目的探讨脑梗死合并亚临床甲状腺功能减退(亚甲减)病人甲状腺功能与24 h尿蛋白、血同型半胱氨酸的关系。方法入选2011年1月至2017年7月海南省人民医院老年病科脑梗死病人200例。按甲状腺功能将其分为4组:对照组40例[脑梗死合并甲状腺功...目的探讨脑梗死合并亚临床甲状腺功能减退(亚甲减)病人甲状腺功能与24 h尿蛋白、血同型半胱氨酸的关系。方法入选2011年1月至2017年7月海南省人民医院老年病科脑梗死病人200例。按甲状腺功能将其分为4组:对照组40例[脑梗死合并甲状腺功能正常,即游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)及促甲状腺激素(TSH)均正常]、轻度亚临床甲减组60例(FT3、FT4正常,4 m IU/L≤TSH<10 m IU/L)、重度亚甲减组60例(FT3、FT4正常,TSH≥10 m IU/L)、临床甲减组40例(FT3、FT4降低,TSH≥4 m IU/L)。其中轻度亚甲减组及重度亚甲减组的病人均分别再随机分为服药亚组和未服药亚组,各亚组均为30例。2个未服药亚组采用常规治疗,2个服药亚组加用左甲状腺素片治疗6个月。记录病人的年龄、性别、血压、血糖、血脂、甲状腺功能等,比较4组24 h尿蛋白、血同型半胱氨酸水平的差异。结果 4组病人年龄、性别、血压、血糖、血脂差异无统计学意义(P>0. 05)。脑梗死合并重度亚甲减组、临床甲减组24 h尿蛋白水平较对照组明显升高(P<0. 05)。重度亚甲减服药亚组6个月时24 h尿蛋白、同型半胱氨酸水平较重度亚甲减未服药亚组降低(P<0. 05)。结论对脑梗死病人应积极筛查甲状腺功能,及早发现和干预重度亚甲减,以减少肾损害和心脑血管疾病风险。展开更多
Background Prevalence of inadequate glycaemic control among patients with type 2 diabetes mellitus （T2DM） remains high. We assessed glycaemic control in the real-life practice among people with T2DM in metropolises ...Background Prevalence of inadequate glycaemic control among patients with type 2 diabetes mellitus （T2DM） remains high. We assessed glycaemic control in the real-life practice among people with T2DM in metropolises in China who were treated with oral antidiabetic drugs （OAD） alone and to determine factors associated with inadequate glycaemic control in this population. Methods An observational, cross-sectional multicentre study was conducted in 16 metropolitan medical centers. People with T2DM who had been followed-up before the index visit which occurred from January to September 2007 were included in the study. All subjects were 〉30 years of age at the time of T2DM diagnosis and had received monotherapy or combination therapy of OAD for at least 6 months. Demographic and clinical data were collected from medical records. The main study outcome was the inadequate glucose control rate, which was calculated by the proportion of patients with haemoglobin Alc （HbAlc） 〉6.5% detected on the index visit. Results In this cohort of 455 patients with T2DM whose mean age was 60.6 years and mean disease duration was 6.1 years, 45.5% had inadequate glycaemic control. The mean （SD） HbA1c was 6.7% （1.3）. Multivariate Logistic regression showed that physical inactivity, disease duration 〉10 years, body mass index （BMI） ≥24 kg/m2, low homeostasis model assessment of β-cell function （HOMA-13） index, less frequency of medical visit and hypertriglyceridaemia were independent determinants of inadequate glycaemic control. Higher incidence of self-reported hypoglycemia experience （47.1% vs. 34.8%, P=0.008） and more fear of hypoglycemia quantified by Worry subscale of the Hypoglycaemia Fear Survey （HFS） II were happened in subjects with good glycemic control. Conclusion Approximately one half of these outpatients with T2DM from the metropolitan medical centers in China had inadequate glycaemic control treated with OAD alone, which raises the need for more effective educational and therapeutic approaches on management of hypertriglycemia, enhancing physical exercise and weight control, and at the same time. Iowerina the hvooalvcemic risk and diminishina the hvooalvcemic fear of oatients.展开更多
文摘目的探讨脑梗死合并亚临床甲状腺功能减退(亚甲减)病人甲状腺功能与24 h尿蛋白、血同型半胱氨酸的关系。方法入选2011年1月至2017年7月海南省人民医院老年病科脑梗死病人200例。按甲状腺功能将其分为4组:对照组40例[脑梗死合并甲状腺功能正常,即游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)及促甲状腺激素(TSH)均正常]、轻度亚临床甲减组60例(FT3、FT4正常,4 m IU/L≤TSH<10 m IU/L)、重度亚甲减组60例(FT3、FT4正常,TSH≥10 m IU/L)、临床甲减组40例(FT3、FT4降低,TSH≥4 m IU/L)。其中轻度亚甲减组及重度亚甲减组的病人均分别再随机分为服药亚组和未服药亚组,各亚组均为30例。2个未服药亚组采用常规治疗,2个服药亚组加用左甲状腺素片治疗6个月。记录病人的年龄、性别、血压、血糖、血脂、甲状腺功能等,比较4组24 h尿蛋白、血同型半胱氨酸水平的差异。结果 4组病人年龄、性别、血压、血糖、血脂差异无统计学意义(P>0. 05)。脑梗死合并重度亚甲减组、临床甲减组24 h尿蛋白水平较对照组明显升高(P<0. 05)。重度亚甲减服药亚组6个月时24 h尿蛋白、同型半胱氨酸水平较重度亚甲减未服药亚组降低(P<0. 05)。结论对脑梗死病人应积极筛查甲状腺功能,及早发现和干预重度亚甲减,以减少肾损害和心脑血管疾病风险。
文摘Background Prevalence of inadequate glycaemic control among patients with type 2 diabetes mellitus （T2DM） remains high. We assessed glycaemic control in the real-life practice among people with T2DM in metropolises in China who were treated with oral antidiabetic drugs （OAD） alone and to determine factors associated with inadequate glycaemic control in this population. Methods An observational, cross-sectional multicentre study was conducted in 16 metropolitan medical centers. People with T2DM who had been followed-up before the index visit which occurred from January to September 2007 were included in the study. All subjects were 〉30 years of age at the time of T2DM diagnosis and had received monotherapy or combination therapy of OAD for at least 6 months. Demographic and clinical data were collected from medical records. The main study outcome was the inadequate glucose control rate, which was calculated by the proportion of patients with haemoglobin Alc （HbAlc） 〉6.5% detected on the index visit. Results In this cohort of 455 patients with T2DM whose mean age was 60.6 years and mean disease duration was 6.1 years, 45.5% had inadequate glycaemic control. The mean （SD） HbA1c was 6.7% （1.3）. Multivariate Logistic regression showed that physical inactivity, disease duration 〉10 years, body mass index （BMI） ≥24 kg/m2, low homeostasis model assessment of β-cell function （HOMA-13） index, less frequency of medical visit and hypertriglyceridaemia were independent determinants of inadequate glycaemic control. Higher incidence of self-reported hypoglycemia experience （47.1% vs. 34.8%, P=0.008） and more fear of hypoglycemia quantified by Worry subscale of the Hypoglycaemia Fear Survey （HFS） II were happened in subjects with good glycemic control. Conclusion Approximately one half of these outpatients with T2DM from the metropolitan medical centers in China had inadequate glycaemic control treated with OAD alone, which raises the need for more effective educational and therapeutic approaches on management of hypertriglycemia, enhancing physical exercise and weight control, and at the same time. Iowerina the hvooalvcemic risk and diminishina the hvooalvcemic fear of oatients.
