糖尿病的药物治疗

1　口服降糖药1 .1　磺脲类 ( SU)　 1 95 5年始用于临床。1 .1 .1　作用机理　 1促进胰岛素 ( INS)的分泌 ,已证明在胰岛 β细胞上有 SU受体 ,受体与细胞膜上ATP-依赖型钾离子通道密切相关 ,SU通过关闭ATP-依赖型钾离子通道使细胞去极化 ,促进钙离子内流增加 ,抑制磷酸二酯酶活性 ,使细胞内 CAMP和三磷酸肌醇水平升高 ,促使胰岛素释放。2加强胰岛素的外周组织 (胰岛素的靶器官 )对葡萄糖的摄取和利用 ,肝对 INS的反应增强 ,减少肝糖生成 ,促进脂肪细胞为葡萄糖的转运 ,增加脂肪合成 ,增强骨骼肌糖合成酶的活性 ,使肌糖合成增加。3…     

糖尿病病人1，5－脱水－D－葡萄糖醇水平检测的临床价值

以气相色谱法测定４６例糖尿病病人、３９例非糖尿病病人及５３例正常人的１，５－脱水－Ｄ－葡萄糖醇（ＡＧ）值，发现糖尿病病人的血清ＡＧ值显著降低，并与果糖胺（ＦＡ）、糖基化血红蛋白（ＨｂＡ１）值呈负相关（分别为ｒ＝－０．４１１，ｒ＝－０．５４５）。若以２０μｇ／ｍｌ为分界值，ＡＧ鉴别糖尿病与非糖尿病有较好的敏感性（９７．５６％）和特异性（９３．４８％）。ＡＧ测定可用作糖尿病筛选及血糖控制指标之一。     

嗜铬细胞瘤危象19例临床分析

嗜铬细胞瘤危象是常见的内科急症,危险性大而最初又常被误诊.本文从1978～1990年共74例嗜铬细胞瘤住院病人中,选择符合“危象”发作且手术后经病理均已证实的19例,分析报告如下:诊断标准综合参考西氏内科临床内科危象内科讲座内科急诊手册制订如下标准:在骤发高血压或持续性高血压阵发性加剧基础上,同时伴有下列一项或多项症状:     

孕产妇血中甲状腺激素及促甲状腺素变化

本文提供了杭州地区正常孕产妇甲状腺激素及促甲状腺素的部分抽样测定值和95%正常范围估计值,以及妊娠,产后动态变化.     

A study on various symptoms of chronic hepatitis treated with radix astragali and its regulative effect to levels of serum hormone

Sixty-seven cases of chronic hepatitis were treated with Radix Astragali. After treatment (2-month course), the clinical improvement rate in 38 cases of the Stagnation of the Liver-Qi and Deficiency of the Spleen type was 92.1%, and in 26 cases of the Deficiency of Liver Yin and Kidney Yin type was 88.5%, more effective than in the control group (P<0.05). The regulative effect to the levels of serum hormone was observed in the patients of the Stagnation of the Liver-Qi and Deficiency of the Spleen type treated with this medicine. The results showed that the levels of serum triiodothyronine, estradiol (female) and testosterone (male) were increased after treatment (1.40±1.38 ng/dl, 129.30±1.23 pg/ml and 496.24±1.47 ng/dl). Pre-treatment levels were 1.22±1.49 ng/dl, 104.60±1.45 pg/ml and 398. 17±1.55 ng/dl respectively (P<0.05); however, the level of serum prolactin (2.75±4.46 ng/ml) was lower after treatment than before treatment (3.20±3.82 ng/ml,P<0.05). No obvious changes were observed in the levels of serum follicle stimulating hormone, luteinizing hormone, thyroid stimulating hormone, thyroxine, triiodothyronine uptake ratio and cortisol after treatment.     

ISCHEMIC PAPILLOPATHY AND CONTRACEPTIVES

In January and again in April 1985, a 30-year old woman received 150 mg injections of Depo-Provera for contraception. 3 days after the 2nd injection, she experienced blurred vision in both eyes and was diagnosed as having bilateral papilledema. Her vision improved after treatment with vitamin B1 and other drugs. But optic atrophy of the right eye and papilledema of the left eye remained. In July 1985, after an injection with Depo-Provera, her vision again worsened. The woman received no more Depo-Provera after this time. In early 1987, she was referred to Beijing's Tong Ren Hospital, where she was diagnosed as having bilateral ischemic papillopathy and optic atrophy. There have been few documented cases in medical literature of ocular complications related to use of contraceptives. In 1981, Petursson et al. reported a case of macula edema resulting from oral contraceptives. In animal studies, oral contraceptives have been linked to papilledema and retinal vein obstruction. The case reported here is the 1st to link use of Depo- Provera with ocular complications.     

糖尿病药物治疗的进展

糖尿病(DM)是严重危害人类健康的常见病.