海洛因依赖者血清瘦素水平及其与骨密度的关系

目的:了解吸毒人员血清瘦素水平的改变情况及其与骨密度的关系.方法:测定男女海洛因依赖者各20名以及32名年龄、性别相匹配的非吸毒对照人员的体重、身高,计算体重指数(BMI),用放射免疫分析法测定海洛因依赖者戒毒前后以及对照人员血清瘦素水平,单能X测定吸毒人员优势足跟骨密度(BMD).结果:海洛因依赖组戒毒前后的血清瘦素水平均比对照组低(P＜0.01),且戒毒后血清瘦素水平比戒毒前还要低(P＜0.05);女性的海洛因依赖者血清瘦素水平比男性高(P＜0.05);血清瘦素水平与BMD的高低、吸毒年限长短及每周吸毒剂量的多少比较无统计学意义.结论:吸毒使体重指数严重下降造成血清瘦素水平下降,但血清瘦素水平下降并未影响骨密度.     

自体外周血干细胞移植治疗严重糖尿病足18例分析

目的:观察自体外周血干细胞移植(peripheral blood stem cell transplantation,PBSCT)治疗严重糖尿病足的临床疗效.方法:18例患者糖尿病足共21肢,经下肢动脉CT血管重建提示下肢血管硬化、狭窄或闭塞,均行自体PBSCT.其中11例13肢足趾坏疽行小范围的坏疽趾截趾术,开放不缝合,1例甲沟炎患者行拔甲术.结果:自体PBSCT术后7日～6个月,疼痛、冷感、麻木等症状均有改善,术后坏疽截趾创面及难治性溃疡的患肢中创面愈合达到18肢(86%),无1肢发生平面截肢或需再次行更高平面的截肢.全部患者的肝、肾功能,出血和凝血时间正常.结论:自体PBSCT治疗严重糖尿病足患者疗效较好.     

有糖尿病家族史者2型糖尿病的临床特点

目的比较有家族史和无家族史2型糖尿病(T2DM)患者的临床特点。方法将T2DM患者按糖尿病家族史分成有DM家族史组和无家族史组。比较2组的体质指数(BMI),血糖,血压,血脂,空腹C肽,餐后2hC肽,发病年龄,大、微血管并发症等方面的差异。结果与无家族史组患者相比,有糖尿病家族史组发病年龄提前,但在BMI、糖化血红蛋白、血糖、空腹C肽、餐后2hC肽和血脂等方面差异无统计学意义。相同病程2组大、微血管病变危险性差异无统计学意义。在有家族史组中,母亲糖尿病史所占比例较父亲糖尿病史高,但两者发病年龄差异无统计学意义。多元逐步线性回归显示家族史、年龄、高BMI、高甘油三酯和舒张期血压是T2DM发病年龄提前的危险因素。结论①在T2DM遗传中存在母系优势,家族史与子女发病年龄提前相关。②遗传因素和环境因素如高BMI、高甘油三酯都与T2DM的提早发生相关。③在相同病程下,2组发生T2DM并发症的危险性无差异。     

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.     

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.     

血浆抵抗素与2型糖尿病的相关性

对37例糖耐量正常者和43例新诊断的2型糖尿病患者的研究显示,血浆抵抗素水平与性别、体质指数、血糖和血脂水平无相关性,与2型糖尿病的发生无相关性。     

睡眠质量对2型糖尿病血糖水平的影响

糖尿病的发生率呈日益上升趋势 ,已成为继心脑血管病后威胁人类健康的常见疾病之一。临床中发现一些血糖控制不佳的２型糖尿病患者常常存在睡眠质量差的问题。本研究旨在探讨睡眠质量对血糖水平的影响。１对象与方法１．１研究对象于２００１年１～６月对２型糖尿病伴有睡眠障碍经适当治疗后睡眠改善的６６例患者进行观察 ,男３３例 ,女３３例。观察对象均来自于温州医学院附属第一医院内分泌科门诊 ,在本科门诊随诊３个月。１．２方法１．２．１所有患者在实验前测定空腹及餐后２ｈ血糖及糖化血红蛋白做为对照 ,血糖均采用强生稳步型血糖仪…