诺和锐胰岛素治疗儿童1型糖尿病的临床观察

目的:观察诺和锐胰岛素治疗儿童1型糖尿病的疗效。方法:对10例应用诺和灵短效胰岛素联合诺和灵中效胰岛素治疗的1型糖尿病患儿以超短效胰岛素诺和锐等量替代短效胰岛素联合诺和灵中效胰岛素治疗1个月,观察HbA1c等代谢指标变化。结果:用诺和锐治疗后患儿餐后2 h血糖、HbA1c显著下降,P<0．01,平均下降值分别为3．51±1．10 mmol／L与0．64％±0．19％。胰岛素用量与血脂无明显变化,P>0．05。治疗期间未发现明显低血糖。结论:超短效胰岛素诺和锐替代短效胰岛素可进一步控制餐后血糖．并显著降低HbA1c,有利于血糖控制。     

Young red blood cells; observations about the cytometric and morphologic alterations in the beginning of their life

Summary A recently described separation technique consisting of a combination of counterflow centrifugation and subsequent density (Percoll) scparation was tested for its ability to enrich red cell populations with young cells in comparison to either separation technique alone. The relative age of every fraction was determined by HbAlc measurements, resulting in the lowest HbAlc for the combination method. Conventional reticulocyte counting and floweytometric counting with thiazole orange indicated that in the youngest fractions the combination method showed the highest reticulocyte counts. There was a good correlation between manual and flowcytometric counting results. Radio-iron studies showed a two-fold enrichment with young cells in the fraction with the lowest HbAIc acquired by the combination technique in comparison to the other two methods. Cytometric measurements showed that the fractions with the lowest HbAlc were the ones with the highest MCV and MCH and the lowest MCHC. Besides loss of their RNA-material, young cells already seem to loose water and haemoglobin like older cells, resulting in a decrease of MCV and MCH and in increase in MCHC. It is concluded that combining counterflow centrifugation with subsequent density fractionation results in superior enrichment with young cells in comparison to the results of each method alone.     

NycoCard ReaderⅡ检测仪测定糖化血红蛋白的临床评价

[目的]研究挪威产NycoCard ReaderⅡ多功能全定量特种蛋白金标检测仪测定糖化血红蛋白（HbAlc）的效果。[方法]采取58例糖尿病患者的抗凝全血，分别使用NycoCard ReaderⅡ分析仪和微柱离子交换法测定样本HbA1c含量，对两种测定方法之间的相关性和NycoCard ReaderⅡ分析仪测定糖化血红蛋白结果的精密度、批内变异、批间变异、干扰因素进行研究。[结果]两种测定方法无显著性差异；NycoCard ReaderⅡ分析仪检测糖化血红蛋白，批内CV值〈1．0％，批间CV值〈2．5％；高浓度的葡萄糖、乳糜、胆红素、对检测结果没有影响。[结论]NycoCard ReaderⅡ分析仪检测HbA1c准确性好、精密度高、干扰因素少、速度快，仪器及试剂成本低廉，适合临床开展。     

糖化血红蛋白检测对非糖尿病高血压患者的临床价值

目的探讨糖化血红蛋白检测对非糖尿病高血压患者的临床价值。方法对268例原发性高血压但未诊断糖尿病住院患者进行三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、空腹血糖（FPG）、空腹胰岛素（Fins）和糖化血红蛋白（HbA1c）检测,同时以243例健康人血标本为健康对照组,检测同样项目并与高血压组进行对比分析。结果高血压组和健康对照组之间的TG、TC、HDL、LDL和FPG水平差异无统计学意义（P〉0.05）;高血压组的Fins和HbA1c水平分别为（8.24±4.55）mU/L、6.92%±1.83%,健康对照组分别为（6.74±3.98）mU/L、5.07%±0.81%,差异有统计学意义（P〈0.05）;Ⅰ级高血压组的HbA1c为6.43%±1.55%,Ⅱ级高血压组为6.95%±1.67%,Ⅲ级高血压组为7.32%±1.76%,差异有统计学意义（P〈0.05）。结论 HbA1c水平与非糖尿病高血压患者有密切关系,是原发性高血压的危险因素。     

中药纠正口服降糖药物继发失效Ⅱ型糖尿病HbAlc水平的临床报道

为观察中药纠正口服降糖药物继发失效的Ⅱ型糖尿病的疗效,以"梅杞汤"为基本方加减治疗20例.结果治疗后HbAlc显著下降(P＜O.001),FPG无显著下降(P＞0.05),HbAlc与FPG出现不平行现象.     

Study on correlation between C-reactive protein and gestational diabetes mellitus

Objective：To investigate correlation between C-reactive protein（CRP） and gestational diabetes mellitus（GDM）, Methods：Twentyfive GDM women were served as study group, and thirty normal pregnant women were selected as control group. The serum FPG, 2hPG, HbAlc and CRP levels and the leukocyte count were detected in the two groups, in order to observe the relationship between gestational diabetes mellitus and inflammatory markers. Results：The age and gestational week did not show difference in the two groups（P〉 0.05）. But there was a significant difference in body mass index（BMI） between the GDM group and the controtgroup（P 〈 0.05）. The serum FPG, 2hPG, HbAlc and CRP levels and the leukocyte count in the GDM group were higher than those in the control group, and the difference was significant（P 〈 0.05）, There was positive correlation between serum C-reactive protein value and FPG, 2hPG, HbAlc serum levels or the leukocyte count in GDM group. But in the control group there was no correlation between them. Conclusion：The results suggest that there is correlation between C-reactive protein and gestational diabetes mellitus, and inflammation may play an important role in the development of gestational diabetes mellitus.     

早期糖尿病的实验室检测指标

糖尿病早期诊断能够提高治疗效果、降低并发症发生概率、延缓糖尿病进程，是提高患者生活质量的关键之一。应用实验室检测指标诊断糖尿病，对于早期发现糖尿病、科学治疗和制定临床预防方案有重要意义。     

糖化血红蛋白在妊娠期糖尿病筛查中的应用

目的:探讨糖化血红蛋白(HbA1C)在妊娠期糖尿病(GDM)筛查中的应用价值.方法:2008年1月～2011年12月,在我科门诊就诊的孕妇236例,其中符合GDM诊断标准的21例为GDM组,其余215例为非GDM组.分别对2组进行空腹血糖(FBG)、口服葡萄糖耐量试验(OGTT)及HbA1C进行检测.比较3种检测方法的检测结果,并对检测结果进行评价.结果:GDM组FBG、OGTT及HbA1C均明显高于非GDM组,差异有统计学意义(P＜0.05),在3种诊断方法中,HbA1C的灵敏度、特异性和阳性预测值最高,分别为90.9％、80.0％、83.3％,提示HbA1C在诊断GDM的3种检查中效果最好.结论:HbA1C水平在GDM患者中明显升高,诊断GDM具有较高的阳性率,早期干预治疗可减少母婴发病率及死亡率.HbA1C为糖尿病的血糖水平监测提供了新的方法,是临床上筛查、诊断、监测妊娠期糖尿病的简单、可靠的方法.     

连续动态血糖监测在2型糖尿病中的临床价值

目的应用动态血糖监测系统（CGMS）研究2型糖尿病（T2DM）强化治疗过程中低血糖发生的特征。方法采用动态血糖监测系统（CGMS）对50例使用胰岛素治疗的HbA1c〈7．0％的2型糖尿患者进行连续3d的血糖监测。结果本组患者血糖42．8mmol/L（低血糖）占3．3％,但以21：00-24：00最多,0-3：00点次之。血糖在2．9-7．8mmol/L之间占71．3％,血糖在2．9-10．0mmol/L之间占89％,血糖〉10mmol/L（血糖控制不良）占7．7％,各时段均能见到,以6：00-12：00为多。探头监测到低血糖患者27例,低血糖的发生率为54．0％（27／50）。21：00-3：00（定义为夜间）低血糖的发生率为66．7％（18／27）。结论CGMS能及时准确地发现低血糖,了解低血糖的影响因素及低血糖后的反应,以指导临床治疗,制定针对性的临床治疗方案。     

276例2型糖尿病患者血清果糖胺及糖化血红蛋白检测结果分析

目的：探讨血清果糖胺（FMN）及糖化血红蛋白（HbAlc）对2型糖尿病的诊断价值。方法：回顾性分析2007年2月-2008年12月我院收治的276例2型糖尿病患者（2型糖尿病组）血清果糖胺及糖化血红蛋白检测结果,并与40例正常人（正常对照组）血清果糖胺及糖化血红蛋白检测结果作对比分析。结果：2型糖尿病组血清果糖胺及糖化血红蛋白均明显高于正常对照组,两者比较均有显著性差异（P〈0．05）。结论：血清果糖胺及血清糖化血红蛋白能准确反映2型糖尿病患者体内糖代谢与控制情况,是评价2型糖尿病患者近期和长期血糖控制信息灵敏而可靠的指标。