BACKGROUND Patients with type 2 diabetes mellitus(T2DM)have large fluctuations in blood glucose(BG),abnormal metabolic function and low immunity to varying degrees,which increases the risk of malignant tumor diseases ...BACKGROUND Patients with type 2 diabetes mellitus(T2DM)have large fluctuations in blood glucose(BG),abnormal metabolic function and low immunity to varying degrees,which increases the risk of malignant tumor diseases and affects the efficacy of tumor chemotherapy.Controlling hyperglycemia may have important therapeutic implications for cancer patients.AIM To clarify the influence of BG fluctuations on chemotherapy efficacy and safety in T2DM patients complicated with lung carcinoma(LC).METHODS The clinical data of 60 T2DM+LC patients who presented to the First Affiliated Hospital of Ningbo University between January 2019 and January 2021 were retrospectively analyzed.All patients underwent chemotherapy and were grouped as a control group(CG;normal BG fluctuation with a mean fluctuation<3.9 mmol/L)and an observation group(OG;high BG fluctuation with a mean fluctuation≥3.9 mmol/L)based on their BG fluctuations,with 30 cases each.BGrelated indices,tumor markers,serum inflammatory cytokines and adverse reactions were comparatively analyzed.Pearson correlation analysis was performed to analyze the correlation between BG fluctuations and tumor markers.RESULTS The fasting blood glucose and 2-hour postprandial blood glucose levels in the OG were notably elevated compared with those in the CG,together with markedly higher mean amplitude of glycemic excursions(MAGE),mean of daily differences,largest amplitude of glycemic excursions and standard deviation of blood glucose(P<0.05).In addition,the OG exhibited evidently higher levels of carbohydrate antigen 19-9,carbohydrate antigen 125,carcinoembryonic antigen,neuron-specific enolase,cytokeratin 19,tumor necrosis factor-α,interleukin-6,and highsensitivity C-reactive protein than the CG(P<0.05).Pearson analysis revealed a positive association of MAGE with serum tumor markers.The incidence of adverse reactions was significantly higher in the OG than in the CG(P<0.05).CONCLUSION The greater the BG fluctuation in LC patients after chemotherapy,the more unfavorable the therapeutic effect of chemotherapy;the higher the level of tumor markers and inflammatory cytokines,the more adverse reactions the patient experiences.展开更多
Objective:To investigate the hook effect in the detection of beta2-microglobulin(β2-MG)with different reagents as well as on two fully automated biochemical analyzers and their solutions.Methods:Using immunoturbidime...Objective:To investigate the hook effect in the detection of beta2-microglobulin(β2-MG)with different reagents as well as on two fully automated biochemical analyzers and their solutions.Methods:Using immunoturbidimetric assay forβ2-MG as the research object,β2-MG levels were detected by different concentration gradients ofβ2-microglobulin samples in Liedemann,Mack,and Myriad reagents of three manufacturers on two automatic biochemical analyzers,and the difference of the hook effect was comparatively analyzed.Results:Leadman reagent showed the hook effect on the Beckman AU5800 automated biochemistry analyzer,while both Maccura and Mindray reagents did not show the hook effect.After the experiments,we found the limit value of the pre-zone check of Leadman reagent,and changed the parameters of the instrument,when the limit value of the pre-zone check was reached,the instrument automatically diluted the specimen five times and then detected it again.After changing the parameters of the instrument,the correlation between the three methods of detecting samples of different concentrations was r>0.99.Conclusion:Before selecting the application of immunoturbidimetric reagents,we have to carry out the risk assessment of the hook effect and selectively set the parameters of the pre-zone check based on the highest concentration that may occur in the clinic;for the items that may have the hook effect,we have to selectively set the parameters of the pre-zone check when the ratio of average reaction rate and the immediate reaction rate is at the limit value,and the phenomenon of antigen excess may occur,the instrument will carry out automatic dilution before detection,so as to avoid the issuance of erroneous results of high-value samples due to the hook effect.展开更多
目的分析脾瘅方加减联合二甲双胍治疗肥胖型2型糖尿病(Diabetes mellitus type 2,T2DM)患者的临床疗效及对其血脂、胰岛素抵抗指数(Homeostatic Model Assessment of Insulin Resistance,HOMA-IR)的影响。方法选取2022年1月—2023年2月...目的分析脾瘅方加减联合二甲双胍治疗肥胖型2型糖尿病(Diabetes mellitus type 2,T2DM)患者的临床疗效及对其血脂、胰岛素抵抗指数(Homeostatic Model Assessment of Insulin Resistance,HOMA-IR)的影响。方法选取2022年1月—2023年2月期间就诊于济宁市中医院的肥胖型T2DM患者100例作为研究对象,按随机数表法分为对照组和观察组,每组各50例。对照组常规服用二甲双胍0.5 g/次,3次/d;观察组在对照组基础上加用脾瘅方对症加减治疗。治疗12周后观察比较两组患者临床疗效,治疗前后血糖指标[血糖(Fasting blood glucose,FBG)、餐后2 h血糖(2-hour postprandial blood glucose,2 h PBG)、糖化血红蛋(Glycosylated hemoglobinA1c,HbA1c)]、中医证候积分、血脂指标[总胆固醇(Total cholesterol,TC)、甘油三酯(Triglycerides,TG)、低密度脂蛋白(Low density lipoprotein,LDL-C)]、胰岛素指标[空腹胰岛素(Fasting insulin,FINS)、胰岛素抵抗指数(Homeostasis Model Assessment-Insulin Resistance,HOMA-IR)、胰岛β细胞功能指数(Homeostatic model assessment ofβ-cell function,HOMA-β)]及炎症因子[白介素-6(Interleukin-6,IL-6)、超敏C反应蛋白(Highsensitivity C-reactive protein,hs-CRP)]水平。结果治疗后观察组临床总有效率94.00%(47/50)明显高于对照组78.00%(39/50),差异有统计学意义(P<0.05)。治疗后两组患者血糖FBG、2 h PBG、HbAlc指标及中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组血糖FBG、2 h PBG、HbAlc指标及中医证候积分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血脂指标TG、TC、LDL-C均较治疗前降低,差异有统计学意义(P<0.05);且观察组血脂指标TG、TC、LDL-C均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者胰岛素FINS、HOMA-IR指标均较治疗前降低,HOMA-β指标均较治疗前升高,差异有统计学意义(P<0.05);且观察组胰岛素FINS、HOMA-IR指标明显低于对照组,HOMA-β指标明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者炎症因子IL-6、hs-CRP水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组炎症因子IL-6、hs-CRP水平均明显低于对照组,差异有统计学意义(P<0.05)。结论脾瘅方加减联合二甲双胍治疗肥胖型T2DM患者能有效调节血糖、血脂水平,改善胰岛素抵抗,减轻炎症反应,临床疗效显著。展开更多
目的探讨对2型糖尿病患者采取运动行为干预的作用。方法选取60例2型糖尿病患者,随机分为对照组及试验组,各30例。对照组采取临床常规干预,试验组在对照组的基础上采取运动行为干预。比较两组患者的糖尿病生存质量特异性量表(DSQL)、罗...目的探讨对2型糖尿病患者采取运动行为干预的作用。方法选取60例2型糖尿病患者,随机分为对照组及试验组,各30例。对照组采取临床常规干预,试验组在对照组的基础上采取运动行为干预。比较两组患者的糖尿病生存质量特异性量表(DSQL)、罗森伯格自尊量表中文版(SES)、老年抑郁量表(GDS)、Borg主观疲劳感知量表(RPE)、匹兹堡睡眠质量指数量表(PSQI)评分及餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)水平。结果试验组患者的DSQL、SES、GDS评分分别为(15.99±2.12)、(17.21±3.18)、(15.39±2.53)分,低于对照组的(33.59±3.11)、(37.71±4.18)、(23.58±3.39)分,差异有统计学意义(P<0.05)。试验组患者的RPE、PSQI评分分别为(32.92±12.15)、(32.55±4.13)分,低于对照组的(55.49±17.19)、(53.42±7.20)分,差异有统计学意义(P<0.05)。试验组患者的2 h PG、HbA1c水平分别为(7.82±0.31)mmol/L、(6.23±0.53)%,低于对照组的(8.32±0.52)mmol/L、(7.12±0.63)%,差异有统计学意义(P<0.05)。结论采取运动行为干预对患有2型糖尿病的患者效果显著,能改善患者的临床症状,值得推广。展开更多
目的分析2型糖尿病患者使用德谷门冬双胰岛素注射液联合二甲双胍治疗后的血糖水平、不良反应,判断其治疗效果。方法选择76例2型糖尿病患者为研究对象,随机分成对照组和观察组,每组38例。对照组患者给予二甲双胍治疗,观察组在对照组基础...目的分析2型糖尿病患者使用德谷门冬双胰岛素注射液联合二甲双胍治疗后的血糖水平、不良反应,判断其治疗效果。方法选择76例2型糖尿病患者为研究对象,随机分成对照组和观察组,每组38例。对照组患者给予二甲双胍治疗,观察组在对照组基础上给予德谷门冬双胰岛素注射液治疗。比较两组治疗前后的血糖[空腹血糖(FPG)、糖化血红蛋白(HbA1c)、餐后2 h血糖(2 h PG)]水平,不良反应发生率,治疗前后的胰岛功能[空腹胰岛素(FINS)、胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)]、疗效。结果两组治疗后FPG、HbA1c、2 h PG均低于治疗前,差异具有统计学意义(P<0.05);观察组治疗后FPG(6.30±1.12)mmol/L、HbA1c(6.37±0.49)%、2 h PG(8.05±1.12)mmol/L明显低于对照组的(7.29±1.34)mmol/L、(7.32±0.83)%、(9.62±1.70)mmol/L,差异具有统计学意义(P<0.05)。与对照组的23.68%相比,观察组治疗期间不良反应发生率5.26%明显较低,差异具有统计学意义(P<0.05)。治疗后,两组患者的FINS、HOMA-β、HOMA-IR均较治疗前改善,且观察组患者FINS(14.03±1.52)mU/L、HOMA-β(80.35±10.36)明显高于对照组的(11.52±1.30)mU/L、(72.15±9.21),HOMA-IR(3.19±0.21)明显低于对照组的(3.81±0.42),差异具有统计学意义(P<0.05)。与对照组的73.68%相比,观察组患者治疗总有效率92.11%明显较高,差异具有统计学意义(P<0.05)。结论经过德谷门冬双胰岛素联合二甲双胍治疗后,2型糖尿病患者的血糖水平明显改善,安全性高,总体疗效较好,对于治疗2型糖尿病有着重大意义。展开更多
基金Supported by Chronic Disease Management Center for Thoracic Tumor,The Affiliated Hospital of Medical School of Ningbo University,No.2021MGZX-07Natural Science Foundation of Ningbo,No.2019A610238.
文摘BACKGROUND Patients with type 2 diabetes mellitus(T2DM)have large fluctuations in blood glucose(BG),abnormal metabolic function and low immunity to varying degrees,which increases the risk of malignant tumor diseases and affects the efficacy of tumor chemotherapy.Controlling hyperglycemia may have important therapeutic implications for cancer patients.AIM To clarify the influence of BG fluctuations on chemotherapy efficacy and safety in T2DM patients complicated with lung carcinoma(LC).METHODS The clinical data of 60 T2DM+LC patients who presented to the First Affiliated Hospital of Ningbo University between January 2019 and January 2021 were retrospectively analyzed.All patients underwent chemotherapy and were grouped as a control group(CG;normal BG fluctuation with a mean fluctuation<3.9 mmol/L)and an observation group(OG;high BG fluctuation with a mean fluctuation≥3.9 mmol/L)based on their BG fluctuations,with 30 cases each.BGrelated indices,tumor markers,serum inflammatory cytokines and adverse reactions were comparatively analyzed.Pearson correlation analysis was performed to analyze the correlation between BG fluctuations and tumor markers.RESULTS The fasting blood glucose and 2-hour postprandial blood glucose levels in the OG were notably elevated compared with those in the CG,together with markedly higher mean amplitude of glycemic excursions(MAGE),mean of daily differences,largest amplitude of glycemic excursions and standard deviation of blood glucose(P<0.05).In addition,the OG exhibited evidently higher levels of carbohydrate antigen 19-9,carbohydrate antigen 125,carcinoembryonic antigen,neuron-specific enolase,cytokeratin 19,tumor necrosis factor-α,interleukin-6,and highsensitivity C-reactive protein than the CG(P<0.05).Pearson analysis revealed a positive association of MAGE with serum tumor markers.The incidence of adverse reactions was significantly higher in the OG than in the CG(P<0.05).CONCLUSION The greater the BG fluctuation in LC patients after chemotherapy,the more unfavorable the therapeutic effect of chemotherapy;the higher the level of tumor markers and inflammatory cytokines,the more adverse reactions the patient experiences.
基金Baoding Science and Technology Bureau(2141ZF313)。
文摘Objective:To investigate the hook effect in the detection of beta2-microglobulin(β2-MG)with different reagents as well as on two fully automated biochemical analyzers and their solutions.Methods:Using immunoturbidimetric assay forβ2-MG as the research object,β2-MG levels were detected by different concentration gradients ofβ2-microglobulin samples in Liedemann,Mack,and Myriad reagents of three manufacturers on two automatic biochemical analyzers,and the difference of the hook effect was comparatively analyzed.Results:Leadman reagent showed the hook effect on the Beckman AU5800 automated biochemistry analyzer,while both Maccura and Mindray reagents did not show the hook effect.After the experiments,we found the limit value of the pre-zone check of Leadman reagent,and changed the parameters of the instrument,when the limit value of the pre-zone check was reached,the instrument automatically diluted the specimen five times and then detected it again.After changing the parameters of the instrument,the correlation between the three methods of detecting samples of different concentrations was r>0.99.Conclusion:Before selecting the application of immunoturbidimetric reagents,we have to carry out the risk assessment of the hook effect and selectively set the parameters of the pre-zone check based on the highest concentration that may occur in the clinic;for the items that may have the hook effect,we have to selectively set the parameters of the pre-zone check when the ratio of average reaction rate and the immediate reaction rate is at the limit value,and the phenomenon of antigen excess may occur,the instrument will carry out automatic dilution before detection,so as to avoid the issuance of erroneous results of high-value samples due to the hook effect.
文摘目的分析脾瘅方加减联合二甲双胍治疗肥胖型2型糖尿病(Diabetes mellitus type 2,T2DM)患者的临床疗效及对其血脂、胰岛素抵抗指数(Homeostatic Model Assessment of Insulin Resistance,HOMA-IR)的影响。方法选取2022年1月—2023年2月期间就诊于济宁市中医院的肥胖型T2DM患者100例作为研究对象,按随机数表法分为对照组和观察组,每组各50例。对照组常规服用二甲双胍0.5 g/次,3次/d;观察组在对照组基础上加用脾瘅方对症加减治疗。治疗12周后观察比较两组患者临床疗效,治疗前后血糖指标[血糖(Fasting blood glucose,FBG)、餐后2 h血糖(2-hour postprandial blood glucose,2 h PBG)、糖化血红蛋(Glycosylated hemoglobinA1c,HbA1c)]、中医证候积分、血脂指标[总胆固醇(Total cholesterol,TC)、甘油三酯(Triglycerides,TG)、低密度脂蛋白(Low density lipoprotein,LDL-C)]、胰岛素指标[空腹胰岛素(Fasting insulin,FINS)、胰岛素抵抗指数(Homeostasis Model Assessment-Insulin Resistance,HOMA-IR)、胰岛β细胞功能指数(Homeostatic model assessment ofβ-cell function,HOMA-β)]及炎症因子[白介素-6(Interleukin-6,IL-6)、超敏C反应蛋白(Highsensitivity C-reactive protein,hs-CRP)]水平。结果治疗后观察组临床总有效率94.00%(47/50)明显高于对照组78.00%(39/50),差异有统计学意义(P<0.05)。治疗后两组患者血糖FBG、2 h PBG、HbAlc指标及中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组血糖FBG、2 h PBG、HbAlc指标及中医证候积分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血脂指标TG、TC、LDL-C均较治疗前降低,差异有统计学意义(P<0.05);且观察组血脂指标TG、TC、LDL-C均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者胰岛素FINS、HOMA-IR指标均较治疗前降低,HOMA-β指标均较治疗前升高,差异有统计学意义(P<0.05);且观察组胰岛素FINS、HOMA-IR指标明显低于对照组,HOMA-β指标明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者炎症因子IL-6、hs-CRP水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组炎症因子IL-6、hs-CRP水平均明显低于对照组,差异有统计学意义(P<0.05)。结论脾瘅方加减联合二甲双胍治疗肥胖型T2DM患者能有效调节血糖、血脂水平,改善胰岛素抵抗,减轻炎症反应,临床疗效显著。
文摘目的 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。
文摘目的探讨对2型糖尿病患者采取运动行为干预的作用。方法选取60例2型糖尿病患者,随机分为对照组及试验组,各30例。对照组采取临床常规干预,试验组在对照组的基础上采取运动行为干预。比较两组患者的糖尿病生存质量特异性量表(DSQL)、罗森伯格自尊量表中文版(SES)、老年抑郁量表(GDS)、Borg主观疲劳感知量表(RPE)、匹兹堡睡眠质量指数量表(PSQI)评分及餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)水平。结果试验组患者的DSQL、SES、GDS评分分别为(15.99±2.12)、(17.21±3.18)、(15.39±2.53)分,低于对照组的(33.59±3.11)、(37.71±4.18)、(23.58±3.39)分,差异有统计学意义(P<0.05)。试验组患者的RPE、PSQI评分分别为(32.92±12.15)、(32.55±4.13)分,低于对照组的(55.49±17.19)、(53.42±7.20)分,差异有统计学意义(P<0.05)。试验组患者的2 h PG、HbA1c水平分别为(7.82±0.31)mmol/L、(6.23±0.53)%,低于对照组的(8.32±0.52)mmol/L、(7.12±0.63)%,差异有统计学意义(P<0.05)。结论采取运动行为干预对患有2型糖尿病的患者效果显著,能改善患者的临床症状,值得推广。
文摘目的分析2型糖尿病患者使用德谷门冬双胰岛素注射液联合二甲双胍治疗后的血糖水平、不良反应,判断其治疗效果。方法选择76例2型糖尿病患者为研究对象,随机分成对照组和观察组,每组38例。对照组患者给予二甲双胍治疗,观察组在对照组基础上给予德谷门冬双胰岛素注射液治疗。比较两组治疗前后的血糖[空腹血糖(FPG)、糖化血红蛋白(HbA1c)、餐后2 h血糖(2 h PG)]水平,不良反应发生率,治疗前后的胰岛功能[空腹胰岛素(FINS)、胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)]、疗效。结果两组治疗后FPG、HbA1c、2 h PG均低于治疗前,差异具有统计学意义(P<0.05);观察组治疗后FPG(6.30±1.12)mmol/L、HbA1c(6.37±0.49)%、2 h PG(8.05±1.12)mmol/L明显低于对照组的(7.29±1.34)mmol/L、(7.32±0.83)%、(9.62±1.70)mmol/L,差异具有统计学意义(P<0.05)。与对照组的23.68%相比,观察组治疗期间不良反应发生率5.26%明显较低,差异具有统计学意义(P<0.05)。治疗后,两组患者的FINS、HOMA-β、HOMA-IR均较治疗前改善,且观察组患者FINS(14.03±1.52)mU/L、HOMA-β(80.35±10.36)明显高于对照组的(11.52±1.30)mU/L、(72.15±9.21),HOMA-IR(3.19±0.21)明显低于对照组的(3.81±0.42),差异具有统计学意义(P<0.05)。与对照组的73.68%相比,观察组患者治疗总有效率92.11%明显较高,差异具有统计学意义(P<0.05)。结论经过德谷门冬双胰岛素联合二甲双胍治疗后,2型糖尿病患者的血糖水平明显改善,安全性高,总体疗效较好,对于治疗2型糖尿病有着重大意义。
