

As the number of older adults increases in the United States and worldwide, management of patients with multiple coexisting chronic diseases has become a critical component in health care. Management of diabetes is particularly challenging in this population due to significant risks of microvascular and macrovascular diseases on the one hand, and complications of the treatment strategies (e.g., hypoglycemia) with intensive control on the other hand. To provide a balanced approach to diabetes in the elderly, a comprehensive and holistic strategy, with consideration of overall health, functional status, psychosocial environment, financial resources and, finally but most importantly, quality of life is needed. Understanding the unique challenges faced by older adults with diabetes and issues pertaining to antidiabetes medications with aging is an important first step in the direction of better and tailored care of this burgeoning population.     

循证护理对老年2型糖尿病合并高血压病患者的效果研究

目的 探讨循证护理对老年2型糖尿病合并高血压病患者的效果.方法 选择该院内分泌科2018年3月—2019年9月收治的106例2型糖尿病合并高血压患者为研究对象,奇偶数法随机分为两组,每组53例.对照组实施常规护理干预,观察组实施循证护理干预.观察与比较两组患者护理前后血糖指标、血压达标率、生活质量评分.结果 护理前,两...     

Glibenclamide vs Gliclazide in Type 2 Diabetes of the Elderly

The objective of this study was to compare the effect of two sulphonylureas on the frequency of hypoglycaemic events and glycaemic control in elderly patients with Type 2 diabetes. Twenty-two untreated elderly patients were treated with glibenclamide or gliclazide in a randomized double-blind fashion. Prior to treatment, a biochemical profile, an oral glucose tolerance test, and a 2-h hyperglycaemic glucose clamp (glucose 5.4 mmol I^-zs-1 above baseline) were performed. Patients were seen regularly over 6 months to assess glycaemic control and the frequency of hypoglycaemic reactions. Hyperglycaemic clamp studies and oral glucose tolerance tests were repeated at 1 and 6 months. The area under the curve for the oral glucose tolerance test (glibenclamide: 15.5 ± 0.7; gliclazide: 14.9 ± 0.8 mmol I^?1 ((p = NS)) and the haemoglobin A1C (glibenclamide: 7.4 ± 0.2%; gliclazide: 7.9 ± 0.5% (p = NS)) were similar at 6 months. Hypoglycaemic reactions were significantly more frequent with glibenclamide than with gliclazide: 17 vs 4 (p < 0.01). Insulin sensitivity index (ml kg^?1 min^?1 pmol ^?1 × 100) was increased significantly by glibenclamide but not gliclazide (glibenclamide: 0.284 ± 0.116 (baseline) vs 0.518 ± 0.102 (6 months) (p < 0.05), gliclazide: 0.260 ± 0.048 (baseline) vs 0.358 ± 0.048 (6 months) (p = NS)). We conclude that glycaemic control was equivalent with the two drugs but the incidence of hypoglycaemic reactions was significantly greater with glibenclamide probably because this drug increases insulin sensitivity to a greater degree.     

高血压病患者血清瘦素浓度与血糖水平的相关性研究

目的　探讨高血压病患者血清瘦素与血糖、年龄、血压、体重指数 (BMI)、体内脂肪含量 (BF % )的关系。方法　测定 2 0 0例高血压病患者 [2型糖尿病 (DM ) 2 0例 ,糖耐量低减 (IGT) 6 3例 ,糖耐量正常 (NGT) 12 0例 ]的空腹血清瘦素浓度、收缩压 (SBP)、舒张压 (DBP)、BMI、BF %、空腹血糖 (FPG)和葡萄糖曲线下面积 (AUCG)。结果　 (1) 2 0 0例的血清瘦素浓度与FPG、ACUG、年龄、BMI、BF %、SBP呈显著正相关 ;(2 )DM组血清瘦素浓度 (μg/L)DM组 (17.7± 9 4 )显著高于IGT组 (12 7± 9 2 )和NGT组(10 8± 6 9) ,但经协方差较正BMI和年龄后 ,3组间血清瘦素浓度差异无显著意义 ;(3)在剔除部分病例后 ,3组间年龄和BMI相配 ,则 3组间血清瘦素浓度无显著差异 ,但仍与BMI和BF %显著相关 ,与血糖值、年龄无显著相关。结论　高血压病患者血清瘦素浓度与血糖无直接相关关系 ,而与人体脂肪含量密切相关。     

高血压病患者血清瘦素浓度与血糖水平的相关性研究

目的探讨高血压病患者血清瘦素与血糖、年龄、血压、体重指数(BMI)、体内脂肪含量(BF%)的关系.方法测定200例高血压病患者[2型糖尿病(DM)20例,糖耐量低减(IGT)63例,糖耐量正常(NGT)120例]的空腹血清瘦素浓度、收缩压(SBP)、舒张压(DBP)、BMI、BF%、空腹血糖(FPG)和葡萄糖曲线下面积(AUCG).结果 (1)200例的血清瘦素浓度与FPG、ACUG、年龄、BMI、BF%、SBP呈显著正相关;(2)DM组血清瘦素浓度(μg/L) DM组(17.7±9.4)显著高于IGT组(12.7±9.2)和NGT组 (10.8±6.9),但经协方差较正BMI和年龄后,3组间血清瘦素浓度差异无显著意义;(3)在剔除部分病例后,3组间年龄和BMI相配,则3组间血清瘦素浓度无显著差异,但仍与BMI和BF%显著相关,与血糖值、年龄无显著相关.结论高血压病患者血清瘦素浓度与血糖无直接相关关系,而与人体脂肪含量密切相关.     

Calcium Antagonists in Patients with Type 2 Diabetes and Hypertension

Hypertension is twice as common in patients with diabetes compared to those without diabetes. It accounts for up to 75% of cardiovascular disease risk leading to the substantial increase in morbidity and mortality. Control of blood pressure in people with diabetes has been shown in randomized controlled trials to decrease cardiovascular risk and improve outcome especially in preventing stroke. A target blood pressure goal of <130/80 mm Hg is currently recommended for patients with diabetes. However, less than 1/3 of these patients achieve such a goal. This is in part due to the inherent difficulty in controlling blood pressure in these patients where hypertension is usually associated with increased salt sensitivity, volume expansion and isolated systolic hypertension. Therefore, patients with diabetes usually require multiple medications for optimal blood pressure control. Calcium channel antagonists have been shown in large clinical trials to be both safe and effective in controlling blood pressure in diabetic patients and will continue to play a major role in the management of hypertension in this population, particularly in the combination therapy that these patients usually require.     

血清瘦素浓度与原发性高血压的关系

为探讨血清瘦素浓度与原发性高血压和肥胖度的关系,测定115例1级原发性高血压患者、96例2级原发性高血压患者和47例正常血压者的空腹血清瘦素浓度、收缩压、舒张压、体重指数、体内脂肪含量和空腹血糖,血清瘦素用放射免疫法测定.分析瘦素与其它各项参数的相关性.结果发现,1级高血压组和2级高血压组血清瘦素浓度均高于同性别的正常组,但经协方差校正体内脂肪含量后,同性别三组间血清瘦素浓度差异无显著意义;男女血清瘦素浓度分别与收缩压、舒张压、年龄、体重指数、体内脂肪含量及空腹血糖呈显著正相关,女性血清瘦素浓度与收缩压及舒张压的相关性强于男性,但校正体内脂肪含量后,男女血清瘦素浓度与收缩压及舒张压均无相关性;Logistic回归分析发现,男女血清瘦素浓度均非高血压的独立预测因素.结果提示,男女血清瘦素浓度与原发性高血压均无直接关系,而与人体肥胖程度密切相关.