糖尿病患者颈动脉彩色多普勒超声检测与血脂的关系分析

目的:探讨糖尿病患者血脂的改变与颈动脉血管并发症的关系。方法:糖尿病患者150例为糖尿病组,年龄60~89岁。106例同期健康体检者为对照组,年龄60~88岁。受试者均测定空腹血压、血糖、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、极低密度脂蛋白(VLDL)、载脂蛋白AI(Apo AI)和载脂蛋白B(ApoB),同时行彩色多普勒颈动脉超声检查。结果:①糖尿病组血糖、TC、TG、VLDL、ApoB[(176.81±58.63)mg/dl、(202.67±42.26)mg/dl、(206.56±145.52)mg/dl、(33.32±32.47)mg/dl、(99.30±34.20)mg/dl]水平明显高于对照组[(125.45±1.58)mg/dl、(176.10±47.17)mg/dl、(116.5±60.43)mg/dl、(22.04±11.44)mg/dl、(80.5±22.7)mg/dl],两组比较差异有显著性(P<0.05)。糖尿病组纤维蛋白原为(4.675±1.643)g/L。对照组为(3.238±1.065)g/L,糖尿病组纤维蛋白明显高于对照组(P<0.01)。②糖尿病患者的颈动脉超声显示颈动脉血管壁回声不均匀,内中膜增厚,可有多支血管斑块形成及不同程度的狭窄。结论:脂代谢异常是血管并发症形成的危险因素,颈动脉粥样硬化斑块是糖尿病患者早期主要血管病变表现之一,颈动脉超声能及早提示糖尿病患者的血管病变程度,为治疗和预防提供依据。     

糖尿病合并高血压患者降压用药情况调查分析

目的:了解糖尿病伴高血压住院患者常用降压药物的种类和降压治疗方案. 方法:分析我院2003-01/2005-08住院确诊为糖尿病伴高血压共373例患者的用药情况,按患者住院科室分组:内分泌科为A组(211例),其他科室为B组(162例),统计分析降压药物的使用及治疗方案. 结果:A,B组患者血管紧张素转换酶抑制剂(ACEI)使用率分别是24.0%和20.7%(P＞0.05);血管紧张素Ⅱ受体阻断药(ARBs)使用率分别是22.8%和20.7%(P＞0.05);利尿剂使用率分别是26.0%和12.3%(P＜0.01);钙拮抗剂(CCB)使用率分别是20.9%和23.7%(P＞0.05);β受体阻断药使用率分别是6.4%和21.5%(P＜0.01);α受体阻断药使用率分别是0.0%和1.1%. 另外,A,B组患者单一药物使用率约5.2%和7.4%,绝大部分患者降压治疗为两种药物及两种药物以上联用降压(94.8%,92.6%). 结论:我院糖尿病合并高血压住院患者降压药物应用种类基本符合JNC-Ⅶ高血压治疗指南. 内分泌科的降压方案比其他科室显得更为合理,尤其是在利尿剂和β受体阻断药的使用上.     

肝源性糖尿病发病机制的探讨

目的 探讨肝源性糖尿病的发病机制.方法 对135例肝硬化患者分别进行空腹血糖、餐后2h血糖、血清空腹胰岛素、谷氨酸脱羧酶抗体、胰岛素释放指数及胰岛素敏感指数测定,并进行比较分析.结果 肝硬化肝源性糖尿病的发生率为39.3%(53/135),其中,丙型肝炎后肝硬化肝源性糖尿病发生率53.3%(16/30),较乙型肝炎后肝硬化(37.1%,26/70)和酒精性肝硬化(31.4%,11/35)明显升高,差异有统计学意义(P＜0.01).肝源性糖尿病患者空腹胰岛素、胰岛素释放指数、谷氨酸脱羧酶抗体阳性率均显著高于健康体检者(P＜0.01),而胰岛索敏感指数显著低于健康体检者(P＜0.01).结论 肝源性糖尿病的发生与肝硬化病因有关.除肝功能损害、胰岛素抵抗、病毒感染、免疫功能紊乱等导致胰岛β细胞功能的损伤外,胰岛素分泌相对或绝对缺乏亦是肝源性糖尿病发生的重要影响因素.     

53例高渗性非酮症糖尿病昏迷临床分析

目的：探讨高渗性非酮症糖尿病治疗方法。方法：对53例糖尿病患者诊断和治疗进行分析。结果：收治的53例患者，13例死亡，其中5例死于合并脑血管疾病。结论：高渗性非酮症糖尿病早期诊断，早期治疗可降低病死率。     

胰岛素经眼吸收后对正常和四氧嘧啶致糖尿病模型家兔的降血糖作用

 国产胰岛素（生化提取法）经眼吸收后能有效地降低正常和四氧嘧啶糖尿病模型家兔血糖。研究结果表明，胰岛素经眼给药后，能有效地降低两者的血糖浓度。用１％ＥＤＴＡ溶液为吸收促进剂，给正常家兔０．５％和１．０％胰岛素５０ｕｌ后，在１５ｍｉｎ即能发挥作用，维持低血糖状态５ｈ以上。给予糖尿病模型家兔１％和２％胰岛素５０ｕｌ后，在３０ｍｉｎ起效，可使血糖降至常范围内，药物疗效维持５ｈ以上。不加１％ＥＤＴＡ溶液的胰岛素作用明显减小。在０．５％～２．０％的剂量范围内吸收不存在饱和现象，而作用效果存在着浓度依赖性。     

银杏叶提取物对糖尿病大鼠血糖代谢的影响

目的:研究银杏叶提取物(EGb)对糖尿病大鼠血糖、胰岛素、内皮素的影响.方法:用链脲佐菌素制备SD大鼠糖尿病模型.观察EGb治疗前后糖尿病大鼠血清葡萄糖、血清胰岛素、血浆内皮素的水平.结果:经EGb治疗后,糖尿病大鼠血糖下降(P<0.05),血清胰岛素升高(P<0.05),内皮素水平亦见下降(P>0.05).结论:EGb对糖尿病有一定的治疗作用,其作用可能与EGb促进胰岛β细胞分泌胰岛素增多有关.     

Intradermal Injection of Transforming Growth Factor-β1 Gene Enhances Wound Healing in Genetically Diabetic Mice

Purpose. To evaluate the biologic effect of direct cutaneous TGF-1 gene delivery on impaired wound healing models using genetically diabetic mice. Methods. Diabetic mice (C57BKS.Cg-m +/+ Leprdb female mice) with 1 cm × 1 cm excisional wounds were intradermally injected with 60 g of plasmid DNA encoding TGF-1 gene. The wound closure was measured up to 14 days postwounding. At days 7 and 14 postwounding, sections of skin were taken for hematoxylin and eosin and Masson's trichome staining to examine the morphology and collagen deposition. The cell proliferation and TGF-1 gene expression were studied using immunohistochemical stainings for 5-bromo-2-deoxy-uridine and for TGF-1. Results. A higher cell proliferation rate and a denser and more organized new extracellular matrix were observed in the treated wound site. Complete wound closure was detected as early as 7 days for TGF-1-treated group in comparison with 11-14 days for the untreated, control plasmid DNA- and PBS-treated groups. Conclusion. A single intradermal injection of TGF-1 plasmid DNA was sufficient to enhance wound healing. This approach represents a new strategy that may be applied to the treatment of excisional wounds in human diabetic patients.     

Plasma calcium and phosphate levels in an adult noninsulin-dependent diabetic population

Summary Duplicate or triplicate measurements of fasting plasma glucose, calcium (Ca), phosphate (Pi), and glycosylated hemoglobins were performed on a group of non-insulin dependent diabetic patients and controls at 3–6 month intervals. In the diabetic group (48 males and 44 females), 18 were on diet only, 21 on diet and oral hypoglycemic treatment, and 51 on diet and insulin. These were a total of 217 measurements for each parameter. Results were compared to 416 measurements obtained from sex and age-matched controls. Plasma Ca levels were higher in the diabetic group (2.48±0.004 vs 2.38±0.006 mmol/liter)P<0.001; plasma Pi levels were similar to those of controls. The difference in plasma Ca was not influenced by age, sex, or mode of treatment. No correlation was found in the three treatment groups between plasma Ca and duration of diabetes nor with patients' weights. The results are consistent with the view that an alteration in calcium homeostasis accompanies the diabetic state.     

The level at which blood pressure should be treated

Summary The large multicenter trials of treatment in mild to moderate hypertension have shown unequivocally that the risk of stroke is reversed. The impact of treatment on ischemic heart disease is more debatable. Since there is no discontinuity in the risk of different levels of blood pressure, any advice about the level of pressure to treat must be arbitrary. The British Hypertension Society Guidelines recommend a sustained diastolic pressure of 100 mmHg or more over a 3- to 4-month period. This empirical advice is based upon subgroup analysis of the MRC and Australian Therapeutic Trials that suggests most of the benefit in treating the mildest degrees of hypertension occur in this group of patients. The role of newer classes of agent, such as ACE inhibitors or calcium-channel blockers, cannot be fully assessed in the absence of proper end-point trials. Whilst reasons for using these agents as first-line therapy have been put forward, these remain speculative in the absence of such trials. The much greater cost of newer agents in the context of universally cost-constrained health services also has to be horne in mind before recommending their widespread use as first-line therapy.     

猫爪草胶囊治疗糖尿病并颈淋巴结结核临床分析

目的 :分析猫爪草胶囊治疗糖尿病并颈淋巴结结核的治疗效果及安全性。方法 :46例 2型糖尿病并颈淋巴结结核患者随机分成两组 ,对照组采用 2HRZ/4HR方案 ,治疗组在 2HRZ/4HR方案基础上加用猫爪草胶囊 ,观察期 6个月。结果 :治疗组 3个月临床治愈率明显高于对照组 (P <0 0 5 ) ,与对照组 6个月治愈率接近。无不良反应。结论 :猫爪草胶囊能缩短治疗疗程 ,改善治疗效果 ,是一种治疗糖尿病并颈淋巴结结核安全有效的方法。