血浆网膜素1与2型糖尿病周围神经病变及其严重程度关系的研究

目的研究2型糖尿病(T2DM)患者血浆网膜素1(Omentin-1)水平与糖尿病周围神经病变(DPN)及其严重程度的关系。方法选取2017年3月-2017年9符合入选标准的T2DM患者122例,分为单纯T2DM患者67例(对照组)和合并DPN患者55例(DPN组)。收集患者临床资料,采用Logisitc回归模型分析DPN的危险因素,作受试者工作特征(ROC)曲线探索Omentin-1诊断DPN的效率,并应用线性回归分析Omentin-1与评估DPN严重程度的多伦多临床评分系统(TCSS)评分间关系。结果 (1) DPN组患者Omentin-1水平低于对照组(P <0.05);Omentin-1与胰岛素抵抗系数(HOMA-IR)(r=-0.375,P=0.000)及糖化血红蛋白(HbAlc)(r=-0.445,P=0.000)呈负相关。(2)多因素Logistic回归示:HbAlc[O^R=4.003(95%CI:1.016,10.776)]和HOMA-IR[(O^R=4.595(95%CI:1.709,12.324)]为DPN的危险因素;而Omentin-1[O^R=0.257(95%CI:0.112,0.589)]为DPN的保护因素。(3) ROC曲线示Omenitn-1诊断DPN的曲线下面积为0.713(95%CI:0.622,0.804),且当Omentin-1切值取18.8 ng/ml时,其诊断效率最高,敏感性为69.7%,特异性为71.8%。(4) Omentin-1与TCSS评分负相关(r=-0.606,P=0.000)。结论 Omentin-1是DPN的保护因素,在T2DM患者中可辅助DPN诊断及其严重程度的评估。

Risk factors,manifestations,diagnosis and treatment of cholelithiasis in children

Cholelithiasis in children refers to cholelithiasis or choledocholithiasis in newborns,infants and adolescents,including a series of symptoms and complications related to stones.The incidence rate of cholelithiasis in children is far lower than that in adults.However,the detection rate of cholelithiasis in children has risen in recent years.The aetiology of cholelithiasis in children is complex,and the pathogenesis is still unclear.According to existing studies,cholelithiasis in children may be related to sex and hormones,obesity,drugs,haemolytic diseases,genetic factors,chemokines,abnormal biliary tract formation,ileal surgery,total parenteral nutrition and other factors.In addition,there is a large occurrence of idiopathic cholelithiasis in children with unknown aetiology.The clinical manifestations of cholelithiasis in children are not completely the same as those in adults,mainly due to the different ages and causes.At present,there is no consensus on the clinical treatment of cholelithiasis in children.Followup and observation,drug dissolution and surgical treatment are all treatment methods for children with cholelithiasis.This study reviewed the related literature reports of cholelithiasis in children and summarized the risk factors,clinical manifestations,diagnosis and treatment of cholelithiasis in children to improve the understanding,diagnosis,and treatment of cholelithiasis in children.