论著

LC + ERCP / EST治疗胆囊结石合并肝外胆管结石患者疗效研究

Clinical efficacy of LC combined with ERCP/EST in treating gallbladder stones complicated by extrahepatic bile duct stones

:1049-1053
 
目的 探讨胆囊结石并发肝外胆管结石经腹腔镜胆囊切除术(LC)联合内窥镜逆行胰胆管造影术(ERCP)/内窥镜下括约肌切开术(EST)治疗的临床效果。方法 选取2020年1月—2023年6间就诊于南平市第一医院的86例胆囊结石合并肝外胆管结石患者,根据治疗方案不同分为对照组(n=40)和观察组(n=46)。对照组给予LC联合经腹腔镜胆总管切开取石术(LCBDE)治疗,观察组给予LC联合ERCP、EST在治疗,观察两组手术相关指标情况、血管紧张素水平、肝功能以及并发症发生情况。结果 观察组患者术中出血量少于对照组的(t=12.440,P<0.001),观察组手术用时、肛门排气时间以及住院时间均短于对照组(均P<0.001);观察组血管紧张素1-7(Ang1-7)、血管紧张素Ⅰ(AngⅠ)、血管紧张素Ⅱ(AngⅡ)水平低于对照组,组间比较差异均无统计学意义(均P>0.05);观察组总胆红素(TBIL)、谷氨酸转氨酶(ALT)水平低于对照组水平,组间比较差异无统计学意义(均P>0.05);观察组无患者发生胆漏、结石残留,对照组胆漏、结石残留发生率分别为5.00%、2.50 %,组间对比差异均无统计学意义(均P>0.05),观察组出血、胆道感染生率分别为4.35 %、2.17 %低于对照组10.00%、5.00 %,组间对比差异均无统计学意义(均P>0.05。结论 LC联合ERCP/EST治疗胆囊结石合并肝外胆管结石可以减少术中出血,缩短手术用时和住院时间。
Objective This study aims to investigate the clinical efficacy of laparoscopic cholecystectomy(LC)combined with endoscopic retrograde cholangiopancreatography(ERCP)or endoscopic sphincterotomy(EST)in the treatment of gallbladder stones complicated by extrahepatic bile duct stones.Methods A total of 86 patients with gallbladder stones and extrahepatic bile duct stones treated at the First Hospital of Nanping from January 2020 to June 2023 were selected.According to different treatment regimens,they were divided into a control group(n=40)and an observation group(n=46).The control group received LC combined with laparoscopic common bile duct exploration(LCBDE),while the observation group received LC combined with ERCP and EST.Surgical-related indicators,angiotensin levels,liver function,and complications were observed in both groups.Results The observation group had less intraoperative bleeding than the control group(t=12.440,P<0.001).The observation group had a shorter operation time,postoperative anal exhaust time,and hospital stay than the control group(all P<0.001).The levels of angiotensin 1-7(Ang1-7),angiotensin I(AngⅠ),and angiotensin II(AngⅡ)in the observation group were lower than those in the control group,with no statistically significant differences between the groups(all P>0.05).Total bilirubin(TBIL)and alanine aminotransferase(ALT)levels in the observation group were comparable to those in the control group(all P>0.05).No patients in the observation group experienced bile leakage or residual stones,while the incidence rates in the control group were 5.00% and 2.50%,respectively,with no statistically significant differences between the groups(all P>0.05).The observation group had lower rates of bleeding and biliary tract infection at 4.35% and 2.17%,respectively,compared to the control group at 10.00% and 5.00%,with no statistically significant differences between the groups(all P>0.05).Conclusions LC combined with ERCP/EST in the treatment of gallbladder stones complicated by extrahepatic bile duct stones can reduce intraoperative bleeding,shorten operation time,and decrease hospital stay.
论著

全面触发工具在新生儿医源性皮肤损伤不良事件中的应用研究

:997-1001
 
目的 研究探讨全面触发工具(GTT)在新生儿医源性皮肤损伤(ISI)不良事件监测中的应用,检验其有效性与适用性。方法 根据GTT白皮书中推荐的护理模块触发器,结合江西省妇幼保健院医院新生儿科ISI发生的特点和实际情况,建立科室审查团队,回顾性分析我院新生儿科重症监护室(NICU)2021年1月—2021年9月168例新生儿的病历。初级审查员负责审查病历;高级审查员负责对确定的ISI和伤害分级作最终决策,对ISI不良事件发生率进行综合的分析,制定符合科室的不良事件触发器,评价GTT在提高新生儿医源性不良事件检出率的优势。结果 168份病历中,设计的14项触发器中14项显示为阳性,触发器阳性检测率为100.00%,触发器阳性总频次为66次,阳性检出频次12例,阳性预测值为18.18%;168份病历GTT检出不良事件频次12次,涉及患儿8例,GTT检出率4.76%;GTT检出E级5例(2.98%),F级3例(1.79%);自愿上报E级3例(1.79%),F级2例(1.19%),均未发生G级、H级、I级事件;自愿上报事件5例,上报率为(2.98%)。结论 建立新生儿ISI不良事件触发器,并规范皮肤管理、规范和监督ISI医疗护理工作,可以最大限度保证患儿安全,提高新生儿综合救治能力,提升医疗护理服务水平。
综述

全身免疫炎症指数与心血管疾病相关研究进展

Research progress on systemic immune inflammation index and cardiovascular disease

:985-990
 
慢性炎症是心血管疾病的常见发病机制,它主要通过损伤内皮细胞、氧化应激和刺激血栓形成影响疾病发展。全身免疫炎症指数(SII)作为一种新型炎症指标,最早用于肿瘤患者的预后评估,现已在多学科领域广泛使用,它由中性粒细胞、血小板、淋巴细胞计算得到,更加全面地反映机体炎症状态。SII已经在多项研究中被证实具有良好的预测价值,该文对SII的优势和在心血管疾病的临床研究进展进行综述,为研究的进一步开展提供参考。
Chronic inflammation is a common pathogenesis of cardiovascular disease,which mainly affects disease progression by damaging endothelial cells,oxidative stress and stimulating thrombosis.As a new type of inflammatory index,the systemic immune inflammatory index(SII)was first used to evaluate the prognosis of cancer patients,and has been widely used in multidisciplinary fields.SII has been confirmed to have good predictive value in a number of studies,and this article reviews the advantages of SII and the progress of clinical research in cardiovascular diseases,so as to provide reference for further research development.
专家述评

脊柱结核的外科治疗研究进展

The progress in surgical treatment research for spinal tuberculosis

:963-973
 
脊柱结核是脊柱感染性疾病中最为常见的类型。本文综述了脊柱结核外科治疗的现状及最新进展。在早期治疗阶段,规范化的抗结核药物治疗能够有效缓解疼痛,改善患者生活质量。但对于中后期,特别是椎旁脓肿较大,椎体骨质破坏较大而导致脊柱不稳定的患者,手术治疗往往是必要且必需的辅助手段,手术可以最大限度清除病变的椎间盘、椎体和脓肿,也应该最大限度保留健康的骨质。其主要原则包括病灶彻底清除、脊髓充分减压、脊柱稳定性重建等步骤。在手术治疗中,一期前路手术作为经典入路已经得到广泛应用,而单纯后路手术治疗也逐渐受到重视。近年来,随着微创手术技术的发展,其在脊柱结核治疗中的应用越来越广泛。微创手术的优势在于术中创伤更小、恢复更快,为患者带来了更好的治疗体验和临床效果。然而,对于手术的选择,临床医师需要综合考虑患者的个体差异性、临床表现及特征、影像学资料和手术适应证等多种因素,以确定最合适的治疗方案。只有充分考虑各种治疗手段的优劣,采取个性化、综合性的治疗方案,才能更好地提高患者的生活质量和治疗效果。
Spinal tuberculosis is the most common types of infectious diseases affecting the spine.This article reviews the current status and progress of surgical treatment for spinal tuberculosis.In the early and initial stages,standardized anti-tuberculosis drug therapy can effectively alleviate pain and improve patients' quality of life.However,for more complex cases in the middle and late stages,surgical treatment is needed,including thorough lesion clearance,adequate spinal cord decompression,and reconstruction of spinal stability.In surgical treatment,anterior approach surgery,as a classical method,has been widely applied,and posterior approach surgery alone has gradually gained attention.In recent years,with the development of minimally invasive surgical techniques,their application in the treatment of spinal tuberculosis has become increasingly widespread.The advantages of minimally invasive surgery lie in smaller intraoperative trauma and faster recovery,providing patients with better treatment experience and clinical outcomes.However,for the selection of surgery,clinicians need to consider multiple factors such as individual differences,clinical manifestations and characteristics,imaging data and surgical indications to determine the most suitable treatment plan.Only by fully considering the advantages and disadvantages of various treatment modalities and adopting personalized,comprehensive treatment plans can the quality of life and treatment outcomes of patients be effectively improved.
护理研究

基于计划行为理论的妊娠期糖尿病患者自我管理行为意向的质性研究

A qualitative study of self-management behavior intention in patients with gestational diabetes mellitus based on the theory of planned behavior

:1215-1219
 
目的 基于计划行为理论探讨妊娠期糖尿病(GDM)孕妇自我管理行为意向,为促进其孕期良好的自我管理提供依据。方法 运用质性研究中的现象学研究方法,对12例GDM孕妇进行深度半结构式访谈,并用Colaizzi七步内容分析法对主题进行归纳。结果 根据计划行为理论对主题进行归纳,共提炼出3种类别:①行为态度:认知不足,积极态度,消极态度;②主观规范:家庭影响,医护压力,人际压力;③知觉行为控制:知识技能获取受限,客观条件束缚共8个主题。结论 GDM患者在自我管理过程中存在对疾病认知不足的问题GDM,自我管理行为受到家庭、医护人员、人际关系等外界压力对自我管理态度的影响,且存在知识技能欠缺,客观条件制约多方面阻碍。医护人员应加强对GDM孕妇的自我管理教育,适时提供支持,提高其自我管理效率。
Objective To explore the self-management behavior intention of pregnant women with gestational diabetes mellitus(GDM)based on the theory of planned behavior,and to provide a basis for promoting good self-management during pregnancy. Methods Using the phenomenological research method in qualitative research,12 pregnant women with GDM were interviewed in an in-depth semi-structured interview,and then the themes were summarized by Colaizzi's seven-step content analysis. Results According to the theory of planned behavior,the themes were summarized into three categories and eight themes including(1)Behavioral Attitudes:cognition deficiency,positive attitude,and negative attitude,(2)Subjective norms:family influence,medical pressure,interpersonal pressure,and(3)Perceptual behavior control:self-management knowledge acquisition limitations,self-management Objective conditions constraint. Conclusions Most of the respondents have insufficient awareness of self-management of gestational diabetes,different patients have different attitudes towards self-management,and self-management behavior is affected by external pressures such as family,medical staff,and interpersonal relationships,and there are many obstacles due to a lack of knowledge and skills,Objective conditions.Medical staff should strengthen the self-management education of pregnant women with gestational diabetes,provide timely support,and improve their self-management efficiency.
论著

雌二醇片/雌二醇地屈孕酮片治疗早发性卵巢功能不全的临床研究

Clinical study on the treatment of premature ovarian insufficiency with Complex Packing Estradiol Tablets/Estradiol and Dydrogesterone Tablets

:1205-1209
 
目的 观察雌二醇片/雌二醇地屈孕酮片对早发性卵巢功能不全(POI)患者卵巢储备功能及血清免疫指标的影响。方法 选取2022年2月—2023年8月福建中医药大学附属第三人民医院妇科收治的早发性卵巢功能不全患者60例,按随机数字表法分为对照组和研究组,对照组(30例)予常规激素替代疗法,研究组(30例)予雌二醇片/雌二醇地屈孕酮片。比较两组血清抗缪勒管激素(AMH)、卵泡刺激素(FSH)、雌二醇(E2)、抗心磷脂抗体(ACA)、抗卵巢抗体(AOA)、抗β2糖蛋白1 IgM抗体(β2GP1-IgM)水平。结果 研究组治疗总有效率高于对照组,治疗后两组患者血清AMH、E2水平均升高,血清FSH、ACA、AOA和β2GP1-IgM水平均降低(均P<0.05),研究组临床疗效优于对照组,且不良反应发生率较低(P<0.05)。结论 雌二醇片/雌二醇地屈孕酮片可改善POI患者的卵巢储备功能,纠正机体自身免疫紊乱,其作用机制可能与免疫调节有关。
Objective To observe the effects of Complex Packing Estradiol Tablets/Estradiol and Dydrogesterone Tablets on ovarian reserve function and serum immune indicators in patients with premature ovarian insufficiency. Methods Sixty patients with early-onset ovarian insufficiency admitted to the gynecology department of the Third People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine from February 2022 to August 2023 were selected and randomly divided into a control group(CG)and a study group(SG)using a random number table method.The CG(30 cases)received Complex Packing Estradiol Tablets/Estradiol and Dydrogesterone Tablets.while the SG(30 cases)received Femoston.Compare two groups of serum anti-Müllerian hormone(AMH),follicle stimulating hormone(FSH),estradiol(E2),anticardiolipin antibody(ACA),anti ovarian antibody(AOA),and anti β2 Glycoprotein 1 IgM antibody(β2GP1 IgM)level. Results The total effective rate of the SG was higher than that of the control group(P<0.05);Compared with before treatment,the serum levels of AMH and E2 increased in both groups of patients after treatment,while serum levels of FSH,ACA,AOA and β The level of 2GP1 IgM decreased(P<0.05),and the clinical efficacy of the SG was better than that of the CG,with a lower incidence of adverse reactions. Conclusions Complex Packing Estradiol Tablets/Estradiol and Dydrogesterone Tablets can regulate the levels of sex hormones in patients with premature ovarian insufficiency,improve ovarian reserve function,correct autoimmune disorders in the body,and its mechanism of action may be related to immune regulation.
论著

复方甘草口服液联合泼尼松治疗特发性肺间质纤维化急性加重期患者的疗效及安全性研究

Study on the efficacy and safety of compound licorice oral liquid combined with prednisone in the treatment of patients with acute exacerbation of idiopathic pulmonary interstitial fibrosis

:1177-1182
 
目的 探讨复方甘草口服液联合泼尼松治疗特发性肺间质纤维化急性加重期患者的疗效。方法 选取张掖市第二人民医院2020年1月—2023年10月收治的128例特发性肺间质纤维化急性加重期患者,应用随机数字表法分为两组,每组各64例。对照组采取泼尼松治疗,观察组采取复方甘草口服液联合泼尼松治疗。对比其临床疗效,治疗前后血清肺纤维化指标及炎症因子水平,最后对比其不良反应发生率。结果 观察组总有效率93.75%,高于对照组的79.69%(χ2=5.490,P=0.019);治疗前两组层黏连蛋白(LN)、Ⅲ型前胶原肽(PC-Ⅲ)、透明质酸(HA)对比差异无统计学意义(P>0.05),治疗后两组患者LN、PC-Ⅲ、HA均降低,观察组[(89.25±7.61)μg/L;(68.33±7.68)mg/L;(81.53±8.54)μg/L]低于对照组[(96.17±8.34)μg/L;(75.68±8.25)mg/L;(95.68±9.25)μg/L],对比差异有统计学意义(t1=4.903,P1<0.001;t2=5.217,P2<0.001;t3=8.992,P3<0.001);治疗前两组患者肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)、IL-10、转化生长因子(TGF-β1)对比差异无统计学意义(P>0.05),治疗后两组TNF-α、IL-4、IL-10、TGF-β1水平降低,观察组[(61.94±8.24)ng/L;(4.43±1.17)ng/mL;(65.49±13.24)g/L;(114.73±13.12)pg/mL]低于对照组[(75.52±9.43)ng/L;(6.31±1.28)ng/mL;(79.27±9.38)g/L;(147.76±15.46)pg/mL],对比差异有统计学意义(t1=8.675,P1<0.001;t2=8.673,P2<0.001;t3=6.794,P3<0.001;t4=13.032,P4<0.001);两组不良反应发生率对比差异无统计学意义(7.81% vs 6.25%,χ2=0.120,P=0.730)。结论 复方甘草口服液联合泼尼松治疗特发性肺间质纤维化急性加重期疗效显著,可辅助延缓患者肺纤维化发展进程,减轻机体炎症反应,安全性较高。
Objective To investigate the efficacy of compound licorice oral liquid combined with prednisone in patients with acute exacerbations of idiopathic pulmonary interstitial fibrosis. Methods A total of 128 patients with acute exacerbation of idiopathic pulmonary interstitial fibrosis admitted to Zhangye Second People's Hospital from January 2020 to October 2023 were divided into two groups by random number table method,with 64 patients in each group.The control group received prednisone treatment,while the observation group received compound licorice oral liquid combined with prednisone treatment.Compare its clinical efficacy,serum pulmonary fibrosis indicators and inflammatory factor levels before and after treatment,and finally compare its incidence of adverse reactions. Results The total response rate in the observation group was 93.75%,which was higher than the 79.69% in the control group(χ2=5.490,P=0.019).There was no difference between the two groups of LN,PC-III,and HA(P>0.05),LN,PC-III and HA were decreased in both groups,while the observation group[(89.25±7.61)μg/L;(68.33±7.68)mg/L;(81.53±8.54)μg/L] was lower than the control group[(96.17±8.34)μg/L;(75.68±8.25)mg/L;(95.68±9.25)μg/L],the contrast difference was statistically significant(t1=4.903,P1<0.001;t2=5.217,P2<0.001;t3=8.992,P3<0.001).There was no difference in TNF-α,IL-4,IL-10,and TGF-β1 between the two groups before treatment(P>0.05),lower levels of TNF-α,IL-4,IL-10,and TGF-β1 in the two patient groups after treatment,the observation group[(61.94±8.24)ng/L;(4.43±1.17)ng/mL;(65.49±13.24)g/L;(114.73±13.12)pg/mL] was lower than the control group[(75.52±9.43)ng/L;(6.31±1.28)ng/mL;(79.27±9.38)g/L;(147.76±15.46)pg/mL],the contrast difference was statistically significant(t1=8.675,P1<0.001;t2=8.673,P2<0.001;t3=6.794,P3<0.001;t4=13.032,P4<0.001).There was no difference in the incidence of adverse effects between the two groups(7.81% vs 6.25%,χ2=120,P=0.730). Conclusions The combination of compound licorice oral liquid and prednisone has a significant therapeutic effect on the acute exacerbation of idiopathic pulmonary interstitial fibrosis.It can assist in delaying the progression of pulmonary fibrosis in patients,reducing the body's inflammatory response,and has high safety.
论著

干预因素对孤独症谱系障碍患儿社交行为影响的观察性研究

An observational study on the impact of intervention factors on social behavior in children with autism spectrum disorders

:1159-1165
 
目的 探索干预因素对4~12岁孤独症谱系障碍(ASD)患儿社交反应的影响,为开展ASD患儿的早期干预提供参考。方法 选取于2020年1月—2023年3月在清远市妇幼保健院儿童神经与发育中心康复干预的ASD患儿,采用社交反应量表(SRS)对患儿进行社交行为评估,采用自编一般情况问卷对家长进行问卷调查,调查内容包括患儿的基本情况(性别、共患病情况、干预时长、上学情况等)。结果 202例ASD患儿中,男性患儿162例(80.2%),女性40例(19.8%),性别对社交反应的影响比较差异无统计学意义(t=2.969,P>0.05)。共患病方面,无共患病的ASD患儿与共患智力发育障碍及注意缺陷多动障碍的患儿相比,其SRS得分差异有统计学意义(F=6.920,P<0.05)。在上学情况方面,普通学校就读的患儿与特殊学校及未上学的患儿相比,其SRS得分差异有统计学意义(F=3.823,P<0.05),但在特殊学校就读的患儿与未上学的患儿相比,差异无统计学意义(P>0.05)。在干预时长方面,干预≥1年与干预<1年及未干预的患儿比较,其SRS得分更低,差异有统计学意义(F=4.477,P<0.05),但干预<1年与未干预患儿相比,两者差异无统计学意义(P>0.05)。结论 ASD患儿中,是否患有其他无共患病、上学情况、干预时长会影响其社交反应;存在共患疾病的ASD患儿社交反应表现更差;相较于就读特殊教育机构和未上学的患儿,就读于普通学校的ASD患儿社交障碍程度更轻;干预时间越长,其社交障碍程度也越轻。
Objective To explore the impact of intervention factors on social response in children with autism spectrum disorder(ASD)aged 4—12,and to provide reference for early intervention in children with ASD. Methods Children with ASD who underwent rehabilitation intervention at the Children's Neurology and Development Center of Qingyuan Maternal and Child Health Hospital from January 2020 to March 2023 were selected.The social behavior of the children was evaluated using the Social Response Scale(SRS),and the parents were surveyed using a self-made general situation questionnaire.The survey content included the basic information of the children(gender,comorbidity,intervention duration,and school attendance,etc.). Results Among the 202 cases of ASD,162 were male(80.2%)and 40 were female(19.8%).There was no statistically significant difference in the impact of gender on social response(t=2.969,P>0.05).In terms of comorbidities,there was a statistically significant difference in SRS scores between ASD children without comorbidities and those with comorbidities such as intellectual development disorder and attention deficit hyperactivity disorder(F=6.920,P<0.05).In terms of school attendance,there was a statistically significant difference in SRS scores between children enrolled in regular schools and those who attended special schools and those who did not attend school(F=3.823,P<0.05),but there was no statistically significant difference between children enrolled in special schools and those who did not attend school(P>0.05).In terms of intervention duration,compared with children with intervention≥1 year and those with intervention<1 year and no intervention,the SRS score was lower and the difference was statistically significant(F=4.477,P<0.05).However,compared with children with intervention<1 year and those without intervention,the difference was not statistically significant(P>0.05). Conclusions No comorbidities,attending regular schools,and intervention duration≥1 year are positive factors that affect social response.Children with ASD who have comorbidities have poorer social response performance;compared to children who attend special education institutions and those who do not attend school,children with ASD who attend regular schools have lower levels of social impairment;the longer the intervention time,the lighter the degree of social impairment.
专家述评

长链非编码RNA在消化道肿瘤中的研究进展

Long non-coding RNAs in human gastrointestinal cancer

:1105-1112
 
在过去的几十年中,随着RNA生物学的深入研究,越来越多的证据表明,非编码RNA(ncRNA)对包括癌症在内的多种疾病进展起着关键作用,同时在作为生物标志物和治疗靶点方面表现出了巨大的潜力。在全球范围内,消化道(GI)肿瘤是肿瘤相关死亡的主要原因,目前消化道肿瘤晚期患者的生存率依然很低。既往大量研究报道了ncRNA中,特别是长链非编码RNA(lncRNA)在消化道肿瘤发生发展中发挥重要作用。本文将着重阐述lncRNA在消化道肿瘤分子生物学中的作用,旨在为深入理解lncRNA在消化道肿瘤发生发展机制以及临床转化应用提供新的思路和线索。
In recent decades,an increasing body of evidence has pointed to the pivotal roles of non-coding RNAs(ncRNAs),particularly long non-coding RNAs(lncRNAs),in the development of various diseases,including cancer.Meanwhile,ncRNAs have been shown great potential as biomarker and therapeutic target.Gastrointestinal(GI)cancers are a leading cause of cancer-related mortality globally and the survival rate of advanced GI cancer patients is still very low.Extensive research has underscored the significant involvement of lncRNAs in the initiation and progression of GI cancers.This review aims to offer a comprehensive overview of lncRNAs,shedding light on their roles in the molecular biology of GI cancers.By synthesizing previous studies,this review seeks to provide new insights into the mechanisms underlying lncRNAs' contribution to GI cancer development and their potential clinical applications.
论著

25-羟维生素D水平与糖尿病周围神经病变发生的相关性研究

Correlation study between 25-hydroxyvitamin D level and diabetic peripheral neuropathy

:1297-1302
 
目的 探究25-羟维生素D[25-(OH)D]水平预测糖尿病周围神经病变发生的相关性。方法 选取2021年6月—2021年12月间在上海市静安区南京西路社区卫生服务中心就诊的200例2型糖尿病患者为研究对象,根据体格检查、血液生化、神经症状评分、肌电图等方法分为无周围神经病变组(n=153)和周围神经病变组(n=47),对比两组患者的一般资料及血清基线25-(OH)D水平,分析25-(OH)D与糖尿病周围神经病变的相关性,采用Logistic回归分析25-(OH)D对糖尿病周围神经病变的预测价值。结果 两组患者基线25-(OH)D水平、空腹血糖、糖化血红蛋白(HbA1c)、收缩压对比差异有统计学意义(P<0.001),而年龄、性别、BMI、腰围、餐后血糖值、谷草转氨酶、空腹C肽、总胆固醇、高密度脂蛋白胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)、血肌酐、血尿酸、舒张压对比无明显差异(P>0.05);基线25-(OH)D水平与密歇根糖尿病周围神经病变评分(MDNS)呈负相关(r=-0.583,P<0.001),空腹血糖与MDNS评分呈正相关(r=0.303,P<0.001);Logistic回归分析提示,25-(OH)D每增加一个单位,糖尿病周围神经病变风险下降25%,校正性别、年龄、HbA1c、LDL后,相关性依然存在。结论 25-(OH)D水平与糖尿病周围神经病变呈负相关,与该病的发生及发展密切相关,血清25-(OH)D水平可作为预测尿病周围神经病变发生、发展的重要指标。
Objective To explore the correlation of 25-hydroxyvitamin D[25-(OH)D] level in predicting the occurrence of diabetic peripheral neuropathy.Methods A total of 200 patients with type 2 diabetes mellitus(T2DM)who were admitted to Community Health Service Center of West Nanjing Road,Jing’an District,Shanghai from June 2021 and December 2021 were selected as the study subjects.According to physical examination,blood biochemistry,neurological symptom score and electromyography,the patients were divided into two groups:no peripheral neuropathy group(n=153)and peripheral neuropathy group(n=47).The general data and serum baseline 25-(OH)D levels of the two groups were compared to analyze the correlation between 25-(OH)D and diabetic peripheral neuropathy.The predictive value of 25-(OH)D in diabetic peripheral neuropathy was analyzed by Logistic regression.Results There were significant differences in baseline 25-(OH)D level,fasting blood glucose(FBG),HbA1c and SBP between two groups(P<0.001),but no significant differences in age,sex,BMI,waist circumference,postprandial plasma glucose,AST,C-peptid total cholesterol,HDL-C,triglyceride,LDL-C,Scr,UA and DBP between two groups(P>0.05).Baseline 25-(OH)D level was negatively correlated with MDNS score(r=-0.583,P<0.001),and FBG was positively correlated with MDNS score(r=0.303,P<0.001).Logistic regression analysis showed that the DPN risk decreased by 25% for every unit increase of 25-(OH)D,and the correlation remained after timely adjustment for sex,age,HbA1c,and LDL-C.Conclusion sThe level of 25-(OH)D is negatively correlated with the occurrence and development of diabetic peripheral neuropathy,and the detection of serum 25-(OH)D level can be used as an important indicator to predict the occurrence and development of urinary peripheral neuropathy.
出版者信息








《广州医药》公众号