缬沙坦联合氨氯地平或氢氯噻嗪对老年高血压患者血压变异性的影响

目的 比较缬沙坦联合氨氯地平或氢氯噻嗪对老年高血压患者血压变异性及一氧化氮、内皮素的影响.方法选取61例2、3级老年高血压患者,随机分为两组,分别给予缬沙坦+氨氯地平或缬沙坦+氢氯噻嗪行降压治疗,观察入选时、治疗第8周和第16周各种相关指示的变化.人选时检测血脂、空腹血糖、血尿酸,试验各个阶段监测24 h动态血压,检测血浆一氧化氮、内皮素水平.结果在患者入选时、治疗第8周和第16周三个时间点,缬沙坦+氨氯地平组和缬沙坦+氢氯噻嗪组24 h血压及白昼血压比较差异无统计学意义.治疗第16周,缬沙坦+氨氯地平组晨峰收缩压较缬沙坦+氢氯嚷嗪组明显降低[(22.6±8.8)mm Hg(1 mm Hg=0.133 kPa)比(26.3±13.7)mm Hg,P＜0.05];缬沙坦+氨氯地平组及缬沙坦+氢氯噻嗪组24 h收缩压变异性(SBPV)进行性降低[缬沙坦+氨氯地平组:(12.5±2.8)mm Hg比(10.2 ±2.2)mm Hg比(8.8±1.6)mm Hg,P＜0.01;缬沙坦±氢氯噻嗪组:(12.5±2.5)mmHg比(10.7±2.2)mm Hg比(9.6±2.0)mmHg,P＜0.01],缬沙坦+氨氯地平组及缬沙坦+氢氯噻嗪组白昼SBPV明显降低[缬沙坦+氨氯地平组:(12.2±3.0)mm Hg比(10.1±2.3)mm Hg比(8.4±1.9)mm Hg,P＜0.01;缬沙坦+氢氯噻嗪组:(11.8±2.7)mm Hg比(10.4±1.9)mm Hg比(9.6±2.2)mm Hg,P＜0.01],缬沙坦+氨氯地平组24 h舒张压变异性(DBPV)显著降低[(15.5±3.4)mm Hg比(13.0±3.5)mm Hg比(12.3±2.5)mm Hg,P＜0.01],缬沙坦+氢氯噻嗪组24 h DBPV无显著性变化;缬沙坦+氨氯地平组第16周白昼SBPV低于缬沙坦+氢氯噻嗪组[(8.4±1.9)mm Hg比(9.6 ±2.2)mm Hg,p＜0.05],缬沙坦+氨氯地平第8周、第16周的24 h DBPV、白昼DBPV低于缬沙坦+氢氯噻嗪组(P ＜0.01～0.05);缬沙坦+氨氯地平组一氧化氮进行性升高[(27.3±13.6)μmol/L比(47.2±16.3)μmol/L比(69.5±18.9)μmol/L,P＜0.01]、内皮素进行性降低[(45.3±8.0)ng/L比(37.4±3.9)ng/L比(34.2±4.4)ng/L,P＜0.01];缬沙坦+氢氯噻嗪组一氧化氮进行性升高[(33.5±13.9)μmol/L 比(49.7±21.9)μmol/L比(66.7 ±24.7)μmol/L,P＜0.01]、内皮素显著降低[(46.6±10.4)ng/L比(37.0±5.4)ng/L比(36.1±8.2)ng/L,P＜0.01].治疗第8周,缬沙坦+氨氯地平组收缩压变异性的降幅与一氧化氮的升幅有相关性(r =0.401,P=0.025).结论缬沙坦联合氨氯地平或氢氯噻嗪均能降低老年高血压患者血压变异性、改善血管内皮功能,缬沙坦联合氨氯地平可能更适合于老年高血压患者.     

不同剂量缬沙坦联用氨氯地平对原发性高血压患者动脉僵硬度的影响

目的探讨不同剂量缬沙坦联合氨氯地平对原发性高血压患者动脉僵硬度的影响。方法选取2014年10月至2016年1月在郑州市第九人民医院门诊就诊和住院的1～2级原发性高血压患者作为研究对象,随机分为40mg缬沙坦组71例(氨氯地平5mg/d联合缬沙坦40mg/d),80mg缬沙坦组70例(氨氯地平5mg/d联合缬沙坦80mg/d),160mg缬沙坦组72例(氨氯地平5mg/d联合缬沙坦160mg/d),统计分析3组患者治疗前后收缩压、舒张压、心踝血管指数(CAVI)、同型半胱氨酸(Hcy)、高敏C反应蛋白等的变化。结果入组患者年龄(60.1±5.3)岁。治疗24周后40、80mg缬沙坦组Hcy治疗前后差异无统计学意义(P0.05),160mg缬沙坦组治疗后Hcy下降[由(10.43±0.05)降至(5.62±0.04)μmol/L,P0.05]。治疗后3组血压都有所降低[40mg缬沙坦组:收缩压/舒张压下降(17±8)/(6±5)mm Hg;80mg缬沙坦组:下降(18±11)/(6±6)mm Hg;160mg缬沙坦组:下降(19±9)/(7±6)mm Hg],但3组组间收缩压、舒张压下降幅度差异无统计学意义(P0.05)。治疗后3组患者CAVI与治疗前相比减小(P0.05),其中160 mg缬沙坦组经治疗后CAVI低于80和40 mg缬沙坦组(5.20±0.58比7.05±0.03、8.52±0.04,P0.01)。结论钙拮抗剂氨氯地平联合不同剂量的缬沙坦均可改善动脉僵硬度,且大剂量缬沙坦改善动脉僵硬度更明显。     

比索洛尔/氢氯噻嗪复方片治疗轻中度原发性高血压

目的 通过动态血压监测(ABPM)评价国产富马酸比索洛尔/氢氯噻嗪复方片治疗轻中度原发性高血压的降压疗效以及对动脉僵硬度指数(AASI)的影响.方法 单中心、开放的临床研究.经过2周的安慰剂导入期,35例轻、中度原发性高血压患者人选.起始口服富马酸比索洛尔2.5 mg/氢氯噻嗪6.2 mg,1次/d,每次1片;4周后,如诊室坐位舒张压(DBP)≥90 mm Hg,改为口服富马酸比索洛尔5.0 mg/氢氯噻嗪6.2 mg,1次/d,每次1片,前后共治疗8周.观察治疗前后动态血压以及AASI的变化.结果 符合方案病例数30例;12例在4周时增加剂量.动态血压监测显示,治疗8周后和基线相比:(1)24 h平均血压(SBP/DBP)分别下降(12.7±10.1)/(9.2±6.6)mm Hg,差异有非常显著意义(P＜0.01),降压总有效率为83%,日间和夜间的平均血压均明显降低.(2)SBP和DBP下降的T/P比值分别为84%和92%.(3)AASI显著下降[(0.34±0.14)vs(0.42士0.14),P=0.008],多元逐步回归分析表明AASI的下降主要与脉压差的降低有关.(4)不良事件主要包括血尿酸升高,偶有轻度头晕、头痛.结论 (1)国产富马酸比索洛尔/氢氯噻嗪复方片能够有效、平稳地治疗轻、中度原发性高血压,治疗过程中应注意检测尿酸.(2)国产富马酸比索洛尔/氢氯噻嗪复方片显著减低AASI,但该作用产生于降压本身,还是降压药物的类效应尚需进一步研究.     

血压晨峰、动态动脉硬化指数与颈动脉内膜中层厚度相关性分析

目的:探讨血压晨峰、动态动脉硬化指数(AASI)与颈动脉内膜中层厚度(IMT)的相关性。方法:对212例入选高血压病例监测24h动态血压,并行颈动脉超声检查,测量颈总动脉IMT,根据IMT增厚与否分为IMT正常组(84例)和IMT增厚组(128例),计算血压晨峰值及AASI;根据是否存在血压晨峰现象,分为血压晨峰组(120例)和无血压晨峰组(92例),观察血压晨峰、AASI与颈动脉IMT的相关性。结果:与IMT正常组比较,IMT增厚组中AASI[(0.42±0.13)比(0.68±0.14)]及血压晨峰值[(25.94±4.57)mmHg比(36.57±8.41)mmHg]明显升高(P<0.05);与无血压晨峰组比较,血压晨峰组中AASI[(0.43±0.13)比(0.71±0.14)]、IMT[(1.01±0.20)mm比(1.25±0.17)mm]显著增加(P<0.05);直线相关分析结果显示,血压晨峰、AASI与颈动脉IMT呈正相关(r=1.22,0.51,P均<0.05)。结论:血压晨峰和动态动脉硬化指数是颈动脉内膜中层厚度的独立危险因素,且具有预测价值。     

拉西地平和氨氯地平对老年高血压患者臂踝动脉脉搏波传导速度的影响

目的比较拉西地平和氨氯地平改善老年高血压患者动脉弹性功能的作用。方法本研究是一项多中心、随机、对照临床试验,入选60~79岁1~2级原发性高血压老年患者134例,随机分为拉西地平(4mg,1次/d,n=66)和氨氯地平(5mg,1次/d,n=68)组,治疗24周,观察治疗对老年高血压患者脉压和臂踝动脉脉搏波传导速度(baPWV)的影响。结果拉西地平和氨氯地平治疗24周,脉压和baPWV均较基线下降[分别为拉西地平(55.1±8.0)比(68.0±11.0)mm Hg,(18.0±3.3)比(19.3±3.3)m/s;氨氯地平(57.1±9.6)比(67.7±12.9)mm Hg,(17.8±3.3)比(19.0±3.1)m/s;均P0.05],两治疗组间脉压和baPWV比较,差异无统计学意义(P0.05)。结论拉西地平和氨氯地平治疗老年高血压患者24周,都显著降低了患者的脉压和baPWV,两组间差异无统计学意义。     

氢氯噻嗪并缬沙坦对高血压患者疗效、心功能及血清RBP4、Vaspin水平的影响

目的:研究氢氯噻嗪联合缬沙坦对老年原发性高血压(EH)患者的疗效,及其对心功能、血清视黄醇结合蛋白4(RBP4)、内脏脂肪组织来源的丝氨酸蛋白酶抑制剂(Vaspin)水平的影响。方法:选择2014年12月~2015年12月期间在我院进行治疗的148例老年EH患者。按照随机数字表法,患者被随机均分为缬沙坦组和联合治疗组(在缬沙坦组基础上接受氢氯噻嗪治疗)。观察比较两组治疗前后血压、左心室质量(LVM)、左心室质量指数(LVMI)、血清RBP4和Vaspin水平。结果:与缬沙坦组比较,联合治疗组治疗6个月后收缩压[(154.35±11.64)mm Hg比(138.37±12.85)mm Hg]、舒张压[(98.68±9.97)mm Hg比(80.35±8.57)mm Hg]、LVM[(204.75±12.35)g比(198.77±12.64)g]、LVMI[(128.68±6.54)g/m2比(118.35±5.74)g/m2]及血清RBP4水平[(26.56±5.67)g/ml比(24.75±5.36)g/ml]均显著降低,血清Vaspin水平[(10.23±1.10)pg/ml比(12.43±1.12)pg/ml]显著升高,P均0.01。与缬沙坦组比较,联合治疗组总有效率显著升高(64.8%比82.4%,P=0.015)。结论:老年原发性高血压患者应用氢氯噻嗪联合缬沙坦治疗,血压和血清RBP4水平明显下降,Vaspin水平显著升高,值得临床推广。     

缬沙坦氨氯地平片对老年高血压患者血压变异性和血管弹性功能的影响

目的观察缬沙坦氨氯地平片对老年高血压血压变异性和血管弹性功能的影响。方法收集2016年1月至2017年12月接受治疗的老年高血压患者400例为研究对象,根据降压方案分为复方组140例(缬沙坦氨氯地平治疗)、氨氯地平组140例(苯磺酸氨氯地平治疗)和缬沙坦组120例,对比组间临床治疗效果和不良反应情况,观察比较治疗前后患者血压变异性(24 h平均收缩压、24 h平均舒张压、24 h收缩压变异系数、24 h舒张压变异系数)和血管弹性功能[心踝血管指数(CAVI)、大动脉弹性指数(C1)、小动脉弹性指数(C2)、颈股动脉脉搏波传导速度(cfPWV)、肱动脉血流介导的内皮依赖性血管舒张功能(FMD)]的变化。结果与氨氯地平和缬沙坦相比,缬沙坦氨氯地平能降低高血压患者的血压变异性:复方组的24 h平均收缩压[(139.5±6.2)比(145.7±9.3)、(143.3±8.9)mm Hg],24 h平均舒张压[(75.3±6.9)比(81.3±8.6)、(80.2±8.5)mm Hg],24 h收缩压变异系数[(13.1±1.1)%比(15.2±1.9)%、(14.7±2.1)%],24 h舒张压变异系数[(10.4±1.4)%比(11.9±1.3)%、(12.1±1.4)%]低于氨氯地平组和缬沙坦组,缬沙坦氨氯地平能增强血管弹性功能,提升血压控制效果:复方组的C1[(10.2±1.4)比(8.8±2.4)、(9.1±2.3)mL/mm Hg×10],C2[(3.7±0.9)比(3.0±0.7)、(3.1±0.8)mL/mm Hg×10],FMD[(9.7±2.3)%比(7.4±1.3)%、(7.6±1.5)%],血压控制总有效率(95.7%比82.9%、83.3%)高于氨氯地平组和缬沙坦组,CAVI(8.0±0.9比8.6±0.8、8.5±0.8),cfPWV[(10.1±1.1)比(11.7±1.7)、(11.2±1.8)m/s]低于氨氯地平组和缬沙坦组(均P0.05)。结论缬沙坦氨氯地平片能够较为有效地控制老年高血压患者血压变异性,改善血管弹性功能。     

美托洛尔合用依那普利对新发青年高血压的疗效

目的 利用动态血压检测评价酒石酸美托洛尔合用马来酸依那普利治疗青年新发高血压的疗效.方法 78例入选患者服用酒石酸美托洛尔12.5 mg,每日2次,马来酸依那普利5 mg,每日1次,并逐渐加量至诊室血压达标或最大量美托洛尔150 mg/d、马来酸依那普利20 mg/d,服用3周.治疗前、后进行动态血压检测.结果 治疗前24 h平均SBP为（162.4±9.8）mm Hg,DBP为（94.2±7.5）mm Hg,治疗后SBP为（128.3±5.8）mm Hg,DBP为（73.2±6.1）mm Hg,均显著降低（P＜0.01）,夜间血压下降率明显增加（P＜0.01）,总有效率97.43%.结论 对新发青年高血压,酒石酸美托洛尔联合马来酸依那普利能达到24 h平稳降压.     

原发性高血压合并糖调节受损患者应用缬沙坦的短期干预效果观察

目的研究缬沙坦对原发性高血压合并糖调节受损的短期干预效果。方法选取我院2010年6月~2014年1月收治的高血压合并糖调节受损患者94例作为研究对象,测定其尿微量蛋白水平,给予患者缬沙坦80 mg/d,治疗8周后观察血压相关指标、尿白蛋白、微量白蛋白尿排泄率及用药安全性。结果治疗后患者收缩压、舒张压、脉压、尿白蛋白排泄率、微量白蛋白分别为(141.31±8.94)mm Hg、(87.03±8.51)mm Hg、(53.31±3.84)mm Hg、(22.64±9.26)μg/min、(15.68±4.67)mg/24 h;治疗前分别为(149.33±10.41)mm Hg、(94.06±9.25)mm Hg、(60.14±5.31)mm Hg、(30.14±9.11)μg/min、(40.35±2.84)mg/24 h,差异有统计学意义(P0.05)。餐后2 h血糖治疗后为(6.64±1.27)mmol/L较治疗前(9.11±2.31)mmol/L显著较低,差异有统计学意义(P0.05),甘油三酯(TG)、总胆固醇、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)治疗前后比较,差异无统计学意义(P0.05)。患者不良反应均可耐受,可自行缓解。结论原发性高血压合并糖调节受损患者大多存在明显肾损害,缬沙坦可显著改善机体糖代谢异常,提高血压控制率,并可降低微量蛋白尿水平,具有较高的临床应用价值。     

缬沙坦联合氨氯地平治疗原发性高血压的临床疗效及安全性

目的探讨原发性高血压患者服用缬沙坦联合氨氯地平的临床治疗效果与服药安全性。方法选择2013年7月~2014年12月于西城区大栅栏社区卫生服务中心就诊的原发性高血压患者120例,男性66例,女性54例,年龄33~82岁。所有患者根据随机原则分为两组,观察组(60例)口服氨氯地平5 mg/d加缬沙坦80 mg/d;对照组(60例)口服氨氯地平5 mg/d,1/日,连续服用4个月。治疗前后测量血压并进行疗效评价。随访记录不良反应情况。结果两组治疗4个月后收缩压和舒张压均较治疗前下降,差异有统计学意义(P均0.05)。与对照组治疗后比较,观察组收缩压和舒张压均下降,数值为[(137.1±16.7)mm Hg vs.(126.7±12.3)mm Hg],[(93.5±10.5)mm Hg vs.(80.4±9.8)mm Hg],差异有统计学意义(P均0.05)。两组患者治疗4个月后,观察组患者总有效率高于对照组(95%vs.70%),差异具有统计学意义(P0.05)。两组患者的不良反应发生情况比较,差异无统计学意义(P0.05)。结论缬沙坦联合氨氯地平治疗原发性高血压较单用氨氯地平可以更有效控制血压,不良反应少,安全性高,值得临床推广使用。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

N-acetyl-L-cysteine combined with mesalamine in the treatment of ulcerative colitis： Randomized,placebo-controlled pilot study

AIM： To evaluate the effectiveness and safety of oral N-acetyl-L-cysteine （NAC） co-administration with mesalamine in ulcerative colitis （UC） patients.
METHODS： Thirty seven patients with mild to moderate UC were randomized to receive a four-wk course of oral mesalamine （2.4 g/d） plus N-acetyl-L-cysteine （0.8 g/d） （group A） or mesalamine plus placebo （group B）. Patients were monitored using the Modified Truelove-Witts Severity Index （MTWSI）. The primary endpoint was clinical remission （MTWSI ≤ 2） at 4 wk. Secondary endpoints were clinical response （defined as a reduction from baseline in the MTWSI of ≥ 2 points） and drug safety. The serum TNF-α, interleukin-6, interleukin-8 and MCP-1 were evaluated at baseline and at 4 wk of treatment. RESULTS： Analysis per-protocol criteria showed clinical remission rates of 63% and 50% after 4 wk treatment with mesalamine plus N-acetyl-L-cysteine （group A） and mesalamine plus placebo （group B） respectively （OR = 1.71; 95% CI： 0.46 to 6.36; P = 0.19; NNT = 7.7）. Analysis of variance （ANOVA） of data indicated a significant reduction of MTWSI in group A （P = 0.046） with respect to basal condition without significant changes in the group B （P = 0.735） during treatment. Clinical responses were 66% （group A） vs 44% （group B） after 4 wk of treatment （OR = 2.5; 95% CI： 0.64 to 9.65; P = 0.11; NNT = 4.5）. Clinical improvement in group A correlated with a decrease of IL-8 and MCP-1. Rates of adverse events did not differ significantly between both groups.
CONCLUSION： In group A （oral NAC combined with mesalamine） contrarily to group B （mesalamine alone）, the clinical improvement correlates with a decrease of chemokines such as MCP-1 and IL-8. NAC addition not produced any side effects.     

Delorme's transrectal excision for internal rectal prolapse

Surgical therapy of functional outlet obstruction in patients with internal rectal intussusception may include abdominal, perineal, or transrectal procedures. Because abdominal procedures often result in significant physiologic impact but unrelieved constipation, the authors have elected Delorme's transrectal excision for management of these patients. Since a short-term placebo effect attends many therapies, this report describes results of transrectal excision only after a threeyear postoperative period. Delorme's transrectal excision of internal intussusception accomplished sustained symptomatic relief in over 70 percent of otherwise refractory constipated patients. The association of internal intussusception with other abnormalities underscores the importance of defining both anatomic and functional components when selecting patients whose constipation may require surgical therapy. Critical technical elements, surgical pitfalls, and potential complications of the procedure are discussed.Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, Toronto, Canada, June 11 to 16, 1989.     

The oral glucose tolerance test: A comparison of the time points on the basis of limit values,normal dispersion,and reproducibility

Summary Time points in the glucose tolerance test (GTT) are compared on the basis of limit values, dispersion within a reference population, and reproducibility. We suggest using the distance between a limit value and the median reference value as a measure of the magnitude of abnormality. The distance between 140 mg/100 ml and the median fasting plasma glucose value is chosen as a standard distance and limits for other points in the GTT are calculated to equal this standard distance of abnormality. We suggest that the probability of correctly interpreting an inividual result is directly related to the reproducibility of the test and inversely related to the percentage of the total range of values which is dispersed among the normal population. The ratio of reproducibility to percentage normal dispersion is proposed as an index of the probability of correctly interpreting an individual result. According to this index, the probability of correct interpretation varies in order: fasting plasma glucose concentration>3-h>2-h>0.5-h>1-h plasma glucose concentration.