大肠癌肠道外少见表现5例报告

在临床上大肠癌常以大便习惯性改变、腹痛、腹块和肠梗阻等症状就医,然而,少数患者却以罕见症象为首发,给临床诊治带来困难,极易导致错误诊治。分析我们两院近数年来诊治928例大肠癌中,有5例     

2型糖尿病患者餐后血脂影响因素研究

目的探讨2型DM患者餐后脂代谢异常的影响因素。方法30例2型DM患者正常饮食下测定早餐前后及中餐前后血脂、血糖、C-肽，对可能影响2型DM患者餐后脂代谢异常的因素进行分析。结果早、中餐后TG、C-肽水平均较餐前明显升高（P〈0．001），HDL—C水平较餐前有所降低（P〈0．001）；早餐前后PC升高水平明显大于中餐前后PG变化（P〈0．05），TG水平升高则略低于中餐前后（P〈0．001），HDL—C变化不大，但早餐后TC、LDL—C较餐前降低，而中餐后TC、LDL—C较餐前升高，两者差异有显著性（P〈0．001）。结论2型DM患者存在明显的餐后脂代谢紊乱，饮食中脂肪、碳水化合物比例不同会导致餐后血糖、血脂及C-肽水平的不同变化。     

The effect of repaglinide on blood glucose and islet β-cell function in newly diagnosed type 2 diabetic patients

Objective To explore the effect of repaglinide intensive treatment on islet β-cell function and long-term control of blood glucose in newly diagnosed type 2 diabetic patients. Methods Self-control and inter-group control prospective study was conducted in 80 newly diagnosed type 2 diabetic patients who were treated with short-term repaglinide intensive treatment and islet β-cell function was assessed by 75 g oral glucose tolerance test (OGTT) before and after repaglinide treatment. The changes of △I30/△G30 ratio, blood lipid, HOMA A and HOMA B were examined. Results After treatment, in successful group, middle group and defeat group, the fasting plasma glucose levels were decreased from 8.9±1.5, 8.6±1.6,9.0±2.0 to 5.0±1.4,6.3±0. 7,6.5±0. 9 mmol/L, 0. 5 h postprandial glucose levels were decreased from (12.6±1.6, 12.6±1.5, 12.4±1.3 to 8.4±1.0, 6.8±0. 7, 8. 6±0. 9)mmol/L,and 2 h postprandial glucose levels were decreased from (13.0±1.2, 13. 1±1.3, 13. 3±1.4 to 9.2±0.9, 6.6±0. 7, 9.2±0. 9)mmol/L,respectively (all P <0. 005). The ratio of △I30/△G30 was increased froml. 69±0. 31, 1.72±0. 33, 1.79±0. 36 to 4. 47±0. 62, 4. 42±0.46,12. 00±0.46 in the three groups, respectively (P<0.05). HOMA B was significantly improved (P<0. 05), while triglycerides and HOMA A were decreased(P<0. 05). The levels of fasting blood glucose and postprandial blood glucose in 21 patients were maintained within normal range for more than six months. There were significant differences in the ratio of △I30/△G30, age, repaglinide dosage and the time of reaching target of glucose [4.47±0.62 vs. 2. 0± 0.46; 39±8 vs. 56±9; 2.0±1.5 vs. 5.0±2.5; 32.4±8.0 vs. 53.3±7.6; all P<0.05] between successful group and defeat group. Conclusions The short-term intensive treatment with repaglinide can significantly improve the early secretion phase of insulin and the islet β-cell function, reconstruct of the physiological model of insulin secretion and relieve the disease.     

The effect of repaglinide on blood glucose and islet β-cell function in newly diagnosed type 2 diabetic patients

Objective To explore the effect of repaglinide intensive treatment on islet β-cell function and long-term control of blood glucose in newly diagnosed type 2 diabetic patients. Methods Self-control and inter-group control prospective study was conducted in 80 newly diagnosed type 2 diabetic patients who were treated with short-term repaglinide intensive treatment and islet β-cell function was assessed by 75 g oral glucose tolerance test (OGTT) before and after repaglinide treatment. The changes of △I30/△G30 ratio, blood lipid, HOMA A and HOMA B were examined. Results After treatment, in successful group, middle group and defeat group, the fasting plasma glucose levels were decreased from 8.9±1.5, 8.6±1.6,9.0±2.0 to 5.0±1.4,6.3±0. 7,6.5±0. 9 mmol/L, 0. 5 h postprandial glucose levels were decreased from (12.6±1.6, 12.6±1.5, 12.4±1.3 to 8.4±1.0, 6.8±0. 7, 8. 6±0. 9)mmol/L,and 2 h postprandial glucose levels were decreased from (13.0±1.2, 13. 1±1.3, 13. 3±1.4 to 9.2±0.9, 6.6±0. 7, 9.2±0. 9)mmol/L,respectively (all P <0. 005). The ratio of △I30/△G30 was increased froml. 69±0. 31, 1.72±0. 33, 1.79±0. 36 to 4. 47±0. 62, 4. 42±0.46,12. 00±0.46 in the three groups, respectively (P<0.05). HOMA B was significantly improved (P<0. 05), while triglycerides and HOMA A were decreased(P<0. 05). The levels of fasting blood glucose and postprandial blood glucose in 21 patients were maintained within normal range for more than six months. There were significant differences in the ratio of △I30/△G30, age, repaglinide dosage and the time of reaching target of glucose [4.47±0.62 vs. 2. 0± 0.46; 39±8 vs. 56±9; 2.0±1.5 vs. 5.0±2.5; 32.4±8.0 vs. 53.3±7.6; all P<0.05] between successful group and defeat group. Conclusions The short-term intensive treatment with repaglinide can significantly improve the early secretion phase of insulin and the islet β-cell function, reconstruct of the physiological model of insulin secretion and relieve the disease.     

乳腺癌病人甲状腺变化的初步探讨

乳腺癌病人甲状腺变化的初步探讨王怡淳，张筱骅温州市第二人民医院（３２５００）乳癌病人血清中甲状腺激素水平紊乱已引起一些学者关注。但其甲状腺的变化报导甚少。本文就乳腺癌病人的甲状腺变化及与乳腺癌病期关系作初步探讨。临床资料一、观察对象及方法：为１９８５...     

T3测定对胃溃疡性病变的临床实用意义

 晚期恶性肿瘤患者的血清中甲状腺激素异常已引起了临床工作者注意。但有关与胃溃疡性病变的关系尚未见报道。本文通过对胃良性溃疡、恶性溃疡患者血清甲状腺激素水平观察，试图评价其对这类疾病的临床实用意义。     

甘精胰岛素加三餐前短效胰岛素和胰岛素泵短期强化治疗对2型糖尿病疗效比较

目的探讨甘精胰岛素联合三餐前短效胰岛素和胰岛素泵治疗对口服降糖药效果不佳的2型糖尿病的疗效、安全性及性价比。方法60例T2DM患者分为甘精胰岛素注射（甘精组）和胰岛素泵（CSII组）,两组的年龄、BMI、FDP、FPG、2hC-P、2hPG、HbA1C差异无统计学意义（P〉O．05）。结果甘精组和CSII组治疗均有效,FPG、2hPG均较治疗前明显下降,FC-P、2hC-P均较治疗前明显升高（P〈0．05）。两组达到相同血糖水平所需的治疗时间以及低血糖发生率无统计学差异（P〉O．05）,但甘精组的胰岛素用量明显低于CSII组（P〈0．05）。结论甘精胰岛素配合三餐前短效胰岛素能有效模拟人生理胰岛素分泌,有效控制高血糖,且效价比高于胰岛素泵。     

The effect of repaglinide on blood glucose and islet β-cell function in newly diagnosed type 2 diabetic patients

Objective To explore the effect of repaglinide intensive treatment on islet β-cell function and long-term control of blood glucose in newly diagnosed type 2 diabetic patients. Methods Self-control and inter-group control prospective study was conducted in 80 newly diagnosed type 2 diabetic patients who were treated with short-term repaglinide intensive treatment and islet β-cell function was assessed by 75 g oral glucose tolerance test (OGTT) before and after repaglinide treatment. The changes of △I30/△G30 ratio, blood lipid, HOMA A and HOMA B were examined. Results After treatment, in successful group, middle group and defeat group, the fasting plasma glucose levels were decreased from 8.9±1.5, 8.6±1.6,9.0±2.0 to 5.0±1.4,6.3±0. 7,6.5±0. 9 mmol/L, 0. 5 h postprandial glucose levels were decreased from (12.6±1.6, 12.6±1.5, 12.4±1.3 to 8.4±1.0, 6.8±0. 7, 8. 6±0. 9)mmol/L,and 2 h postprandial glucose levels were decreased from (13.0±1.2, 13. 1±1.3, 13. 3±1.4 to 9.2±0.9, 6.6±0. 7, 9.2±0. 9)mmol/L,respectively (all P <0. 005). The ratio of △I30/△G30 was increased froml. 69±0. 31, 1.72±0. 33, 1.79±0. 36 to 4. 47±0. 62, 4. 42±0.46,12. 00±0.46 in the three groups, respectively (P<0.05). HOMA B was significantly improved (P<0. 05), while triglycerides and HOMA A were decreased(P<0. 05). The levels of fasting blood glucose and postprandial blood glucose in 21 patients were maintained within normal range for more than six months. There were significant differences in the ratio of △I30/△G30, age, repaglinide dosage and the time of reaching target of glucose [4.47±0.62 vs. 2. 0± 0.46; 39±8 vs. 56±9; 2.0±1.5 vs. 5.0±2.5; 32.4±8.0 vs. 53.3±7.6; all P<0.05] between successful group and defeat group. Conclusions The short-term intensive treatment with repaglinide can significantly improve the early secretion phase of insulin and the islet β-cell function, reconstruct of the physiological model of insulin secretion and relieve the disease.     

糖尿病并发脑神经病变临床分析

糖尿病并发脑神经病变临床上较少见,文献报道亦不多。近7年来,我院收住糖尿病患者833例,其中并发脑神经病变15例,并发率为1.8％(15/833),现总结分析如下。1 临床资料1.1 一般资料 本组15例,男7例,女8例,年龄41～79岁,平均57.7岁。依据1997年全国糖尿病研究专题会议诊断标准,均可诊为糖尿病Ⅱ型。15例患者空腹血糖10.5—47.23mmol/L,平均16.4mmol/L,尿糖+～(?);2例首发以面神经麻痹就诊,     

糖尿病合并细菌性肝脓肿的临床特点和治疗

目的:探讨糖尿病合并细菌性肝脓肿(diabetic bacterial hepatic abscess,DBHA)的临床特点和治疗方法.方法:对26例DBHA和36例非糖尿病肝脓肿(nondiabetic hepatic abscess,NDHA)患者的临床特点和治疗转归进行回顾性对比分析.结果:26例DBHA均为2型糖尿病患者,老年人居多,36例NDHA以中年人为多;DBHA组无定位症状者10例(38%),NDHA组6例(17%),两组比较差异有统计学意义,P＜0.05;DBHA组的病原菌主要为肺炎克雷伯杆菌(6例)、大肠埃希菌(2例),NDHA组为大肠埃希菌(3例)、星座链球菌(1例)、肺炎克雷伯杆菌(1例);DBHA组治愈率(35%)较NDHA组(67%)低,DBHA组平均住院时间(31日)较NDHA组(22日)长,两组比较差异均有统计学意义,均为P＜0.05;DBHA组行保守治疗患者的平均住院时间为37日,较行肝脓肿穿刺的患者长(27日),比较差异有统计学意义,P＜0.05.结论:DBHA是老年糖尿病患者的严重感染,较NDHA发病隐匿、治愈率低、住院时间长,及时行脓肿穿刺术是缩短DBHA病程的有效治疗方法.