Blood glucose response after oral intake of lactulose in healthy volunteers:A randomized,controlled,cross-over study

AIM To investigate possible changes of blood glucose levels after oral intake of lactulose in healthy subjects.METHODS The study was performed as prospective, randomized, two-part study with 4-way cross-over design with n = 12 in each study arm. Capillary blood glucose levels were determined over a time period of 180 min after intake of a single dose of 10 g or 20 g lactulose provided as crystal or liquid formulation. During the manufacturing process of lactulose, impurities with sugars(e.g., lactose, fructose, galactose) occur. Water and 20 g glucose were used as control and reference. Because lactulose is used as a functional food ingredient, it may also be consumed by people with impaired glucose tolerance, including diabetics. Therefore, it is of interest to determine whether the described carbohydrate impurities may increase blood glucose levels after ingestion. RESULTS The blood glucose concentration-time curves after intake of 10 g lactulose, 20 g lactulose, and water were almost identical. None of the three applications showed any changes in blood glucose levels. After intake of 20 g glucose, blood glucose concentration increased by approximately 3 mmol/L(mean Cmax = 8.3 mmol/L), reaching maximum levels after approximately 30 min and returning to baseline within approximately 90 min, which was significantly different to the corresponding 20 g lactulose formulations(P < 0.0001). Comparing the two lactulose formulations, crystals and liquid, in the dosage of 10 g and 20 g, there was no difference in the blood glucose profile and calculated pharmacokinetic parameters despite the different amounts of carbohydrate impurities(1.5% for crystals and 26.45% for liquid). Anyhow, the absolute amount of single sugars was low with 0.3 g in crystals and 5.29 g in liquid formulation in the 20 g dosages. Lactulose was well tolerated by most volunteers, and only some reported mild to moderate mainly gastrointestinal side effects. CONCLUSION The unchanged blood glucose levels after lactulose intake in healthy subjects suggest its safe use in subjects with impaired glucose tolerance.

Effect of different blood glucose levels on viscera injury, oxidative stress response and Wnt5a inflammatory pathway in children with sepsis

Objective:To investigate the effect of different blood glucose levels on viscera injury, oxidative stress response and Wnt5a inflammatory pathway in children with sepsis.Methods:70 children with sepsis treated in our hospital between January 2014 and December 2015 were retrospectively collected and divided into the sepsis group A (blood glucose>10 mmol/L) (n=29) and the sepsis group B (blood glucose ≤10 mmol/L) (n=41) according to the different blood glucose levels, and 50 healthy children who accepted vaccination and were with normal blood glucose levels in our hospital during the same period were selected as healthy control group. The day after admission, RIA method was used to determine liver function indexes;automatic biochemical analyzer was used to determine oxidative stress indexes;enzyme-linked immunosorbent assay (ELISA) was used to detect Wnt5a inflammatory pathway index levels.Results: Liver function indexes total bilirubin (TBIL), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels of sepsis group A were higher than those of sepsis group B and healthy control group (P<0.05);oxidative stress indexes advanced protein oxidation products (AOPPs), lipid hydrogen peroxide (LHP), reactive oxygen species (ROS), and malondialdehyde (MDA) levels were higher than those of sepsis group B and healthy control group while glutathione peroxidase (GSH-Px) level was lower than that of sepsis group B and healthy control group (P<0.05);serum Wnt5a inflammatory pathway indexes interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-12 (IL-12) and macrophage inflammatory protein-1β (MIP-1β) levels were higher than those of sepsis group B and healthy control group (P<0.05).Conclusions:Sepsis children with high blood glucose are with severe liver function damage as well as intense oxidative stress and inflammatory response, which are the important indexes for severe illness and poor prognosis.

Shuxuetong injection protects cerebral microvascular endothelial cells against oxygen-glucose deprivation reperfusion

Shuxuetong injection composed of leech(Hirudo nipponica Whitman) and earthworm(Pheretima aspergillum) has been used for the clinical treatment of acute stroke for many years in China. However, the precise neuroprotective mechanism of Shuxuetong injection remains poorly understood. Here, cerebral microvascular endothelial cells(bEnd.3) were incubated in glucose-free Dulbecco's modified Eagle's medium containing 95% N_2/5% CO_2 for 6 hours, followed by high-glucose medium containing 95% O_2 and 5% CO_2 for 18 hours to establish an oxygen-glucose deprivation/reperfusion model. This in vitro cell model was administered Shuxuetong injection at 1/32, 1/64, and 1/128 concentrations(diluted 32-, 64-, and 128-times). Cell Counting Kit-8 assay was used to evaluate cell viability. A fluorescence method was used to measure lactate dehydrogenase, and a fluorescence microplate reader used to detect intracellular reactive oxygen species. A fluorescent probe was also used to measure mitochondrial superoxide production. A cell resistance meter was used to measure transepithelial resistance and examine integrity of monolayer cells. The fluorescein isothiocyanate-dextran test was performed to examine blood-brain barrier permeability. Real-time reverse transcription polymerase chain reaction was performed to analyze mRNA expression levels of tumor necrosis factor alpha, interleukin-1β, interleukin-6, and inducible nitric oxide synthase. Western blot assay was performed to analyze expression of caspase-3, intercellular adhesion molecule 1, vascular cell adhesion molecule 1, occludin, vascular endothelial growth factor, cleaved caspase-3, B-cell lymphoma 2, phosphorylated extracellular signal-regulated protein kinase, extracellular signal-regulated protein kinase, nuclear factor-κB p65, I kappa B alpha, phosphorylated I kappa B alpha, I kappa B kinase, phosphorylated I kappa B kinase, claudin-5, and zonula occludens-1. Our results show that Shuxuetong injection increases bEnd.3 cell viability and B-cell lymphoma 2 expression, reduces cleaved caspase-3 expression, inhibits production of reactive oxygen species and mitochondrial superoxide, suppresses expression of tumor necrosis factor alpha, interleukin-1β, interleukin-6, inducible nitric oxide synthase mRNA, intercellular adhesion molecule-1, and vascular cell adhesion molecule-1, markedly increases transepithelial resistance, decreases blood-brain barrier permeability, upregulates claudin-5, occludin, and zonula occludens-1 expression, reduces nuclear factor-κB p65 and vascular endothelial growth factor expression, and reduces I kappa B alpha, extracellular signal-regulated protein kinase 1/2, and I kappa B kinase phosphorylation levels. Overall, these findings suggest that Shuxuetong injection has protective effects on brain microvascular endothelial cells after oxygen-glucose deprivation/reperfusion. Moreover, its protective effect is associated with reduction of mitochondrial superoxide production, inhibition of the inflammatory response, and inhibition of vascular endothelial growth factor, extracellular signal-regulated protein kinase 1/2, and the nuclear factor-κB p65 signaling pathway.

Association of point in range withβ-cell function and insulin sensitivity of type 2 diabetes mellitus in cold areas

Background and Objective:Self-monitoring of blood glucose(SMBG)is crucial for achieving a glycemic target and upholding blood glucose stability,both of which are the primary purpose of anti-diabetic treatments.However,the association between time in range(TIR),as assessed by SMBG,andβ-cell insulin secretion as well as insulin sensitivity remains unexplored.Therefore,this study aims to investigate the connections between TIR,derived from SMBG,and indices representingβ-cell functionality and insulin sensitivity.The primary objective of this study was to elucidate the relationship between short-term glycemic control(measured as points in range[PIR])and bothβ-cell function and insulin sensitivity.Methods:This cross-sectional study enrolled 472 hospitalized patients with type 2 diabetes mellitus(T2DM).To assessβ-cell secretion capacity,we employed the insulin secretion-sensitivity index-2(ISSI-2)and(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index,while insulin sensitivity was evaluated using the Matsuda index and HOMA-IR.Since SMBG offers glucose data at specific point-in-time,we substituted TIR with PIR.According to clinical guidelines,values falling within the range of 3.9-10 mmol were considered"in range,"and the corresponding percentage was calculated as PIR.Results:We observed significant associations between higher PIR quartiles and increased ISSI-2,(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index,Matsuda index(increased)and HOMA-IR(decreased)(all P<0.001).PIR exhibited positive correlations with log ISSI-2(r=0.361,P<0.001),log(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index(r=0.482,P<0.001),and log Matsuda index(r=0.178,P<0.001)and negative correlations with log HOMA-IR(r=-0.288,P<0.001).Furthermore,PIR emerged as an independent risk factor for log ISSI-2,log(ΔC-peptide_(0-120)/Δglucose_(0-120))×Matsuda index,log Matsuda index,and log HOMA-IR.Conclusion:PIR can serve as a valuable tool for assessingβ-cell function and insulin sensitivity.

Influence of High Blood Glucose Fluctuation on Endothelial Function of Type 2 Diabetes Mellitus Rats and Effects of Panax Quinquefolius Saponin of Stem and Leaf

Objective： To observe the influence of high blood glucose fluctuation on the endothelial function of type 2 diabetes mellitus （T2DM） rats and the effects of Panax Quinquefolius Saponin （PQS） of stem and leaf. Methods： The T2DM model was induced by intraperitoneal injection of a small dose of streptozotocin （STZ, 35 mg/kg） plus high fat and high caloric laboratory chow. Then, diabetic rats were divided into steady high blood glucose （SHG） group and fluctuant high blood glucose （FHG） group according to fasting blood glucose coefficient of variation （FBG-CV）, and then, the FHG group rats were divided into 4 groups according to the level of FBG-CV and fasting blood glucose： PQS 30 mg/（kg·d） group, PQS 60 mg/（kg·d） group, metformin hydrochloride control （MHC） group, and FHG control group, 10 in each group. Meanwhile, 10 rats without any treatment were used as normal control （NOR） group. Eight weeks later, the aortic arteries histology, plasma hepatocyte growth factor （HGF）, and serum nitric oxide （NO）, endothelin-1 （ET-1）, tumor necrosis factor α （TNF-α）, and soluble intercellular adhesion molecule 1 （slCAM-1） were measured. Results： In comparison with the NOR group, the level of plasma HGF and serum NO, ET-1 and TNF-α, and slCAM-1 in SHG and FHG control groups were all significantly increased （P〈0.01）; in comparison with the SHG group, plasma HGF and serum NO, ET-1, TNF-α, and slCAM-1 in FHG group were all significantly increased further （P〈0.01 or P〈0.05）; meanwhile, in comparison with the FHG control group, the level of plasma HGF and serum NO, ET-1, TNF- α, and slCAM-1 in PQS and MHC groups were all decreased significantly （P〈0.01）. However, comparison of the aortic arteries histology among groups showed no significant differences either before or after treatment. Conclusion： Blood glucose fluctuation could facilitate the development of vascular endothelial dysfunction in T2DM rats, while PQS could improve the endothelial function of T2DM rats with high blood glucose fluctuation, which may be related to its effects of relieving vessel stress, decreasing vasoconstrictor ET-1 production, preventing compensated increase of NO, and reducing inflammatory reaction.

Effectiveness and safety of human umbilical cord-mesenchymal stem cells for treating type 2 diabetes mellitus

BACKGROUND Progressive pancreaticβ-cell dysfunction is a fundamental part of the pathology of type 2 diabetes mellitus(T2DM).Cellular therapies offer novel opportunities for the treatment of T2DM to improve the function of isletβ-cells.AIM To evaluate the effectiveness and safety of human umbilical cord-mesenchymal stem cell(hUC-MSC)infusion in T2DM treatment.METHODS Sixteen patients were enrolled and received 1×10^(6) cells/kg per week for 3 wk as intravenous hUC-MSC infusion.The effectiveness was evaluated by assessing fasting blood glucose,C-peptide,normal glycosylated hemoglobin A1c(HbA1c),insulin resistance index(homeostatic model assessment for insulin resistance),and isletβ-cell function(homeostasis model assessment ofβ-cell function).The dosage of hypoglycemic agents and safety were evaluated by monitoring the occurrence of any adverse events(AEs).RESULTS During the entire intervention period,the fasting plasma glucose level was significantly reduced[baseline:9.3400(8.3575,11.7725),day 14±3:6.5200(5.2200,8.6900);P<0.01].The HbA1c level was significantly reduced on day 84±3[baseline:7.8000(7.5250,8.6750),day 84±3:7.150(6.600,7.925);P<0.01].The patients’isletβ-cell function was significantly improved on day 28±3 of intervention[baseline:29.90(16.43,37.40),day 28±3:40.97(19.27,56.36);P<0.01].The dosage of hypoglycemic agents was reduced in all patients,of whom 6(50%)had a decrement of more than 50%and 1(6.25%)discontinued the hypoglycemic agents.Four patients had transient fever,which occurred within 24 h after the second or third infusion.One patient(2.08%)had asymptomatic nocturnal hypoglycemia after infusion on day 28±3.No liver damage or other side effects were reported.CONCLUSION The results of this study suggest that hUC-MSC infusion can improve glycemia,restore isletβ-cell function,and reduce the dosage of hypoglycemic agents without serious AEs.Thus,hUC-MSC infusion may be a novel option for the treatment of T2DM.

胰岛素不同注射方式对糖尿病血糖控制效果的影响研究

目的分析胰岛素不同注射方式对2型糖尿病患者血糖控制情况的影响。方法选取2021年9月—2023年9月安溪县医院收治的186例2型糖尿病患者为研究对象,利用最新统计学软件生成随机序列后将其分为对照组、观察组,各93例。两组研究对象均选用门冬胰岛素治疗,其中对照组注射方式为多次胰岛素皮下注射,观察组注射方式为胰岛素泵持续泵注。对比两组血糖控制情况、胰岛素使用剂量、血糖达标情况以及胰岛β细胞功能。结果观察组空腹血糖、餐后2 h血糖及糖化血红蛋白水平均低于对照组,差异有统计学意义(P均<0.05)。观察组平均每天胰岛素使用量低于对照组,血糖达标时间短于对照组,且在达标即刻使用的胰岛素总量少于对照组,差异有统计学意义(P均<0.05)。观察组胰岛β细胞功能优于对照组,差异有统计学意义(P<0.05)。结论对于2型糖尿病患者,采用胰岛素泵持续泵注这一注射方式,有利于改善血糖、血压及血脂水平,同时改善胰岛β细胞功能,且使用胰岛素剂量更低,能够更快速地达到控糖标准。

利拉鲁肽治疗冠心病合并2型糖尿病患者的临床研究

目的 分析利拉鲁肽治疗冠心病合并2型糖尿病患者的临床效果。方法 102例冠心病合并2型糖尿病患者,应用电脑随机选择方式将患者分为对照组和观察组,每组51例。对照组给予二甲双胍治疗,观察组给予二甲双胍结合利拉鲁肽治疗。对比两组心功能指标(左室射血分数、左室舒张末内径、心排血量以及QT离散度)、血糖指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]、胰岛素抵抗情况[胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)]。结果 治疗后,观察组左室射血分数(56.10±9.06)%、左室舒张末内径(45.80±6.64)mm、心排血量(5.60±1.18)L/min、QT离散度(45.03±6.31)ms优于对照组的(50.50±7.90)%、(50.20±7.07)mm、(4.88±1.01)L/min、(53.77±8.50)ms(P<0.05)。治疗后,观察组2 h PG(7.28±1.30)mmol/L、FPG(6.06±0.27)mmol/L、HbA1c(5.88±0.32)%优于对照组的(8.71±1.20)mmol/L、(7.01±0.76)mmol/L、(6.65±0.52)%(P<0.05)。治疗后,观察组HOMA-β、HOMA-IR优于对照组(P<0.05)。结论 结合冠心病合并2型糖尿病患者实际情况应用二甲双胍结合利拉鲁肽治疗,能够有效改善患者的心功能指标、血糖指标及胰岛素抵抗情况,具有优良的应用前景,在今后的工作过程中能够进一步应用。

TyG指数、血压、血糖相关指标与单纯性超重/肥胖患者早期肾功能损伤的关系

目的:探讨TyG指数、血压、血糖相关指标与单纯性超重/肥胖患者早期肾功能损伤(ERFI)的关系及交互作用。方法:选取2017年1月至2021年12月于郑州大学第一附属医院体检的BMI≥24 kg/m 2者3956例为研究对象,按尿白蛋白与肌酐比值(UACR)分组,<3 mg/mmol为对照组(n=3844),3~≤30 mg/mmol为ERFI组(n=112)。采用Logistic回归分析甘油三酯葡萄糖(TyG)指数、血压和糖化血红蛋白(HbA1c)与ERFI的关联,并进一步分析各因素的交互作用。结果:ERFI组的BMI、收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、HbA1c、总胆固醇(TG)、TyG指数高于对照组,HDL-C低于对照组(P<0.05)。TyG指数>8.77(OR=2.138,95%CI:1.411~3.240)、正常血压高值(OR=2.450,95%CI:1.652~3.635)和HbA1c 5.61%~<7.00%(OR=1.510,95%CI:1.024~2.226)是单纯性超重/肥胖患者ERFI的危险因素。TyG指数与血压有交互作用(RERI=1.754,95%CI:-0.126~3.636;APAB=0.405,95%CI:0.068~0.741)。结论:TyG指数≥8.77、正常血压高值和HbA1c 5.61%~<7.00%可增加单纯性超重/肥胖患者ERFI的患病风险,且血压与TyG指数存在交互作用。

4℃保存全血制备的去白细胞混合浓缩血小板体外质量评价

目的 探讨全血4℃冷藏条件下保存制备去白细胞混合浓缩血小板的可行性,为成分制备提供理论依据。方法 将采集的400 mL ACD-B抗凝全血随机分两组,分别进行4℃和室温保存,在保存后6 h内分离制备出白膜层,于22℃静置过夜保存,次日将白膜层汇集制备去白细胞混合浓缩血小板,于制备后d1、d3、d5、d7取样,进行血细胞计数及相关参数检测,测定pH、葡萄糖、乳酸含量反映代谢情况,检测血栓弹力图、血小板聚集率及PAC-1、CD62P反映血小板体外功能及活化情况,比较两组血小板差异。结果 随着保存时间的延长,两组去白细胞混合浓缩血小板计数逐渐下降,血小板分布宽度(PDW)、平均血小板体积(MPV)、大型血小板比例(P-LCR)均逐渐上升,差异无统计学意义(P>0.05)。两组去白细胞混合浓缩血小板pH、葡萄糖含量均逐渐降低,乳酸含量逐渐增高,无显著性差异(P>0.05)。血栓弹力图结果显示,反应血小板功能的MA值保存期内无显著性变化,且两组间无显著性差异(P>0.05)。血小板聚集率随着保存时间的延长而逐渐降低,两组无统计学差异。血小板PAC-1及CD62P表达率随着保存时间的延长而逐渐升高,两组无统计学差异(P>0.05)。结论 全血4℃冷藏保存与室温保存6 h内制备的去白细胞混合浓缩血小板在体外计数、功能、活化方面无统计学差异,4℃冷藏6 h内的全血可考虑作为制备去白细胞混合浓缩血小板的起始血液。

高水平空腹血糖与缺血性卒中患者静脉溶栓后功能结局的关系分析

目的探讨空腹血糖与接受静脉溶栓的缺血性卒中患者功能结局的关系。方法回顾性收集2018年10月—2020年11月首都医科大学附属北京天坛医院静脉溶栓患者的病历资料。纳入发病4.5 h内接受阿替普酶静脉溶栓的缺血性卒中患者为研究对象,采集相关研究数据(包括空腹血糖等)。研究结局设定为出院时功能结局良好,即mRS评分0~1分。采用多因素logistic回归分析探讨空腹血糖与功能结局的关联性。结果共入组205例患者,平均年龄为(63.21±11.67)岁,其中153例(74.63%)患者为男性,入院NIHSS评分为5(3~9)分。其中117例(57.07%)患者出院时功能结局不良,88例(42.93%)患者出院时功能结局良好。功能结局良好的患者空腹血糖水平低于功能结局不良的患者[5.10(4.46~7.06)mmol/L vs.6.33(5.09~7.79)mmol/L,P=0.001]。多因素logistic回归分析结果显示,校正年龄、性别、NIHSS评分后,空腹血糖水平与接受静脉溶栓功能结局相关(OR0.876,95%CI0.774~0.991,P=0.035);校正年龄、性别、NIHSS评分、桥接取栓后,关联性没有达到统计学意义(OR0.891,95%CI0.791~1.004,P=0.058)。结论对于接受静脉溶栓的缺血性卒中患者,高水平空腹血糖可能会增加静脉溶栓后出院功能结局不良风险。

胰激肽原酶辅助治疗糖尿病肾病的临床疗效及对患者肾功能与血糖水平和炎症因子的影响

目的探讨胰激肽原酶辅助治疗糖尿病肾病(DN)患者的临床疗效。方法选取2020年2月至2021年10月哈尔滨市第一医院收治的113例DN患者作为研究对象,按照随机数字表法分为B组(n=56)与A组(n=57)。B组给予贝那普利治疗,A组在B组基础上联合胰激肽原酶辅助治疗,比较两组临床疗效、肾功能、血糖水平、炎症因子和25-羟维生素D_(3)[25-(OH)D_(3)]水平及不良反应发生率。结果A组治疗总有效率高于B组(93.18%vs.76.75%),差异有统计学意义(P<0.05)。治疗12周后,两组24h尿蛋白水平、尿微量白蛋白/尿肌酐比值(UACR)、24h微量白蛋白排泄率(UAER)均低于治疗前,且A组低于B组,差异有统计学意义(P<0.05)。治疗12周后,两组糖化血红蛋白A1c(HbA1c)、空腹血糖(FBG)和餐后2h血糖(2hPBG)水平均低于治疗前,且A组低于B组,差异有统计学意义(P<0.05)。治疗12周后,两组肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)水平均低于治疗前,25-(OH)D_(3)、白细胞介素2(IL-2)水平均高于治疗前,且A组TNF-α、IL-6水平均低于B组,25-(OH)D_(3)、IL-2水平均高于B组,差异有统计学意义(P<0.05)。A组与B组不良反应发生率(12.25%vs.8.95%)比较差异无统计学意义。结论胰激肽原酶辅助治疗DN效果显著,可明显降低炎症因子水平,改善患者肾功能和25-(OH)D_(3)水平,控制血糖稳定,且不增加不良反应的发生。

三黄益肾胶囊调控NF-κB信号通路减轻糖尿病肾病大鼠炎症反应的机制研究

目的:旨在探究三黄益肾胶囊治疗糖尿病肾病(DN)可能的炎症反应机制。方法:按照随机数字表法将60只大鼠分为正常组、模型组、厄贝沙坦组及三黄益肾低、中、高剂量组,每组10只。除正常组外,其余各组大鼠用高糖高脂饲料联合链脲佐菌素(STZ)注射建立DN模型。正常组和模型组给予生理盐水2 mL灌胃;厄贝沙坦组给予厄贝沙坦11.51 mg/kg灌胃;三黄益肾低、中、高剂量组分别给予三黄益肾胶囊0.41、0.81、1.62 g/kg灌胃。各组大鼠均1次/d,连续给药4周。比较各组大鼠空腹血糖(FBG)、体质量、24 h尿白蛋白、肾功能指标、肾组织病理学变化、肾组织抗氧化相关指标(SOD、GSH-Px活性及MDA水平)、肾组织炎症介质[白细胞介素6(IL-6)、白细胞介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)]、肾组织诱导型一氧化氮合酶(iNOS)、肾组织CD68、CC趋化因子受体2(CCR2)表达、肾组织CC趋化因子配体2(CCL2)、NF-κB P65、p-NF-κB P65、IκB、p-IκB表达。结果:与模型组比较,各三黄益肾胶囊组大鼠体质量高,FBG、血清肌酐(Cr)、尿素氮(BUN)及24 h尿蛋白水平低,肾脏组织病理变化减轻,三肾组织中SOD、GSH-Px活性高,MDA水平低,IL-6、IL-1β、TNF-α水平低,肾组织中iNOS水平低,肾组织CCR2与CD68共定位水平低,CCL2、p-NF-κB P65、p-IκB蛋白表达低。结论:三黄益肾胶囊治疗DN的机制可能与抑制肾组织中NF-κB信号通路激活,减轻肾脏氧化应激及炎症反应有关。

探究2型糖尿病患者采用双胍类降糖药物的治疗效果

目的探究2型糖尿病应用双胍类降糖药物的疗效。方法选取2023年1—12月滕州市妇幼保健院收治的80例2型糖尿病为研究对象,根据随机数表法分为对照组和观察组,各40例。对照组口服瑞格列奈片,观察组口服双胍类降糖药物二甲双胍片,持续用药8周后,对比两组血糖、胰岛功能及不良反应。结果两组治疗前的血糖及胰岛功能比较,差异无统计学意义(P均>0.05);治疗4、8周后,观察组的血糖及胰岛功能更优于对照组,差异有统计学意义(P均<0.05)。观察组不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论2型糖尿病患者应用双胍类降糖药物二甲双胍片治疗,可改善血糖与胰岛功能,可减少不良反应。

急性血糖波动对N末端B型利钠肽前体评估心功能的影响

目的 研究短时间内血糖浓度波动对NT-proBNP水平的影响。方法 选取2019年9~10月进行OGTT试验的住院患者32例。分别检测每位患者在空腹时、OGTT试验开始后30 min、60 min、120 min和180 min时血浆NT-proBNP、血糖、胰岛素和C-肽的水平。通过Pearson和Spearman相关分析探究个体NT-proBNP水平与血糖浓度的相关性,应用单因素重复测量方差分析和广义线性混合模型进一步分析检测时间、血糖、胰岛素和C-肽对NT-proBNP水平的影响。结果 相关分析表明,在32例患者中,只有5例患者的NT-proBNP水平与血糖浓度有相关性(P<0.05)。然而,每例患者NT-proBNP水平与血糖浓度的相关性趋势和最佳拟合曲线各不相同。单因素重复测量方差分析表明,不同时间和不同血糖浓度下NT-proBNP水平的差异无统计学意义[F(1.36,40.87)=1.23,P=0.29,η2=0.04]。广义线性混合模型表明NT-proBNP水平不受检测时间、血糖、胰岛素和C-肽浓度的影响(P>0.05)。结论 急性血糖浓度波动不影响NT-proBNP水平从而不影响NT-proBNP对心功能的评估。

肾移植受者术前合并代谢综合征对早期移植肾功能的影响

目的探讨同种异体肾移植受者术前合并代谢综合征对早期移植肾功能的影响。方法回顾性分析117例肾移植受者的临床资料,根据移植肾功能分为移植物功能延迟恢复(DGF)组(29例)和非DGF组(88例),应用单因素和多因素回归分析同种异体肾移植受者发生DGF的相关危险因素,分析肾移植受者术前合并代谢综合征对早移植肾功能的影响。结果117例肾移植受者,47例术前合并代谢综合征,29例术后发生DGF,DGF组中83%术前合并代谢综合征,高于非DGF组中的74%(P<0.05)。单因素分析结果显示,DGF组供者体质量指数(BMI)、终末血清肌酐(Scr),受者术前BMI、血糖、甘油三酯水平、术前合并代谢综合征比例均高于非DGF组(均为P<0.05)。多因素logistic回归分析结果显示,供者Scr水平高、受者术前血红蛋白水平高、受者术前合并代谢综合征是肾移植术后发生DGF的独立危险因素(均为P<0.05)。结论受者术前合并代谢综合征是同种异体肾移植发生DGF的独立危险因素,应采取相关策略以减少DGF和其他与代谢相关的并发症的发生率。

基于IMPACT模式的延续性护理在老年2型糖尿病合并冠心病患者中的应用效果

目的:观察基于确定-定义-产生-应用-计算-跟踪(IMPACT)模式的延续性护理在老年2型糖尿病合并冠心病患者中的应用效果。方法:选取2020年8月至2022年8月该院收治的94例老年2型糖尿病合并冠心病患者进行前瞻性研究,采用随机数字表法将其分为观察组与对照组各47例。对照组采取常规护理,观察组采取基于IMPACT模式的延续性护理。比较两组护理前后血糖指标[餐后2 h血糖(2hPG)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)]水平、心功能指标[左心室射血分数(LVEF)、左心室短轴缩短率(FS)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)]水平、健康行为[健康促进生活方式量表Ⅱ(HPLP-Ⅱ)]评分、生命质量[2型糖尿病患者生存质量量表(DMQLS)]评分和护理满意度。结果:护理后,两组2hPG、FBG、HbA1c水平均低于护理前,且观察组低于对照组,差异有统计学意义(P<0.05);两组LVEF、FS水平均高于护理前,且观察组高于对照组,两组LVEDD、LVESD水平均低于护理前,且观察组低于对照组,差异有统计学意义(P<0.05);两组压力管理、健康责任感、人际关系、营养、体育运动和精神成长等HPLP-Ⅱ评分均高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05);两组疾病、生理、心理、社会、满意度等DMQLS评分均高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05);观察组护理满意度为95.74%(45/47),高于对照组的82.98%(39/47),差异有统计学意义(P<0.05)。结论:基于IMPACT模式的延续性护理应用于老年2型糖尿病合并冠心病患者中可降低血糖指标水平,改善心功能指标水平,提高健康行为评分、生命质量评分和护理满意度,其效果优于常规护理。

妊娠期糖尿病孕妇孕期血糖代谢情况与新生儿血糖、肾功能及胆红素代谢的相关性

目的 分析妊娠期糖尿病(GDM)孕妇孕期糖代谢情况与新生儿血糖、肾功能及胆红素代谢的相关性。方法 选取宣城市人民医院在2021年1月至2023年3月期间收治的95例GDM患者及所分娩的新生儿进行研究,GDM产妇根据分娩完成时的血糖水平分为血糖控制理想组与血糖控制不佳组;另选取同期妊娠的100名健康产妇及所分娩的新生儿为对照组。比较三组产妇妊娠完成时的血糖水平;比较三组新生儿入住新生儿科时的血糖值、血红蛋白及血钙水平;比较三组新生儿入住新生儿科时的肾功能指标[血尿素氮(BUN)、血肌酐(SCr)];比较三组新生儿入住新生儿科时的胆红素代谢情况[总胆红素(TBil)、直接胆红素(DBil)以及间接胆红素(IBil)];分析新生儿血糖水平、肾功能、胆红素水平与GDM产妇血糖代谢的相关性。结果 95例患者中,有54例患者血糖控制理想(血糖控制理想组),41例患者血糖控制不佳(血糖控制不佳组)。血糖控制不佳组的空腹血糖、糖化血红蛋白、餐后2 h血糖均高于对照组、血糖控制理想组,差异均有统计学意义(P<0.05);新生儿出生时血糖值、血钙水平:对照组>血糖控制理想组>血糖控制不佳组,血红蛋白、SCr、TBil、IBil水平:对照组<血糖控制理想组<血糖控制不佳组,差异均有统计学意义(P<0.05);新生儿血糖、血钙水平与GDM产妇血糖代谢呈负相关,血红蛋白、SCr、TBil、IBil水平与GDM产妇血糖代谢呈正相关(P<0.05)。结论 GDM对胎儿及新生儿影响较大,应加强妊娠期血糖控制,密切关注GDM产妇所生新生儿血糖、肾功能及胆红素代谢情况,防止并发症的发生。

二甲双胍恩格列净片治疗2型糖尿病合并HFpEF的临床效果

目的:探讨二甲双胍恩格列净片治疗2型糖尿病(T2DM)合并射血分数保留性心力衰竭(HFpEF)患者的临床效果和安全性。方法:选取2021年10月—2022年9月保定市第一中心医院80例T2DM合并HFpEF患者,通过随机数字表法将其分为观察组(n=40)和对照组(n=40)。对照组给予常规药物治疗,观察组在对照组的用药基础上联合二甲双胍恩格列净片治疗。两组均接受为期6个月的连续治疗。对比两组血糖指标、心功能指标及不良反应发生情况。结果:治疗后,两组空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)均较治疗前下降,且观察组均低于对照组(P<0.05)。治疗后,两组左室射血分数(LVEF)、左室舒张末径(LVEDD)、左室收缩末径(LVESD)、脑钠肽(BNP)均优于治疗前,且观察组均优于对照组(P<0.05)。观察组不良反应发生率(5.0%)低于对照组(22.5%),差异有统计学意义(P<0.05)。结论:二甲双胍恩格列净片治疗2型糖尿病合并HFpEF临床效果显著,能够使患者的血糖水平下降并提高心功能相关指标,同时安全性较高。

分析不同高血压分级血压变异性与空腹甘油三酯血糖指数及内皮功能的相关性

目的 探讨不同高血压分级血压变异性与空腹甘油三酯血糖指数及内皮功能的相关性。方法 选取天津市第一医院2020年10月—2023年10月收治的150例高血压患者作为研究对象,将患者分为:1级组(n=50),即140~159 mmHg和(或)舒张压90~99 mmHg,2级组(n=60),即收缩压160~179 mmHg和(或)舒张压100~109 mmHg,3级组(n=40),即收缩压≥180 mmHg和(或)舒张压≥110 mmHg。测量所有患者收缩压加权标准差(SBPwSD)和舒张压加权标准差(DBPwSD)评价血压变异性,检测空腹血糖、空腹甘油三酯水平,计算空腹甘油三酯血糖指数(TyG),以及记录丙二醛(MDA)、一氧化氮(NO)、内皮素-1(ET-1)、超氧化物歧化酶(SOD)水平对内皮功能进行评价。采用Spearman相关分析法分析血压变异性与空腹TyG及内皮功能的相关性。结果 1级组DBPwSD、SBPwSD低于2级组和3级组(P<0.05);1级组空腹血糖、空腹甘油三酯、TyG低于2级组和3级组(P<0.05);1级组MDA、ET-1低于2级组和3级组,NO、SOD高于2级组和3级组(P<0.05);DBPwSD、SBPwSD与空腹血糖、空腹甘油三酯无关(P>0.05),DBPwSD、SBPwSD与NO、SOD水平呈负相关,与TyG、MDA、ET-1呈正相关(P<0.05)。结论 不同血压分级的高血压患者血压变异性、TyG及血管内皮功能具有明显差异,且高血压患者血压变异性与TyG和血管内皮功能具有明显相关性。