港航企业离退休中老年人心血管危险因素分析

目的了解海口港航企业离退休人员高血压、高血糖、血脂异常等心血管危险因素的患病率和聚集率,为企业离退休人员心血管疾病的预防和控制提供依据。方法对2009年9—12月海口某港航企业1023例50岁以上离退休中老年人健康检查的数据进行统计分析。结果 1023例中高血压患病率为51.12%,男女性别间差异无统计学意义;高血糖患病率为19.55%,男女性别间差异无统计学意义;血脂异常患病率为36.66%,男女性别间差异有统计学意义;心血管危险因素聚集率为51.61%,男女性别间差异有统计学意义。高血压、高血糖患病率和心血管危险因素聚集率随年龄增高而增加,血脂异常患病率各年龄组间差异无统计学意义。结论中老年人中不仅高血压,高血糖、血脂异常患病率高,心血管危险因素聚集率也在增加,因此,对心血管疾病防治应采取降血压,降血糖、调血脂、纠正不良生活方式等多种办法相结合的综合防治措施。     

高血糖对老年急性ST段抬高心肌梗死患者预后的影响

目的探讨入院时血糖水平对老年急性ST段抬高心肌梗死(STEMI)患者预后的影响。方法检测186例老年急性STEMI患者入院时的随机血糖,根据血糖水平分为A、B、C三组。A组血糖≤7.7 mmol/L,B组血糖7.8～10.9mmol/L,C组血糖≥11.0 mmol/L。结果①C组心功能Killip分级≥2级者明显高于A、B组(分别为44.6%比23.5%、29.5%,p<0.01)。②C组住院期间死亡率明显高于A、B组(分别为8.9%比4.4%、4.8%,p<0.05)。结论合并高血糖的老年急性STEMI患者心功能及预后均较差。     

Suppressive effect of short-interfering RNA on hyperglycemia-induced expression of intercellular adhesion molecule-1 on cultured vascular endothelial cells

PURPOSE: The pathology of diabetic retinopathy involves endothelial dysfunction, in which leukocyte adhesion to the vascular endothelium via intercellular adhesion molecule-1 (ICAM-1) may play a key role. Short-interfering RNAs (siRNAs) are unique modulators of gene expression in mammalian cells. The purpose of this study was to evaluate the enhanced effect of hyperglycemia and the attenuating effect of siRNAs on ICAM-1 expression in cultured endothelial cells. METHODS: Human umbilical vein endothelial cells (HUVECs) were seeded onto 24-well culture plates. The following day, ICAM-1-specific siRNAs were transfected using Lipofectamine 2000. Glucose (15, 30, or 45 mM) or interleukin-1ss as a positive control was added to the medium to stimulate ICAM-1. After 48 hours, the HUVECs were collected to measure the ICAM-1 expression by enzyme-linked immunosolvent assay. Fluoresceinated siRNAs were transfected into HUVECs to confirm transfection of the siRNAs into HUVECs by fluorescein microscopy. RESULTS: Glucose enhanced the ICAM-1 expression in a dose-dependent manner. ICAM-1 expression stimulated by hyperglycemia decreased significantly in the HUVECs transfected with corresponding siRNAs. Transfection of siRNAs was confirmed with enhanced fluorescence in HUVECs incubated with control siRNAs. CONCLUSIONS: These results suggested that hyperglycemia stimulated protein expression of ICAM-1 and that siRNAs suppressed gene expression of ICAM-1 in HUVECs. The RNA-targeting approach using siRNAs may provide a novel therapeutic option for diabetic retinopathy.     

Manejo de la hiperglucemia con fármacos no insulínicos en pacientes adultos con diabetes tipo 2

Treatment of diabetes mellitus type 2 (DM2) includes healthy eating and exercise (150 minutes/week) as basic pillars. For pharmacological treatment, metformin is the initial drug except contraindication or intolerance; in case of poor control, 8 therapeutic families are available (6 oral and 2 injectable) as possible combinations. An algorithm and some recommendations for the treatment of DM2 are presented. In secondary cardiovascular prevention, it is recommended to associate an inhibitor of the sodium-glucose cotransporter type 2 (iSGLT2) or a glucagon-like peptide-1 receptor agonist (arGLP1) in patients with obesity. In primary prevention if the patient is obese or overweight metformin should be combined with iSGLT2, arGLP1, or inhibitors of type 4 dipeptidylpeptidase (iDPP4). If the patient does not present obesity, iDPP4, iSGLT2 or gliclazide, sulfonylurea, recommended due to its lower tendency to hypoglycaemia, may be used.     

Alcohol consumption and impaired glycoregulation results in a population of 6665 salaried employees

Alcohol consumption and glycosuria were found to be associated (p < 0.001) in a population of 6571 salaried employees who underwent a systematic examination. The prevalence of glycosuria was found to range from 1.3% among 2609 non-drinkers to 5% among 816 heavy drinkers (six glasses or more of alcoholic beverage daily). This association was still significant after adjustement for age, sex and body mass index. Similarly, a positive association was observed between fasting glycemia and alcoholic intake in a subgroup of 998 subjects when such a result was available (p < 0.05).     

血糖控制优化方案在肝胆外科术后应激性高血糖病人中的应用

目的 探讨血糖控制优化方案(BGCOP)在肝胆外科术后应激性高血糖(SHG)病人中的应用效果。 方法 采用简单化随机分组法将2015年1—12月山东大学齐鲁医院86名符合条件的肝胆外科病人分为试验组(43例)和对照组(43例)。试验组采取BGCOP控制血糖,对照组采取常规胰岛素强化治疗方案(CIIT)控制血糖。比较术后两组病人的血糖控制效果、不良反应发生率和并发症发生率。 结果 两组病人的一般资料在年龄、体质指数(BMI)、急性生理与慢性健康评分(APACHE)等方面差异无统计学意义(P＞0.05),对后续研究没有影响。试验组采取BGCOP方案后血糖控制到目标值的时间为(4.54±1.51)h,对照组采用CIIT方案后血糖控制到目标值的时间为(8.54±2.68)h,试验组采用BGCOP方案后血糖控制到目标值的时间明显低于对照组,高血糖指数(0.86±0.24)也明显低于对照组(1.97±0.94),差异有统计学意义(t=8.724,t=7.895,P＜0.001);试验组病人50%葡萄糖救援、低血糖、严重低血糖发生率明显低于对照组,均差异有统计学意义(P＜0.05);两组病人发生高渗性昏迷的比率差异无统计学意义(P＞0.05);试验组病人发生肺部感染、腹部感染和切口感染的比率明显低于对照组病人,差异有统计学意义(P＜0.05)。 结论 与CIIT相比,BGCOP方案能更有效地控制肝胆外科术后SHG病人的血糖水平。     

老年Ⅱ型糖尿病患者血清C反应蛋白与血糖相关性分析

目的 :考察老年Ⅱ型糖尿病 (NIDDM)患者血清C 反应蛋白水平及其与血糖水平的相关性。方法 :选取老年NIDDM患者 183例 ,其中病史 5年以上血糖控制良好、无并发症且无感染性疾病者 97例 ;初次确诊、血糖控制不良者 86例 ,其中无感染性疾病者 5 0例 ,有急性腹泻或尿路感染者 36例。未患NIDDM者 70人作为对照组 ,其中 35人为健康体检者 ,另 35人为有发热性疾病、有症状的感染或慢性感染性疾病患者。测定空腹血糖和C 反应蛋白浓度。结果 :老年NID DM患者血清C 反应蛋白水平显著升高 ,结论 :高血糖可能是血清C 反应蛋白水平增高的相关因素。     

胰岛素泵治疗2型糖尿病高血糖状态的疗效分析

目的总结并分析采用连续皮下胰岛素输注方法强化治疗2型糖尿病高血糖状态的疗效以及剂量。方法216例血糖控制差的住院2型糖尿病患者,给予胰岛素泵强化治疗,疗程8d,不合用其他口服降糖药,观察达到满意血糖控制（FPG〈7mmol／L,2hPG〈10mmol／L）的天数以及胰岛素泵的基础量和餐前大剂量,并分析与上述指标相关的因素。结果血糖达满意控制的平均天数为（5．4±1．8）d,日基础量为（0．23±0．07）U／kg,早餐前大剂量为（0．12±0．05）U／kg,午餐前大剂量为（0．14±0．06）U／kg,晚餐前大剂量为（0．14±0．06）U／kg,在血糖满意控制后,胰岛素用量显著减少。发生低血糖症（0．04±0．21）次／人,生化低血糖（0．07±0．25）次／人,低血糖反应（0．96±1．18）次／人。结论经过胰岛素泵的强化治疗,T2DM的高血糖状态可在5—6d得以纠正。经多元回归分析,影响达目标血糖时间的因素为FPG和年龄,影响胰岛素用量的因素为糖尿病的病程、治疗前FPG和2hPG。     

脂肪肝450例患者发病相关因素的分析

目的 探讨河南大学教职工脂肪肝发病以及血脂、血糖、年龄、性别和肥胖的关系。方法 依据2007年健康检查诊断的脂肪肝为样本,分别对其血脂、血糖和体重进行检测并作统计分析。结果 在450例脂肪肝患者中有男性318例（24．9％）,女性132例（13．0％）,发现245例甘油三酯偏高（54．4％）,189例超重或肥胖（42．0％）。结论 脂肪肝发病与高血脂症、及肥胖关系密切,40～60岁为高发年龄,男性明显高于女性。与饮酒、运动少、应酬多等生活习惯也有一定关系。     

非糖尿病患者的高血糖状态对ST段抬高型心肌梗死预后的预测作用

目的验证非糖尿病的ST段抬高型心肌梗死（STEMI）患者的血糖升高是否有助于短期预后评估。方法回顾性分析270例非糖尿病的ST段抬高型心肌梗死患者的临床资料,根据发病后是否发生高血糖分为血糖升高组和血糖正常组,前者根据血糖升高程度和持续时间分别再分为血糖轻中等程度升高、显著升高亚组,以及一过性血糖升高、血糖持续升高亚组。分别比较组间、亚组间以及组-亚组间短期病死率和发生恶性心律失常比例的差别。结果血糖升高组短期病死率高于血糖正常组。血糖显著升高亚组病死率和恶性心律失常发生率高于血糖轻中等程度升高亚组及血糖正常组。血糖持续性升高亚组病死率和恶性心律失常发生率高于血糖一过性升高亚组及血糖正常组。结论对非糖尿病的ST段抬高型心肌梗死患者,高血糖和患者短期预后有关。血糖升高水平越高,持续时间越久,预后越差。