【摘要】 目的 探讨灯盏花素注射液联合血管紧张素转换酶抑制剂（ACEI）依那普利治疗糖尿病早期肾病的临床效果。 方法 2006年10月-2009年12月，将59例临床确诊2型糖尿病早期肾病的患者随机分为治疗组（n=30）与对照组（n=29）。对照组在基本治疗的基础上应用依那普利，治疗组在基本治疗的基础上联合应用依那普利和灯盏花素注射液，疗程均为3周。观察治疗前后两组患者24 h尿微量白蛋白排泄率（UAER）、全血黏度、血浆黏度、甘油三酯（TG）、尿素氮（BUN）、血肌酐（SCr）的变化。 结果 两组患者治疗前后自身对比，24 h UAER均有明显下降（Plt;0.05）；治疗组UAER下降较对照组更为明显（Plt;0.05）。 结论 ACEI联合灯盏花素，其降低24 h UAER疗效优于单纯ACEI疗效，还可有效降低全血黏度和血浆黏度，降低纤维蛋白原含量，改善患者血液流变性。【Abstract】 Objective To investigate the therapeutic effects of breviscapine combined with angiotensin converting enzyme inhibitor (enalapril) on early diabetic nephropathy. Methods A total of 59 patients with early diabetic nephropathy diagnosed between October 2006 and December 2009 were randomly divided into treatment group (n=30) and control group (n=29). The patients in treatment group were treated by breviscapine combined with enalapril, while the patients were treated with only enalapril in the control group. All of the patients were treated for three weeks. Urinaryalbuminexcretion (UAE), whole blood viscosity, plasma viscosity, triglycercide, blood urea nitrogen and serum creatinine in the two groups were detected before and after the treatment. Results After the threatment, UAE decreased in both of the two groups compared with the value before the treatment (Plt;0.05); the decrease in treatment groups was more obvious than that in the control group (Plt;0.05). Conclusion The combination of breviscapine and enalapril is effective on early diabetic nephropathy.
目的 探讨Grave病患者采用131I治疗前后血清中白细胞介素-2（IL-2）及白细胞介素-12 p40（IL-12p40）含量的改变及细胞因子在该疾病中的作用与意义。 方法 采用酶联免疫吸附试验双抗夹心法、放射免疫法，对2009年10月－2011年12月收治的28例Grave病患者（治疗组）经131I治疗前后血清中IL-2和IL-12p40含量进行自身对比及与健康志愿者（对照组）对比；同时对治疗组患者治疗前、后的血清游离三碘甲腺原氨酸（FT3）、血清游离甲状腺素（FT4）、促甲状腺激素（TSH）水平与对照组进行对比。 结果 治疗后患者血清中IL-2和IL-12p40的水平为（19.54 ± 11.17）、（615.88 ± 349.32） ng/mL，明显高于治疗前（P＜0.05），且与对照组比较差异无统计学意义（P＞0.05）；患者治疗前后血清中IL-2和IL-12p40水平与FT3、FT4水平有显著相关性。 结论 血清IL-2和IL-12p40可能共同参与Grave病的发病过程，并且这两种因子的水平与FT3、FT4水平呈负相关性。
目的 探讨血尿酸与胰岛素分泌和敏感性的关系。 方法 对成都市龙泉驿区2007年6月－7月间20～75岁常住自然人群565人进行人口学、腰围、臀围、血压、75 g葡萄糖耐量及胰岛素测定（0、30、120 min），血脂、血肌酐及血尿酸检测。以早期胰岛素分泌功能指数（△I30/△G30）和葡萄糖处置指数（DIo）代表胰岛素分泌功能，以Matsuda 指数代表胰岛素敏感性，分别与血尿酸进行相关性研究。 结果 男性的血尿酸与年龄呈负相关，与舒张压、葡萄糖负荷后120 min胰岛素和甘油三酯呈正相关。女性的血尿酸与甘油三酯、低密度脂蛋白、血肌酐呈正相关，与高密度脂蛋白、Matsuda指数呈负相关。无论男性和女性，均未发现血尿酸与△I30/△G30、DIo相关。 结论 女性的胰岛素敏感性下降与血尿酸升高有关。未发现血尿酸与胰岛素分泌有相关关系。
Objective To identify the best therapy regimen for a patient with rare hypoglycemia due to insulin autoantibody (IAA). Methods We searched The Cochrane Library (Issue 3, 2008), PubMed (1966-July 2009), EMbase (1974-July 2009) and CBM (1978-July 2009) to identify relevant evidence. The quality of the retrieved studies was critically assessed. Results A total of 291 records were retrieved. No clinical guidelines, systematic reviews or clinical randomized studies were identified. Thirty treatment-related studies involving 6 interventions showed that insulin combined with Prednisone was relatively more effective and safer than conventional therapies. Conclusion The steroid treatment might be useful for the improvement of glycamic control in patients with high IAA levels and severe hypoglycemia and hyperglycemia due to insulin antibodies raised against subcutaneously-injected human insulin.
Objective To explore the association between 25-hydroxyvitamin D (25OHD) level and risk of the onset of metabolic syndrome (MS) in people in Chengdu. Methods In total, 474 participants were selected randomly by cluster sampling from one urban district and two rural villages in Longquanyi district of Chengdu. The data of sociodemographic information, lifestyle and family history were collected by questionnaires. Binary logistic regression was performed to assess the relationship between baseline 25OHD level and incident of MS, while multiple linear regression was conducted to analyze the relationship between baseline 25OHD level and insulin resistance. Results Four hundred seventy-four people were enrolled in the cohort study, 39 of them developed MS, with the incidences of 20.8 events per 1 000 person years. Among women, low 25OHD status was significantly associated with the risk of developing MS (OR=4.29, 95%CI 1.05 to 29.50, P=0.044) after adjustment for multiple potential confounders. In a multiple linear regression analysis, low 25OHD level of baseline was independently associated with the increased HOMA-IR over a 4-year period among Chengdu individuals (P<0.05) and was independently related to the decreased ISIcomp over a 4-year period in female (P<0.05). Conclusions The current prospective study suggests that low 25OHD level may contribute to increase insulin resistance in Chengdu population. Furthermore, low 25OHD level may increase the risk of MS among women in Chengdu.
【摘要】 目的 探讨胰岛素强化治疗对2型糖尿病（type 2 diabetes mellitus，T2DM）患者血清脂联素（adiponectin，APN）的影响。 方法 2007年7—12月，研究纳入连续使用胰岛素治疗至少3个月但血糖控制欠佳[6.5%≤糖化血红蛋白（hemoglobin A1c， HbA1c）≤11.0%]的T2DM患者40例，其中男18例，女22例；年龄29~〖JP2〗69岁；平均诊断T2DM病史11年。治疗方案为进行16周的胰岛素强化治疗，血糖控制目标为空腹血糖≤7 mmol/L，〖JP〗餐后2 h血糖≤8 mmol/L。分别于强化治疗前、强化治疗4周后及强化治疗16周后测定HbA1c以及血清APN水平。 结果 与强化治疗前相比，胰岛素治疗4周后空腹及三餐后2 h血糖明显下降（Plt;0.05），但HbA1c和血清APN水平差异无统计学意义（Pgt;0.05）；强化16周后，HbA1c水平明显低于治疗前和治疗4周后且差异具有统计学意义（Plt;0.05），APN水平高于治疗前和治疗4周后且差异有统计学意义（Plt;0.05）。体质量指数在强化治疗16周后明显增加且与强化治疗前和强化治疗后4周相比差异具有统计学意义（Plt;0.05）。APN与空腹血糖（b=-0.225，P=0.013）、早餐后2 h血糖（b=-0.229，P=0.012）呈负相关。 结论 胰岛素强化治疗可以提高T2DM患者血清APN水平。【Abstract】 Objective To investigate the effect of intensive insulin therapy on serum adiponectin (APN) level in patients with type 2 diabetes mellitus (T2DM). Methods Forty patients with T2DM who had undergone insulin therapy for at least three months but with their blood glucose poorly controlled [glycosylated hemoglobin Alc (HbA1c) level ranged from 6.5% to 10.0%] from July to December 2007 were enrolled in this study. There were 18 males and 22 females with their age ranged from 29 to 69 years. They had an average time of T2DM history of 11 years. Intensive insulin therapy was carried out for 16 weeks with a target of less than 7 mmol/L for fasting blood glucose and 8 mmol/L for postprandial blood glucose. HbA1c and serum adiponectin concentrations were detected at baseline, at week 4 after intensive therapy and at the end of the study. Results After 4 weeks of intensive blood glucose control, fasting and postprandial blood glucose levels decreased significantly (Plt;0.05), but the HbA1c and serum APN concentrations did not reduce remarkably (Pgt;0.05). After 16 weeks of treatment, the level of HbA1c was significantly lower than those at baseline and 4 weeks after treatment (Plt;0.05), and serum APN concentration increased significantly (Plt;0.05), compared with those two time points. However, an evident increase of body mass index (BMI) was found while compared with BMI at baseline and 4 weeks after treatment (Plt;0.05). The linear regression analysis indicated that APN was negatively associated with fasting blood glucose (b=-0.225,P=0.013) and blood glucose level 2 hours after breakfast (b=-0.229,P=0.012). Conclusion Intensive insulin therapy can improve serum adiponectin level in type-2 diabetic patients.
Objective To evaluate the accuracy of newer-generation home blood glucose meter (Accu-Check? Integra) in patients with impaired glucose regulation (IGR) and newly-diagnosed type 2 diabetes mellitus. Methods A cross-sectional study was performed on 109 cases with newly-diagnosed type 2 diabetes or IGR who were asked to take oral glucose tolerance test (OGTT), while paired samples, that were Accu-Check? Integra in capillary blood glucose (CBG) and laboratory glucose in venous plasma glucose (VPG ), were taken simultaneously. Taking VPG as the reference value, the accuracy of the home glucose meter was assessed according to the international standardization organization (ISO), including, the accuracy was studied by means of Median absolute difference (Median AD) and Median absolute relative difference (Median RAD), the consistency of CBG and VPG was studied by Clarke Error Grid analysis, the correlation of CBG and VPG was analyzed according to liner regression analysis, and the sensitivity and specificity for hyperglycemia were also calculated. Results There were 292 VPG values paired with CBG values, among which 93.49% of CBG values met ISO home glucose meter criteria, the median AD was 7.2 mg/dL, and the median RAD was 4.76%. Paired glucose measurements from the Accu-Check Integra meter and laboratory glucose measurement demonstrated that 100% of paired points in the overall subject population fell in zones A and B of the Clarke Error Grid. The CBG value was well correlated to VPG value in the overall level, and the sensitivity and specificity were 94.6% and 95.7% respectively for hyperglycemia. Conclusion The newer-generation home blood glucose meter (Accu-Check? Integra) demonstrates a high degree of accuracy, and it can precisely report the real value of blood glucose.