目的 了解DFU患者的TXA2表达水平的变化及其影响因素,并讨论其与糖尿病血管病变的严重程度的相关性。方法 选择我院内分泌科2009年6月—2012年12月收治的2型糖尿病足部溃疡并坏疽形成的患者共30例、DFU非坏疽组38例、无DFU的2型糖尿病组患者40例,收集其一般资料及检查结果。分析TXA2的表达水平与其他资料的关系。并采用相关分析TXA2的稳定代谢产物TXB2水平升高的危险因素。结果 年龄、糖尿病病程、吸烟、BMI、血浆白蛋白与TXB2水平相关。结论 2型糖尿病足部溃疡患者的血浆血栓素A2水平显著增高,并且表达水平与病情严重程度相关,且与糖尿病病程、血脂、血糖 、血胰岛素、胰岛素抵抗指数水平、血压控制水平等呈明显相关关系。提示其可作为 2 型糖尿病患者血管内皮功能及动脉硬化的早期反映。

目的 探讨糖尿病自我管理支持对社区2型糖尿病患者生化指标控制的影响。方法 2015年1月1日前已确诊为2型糖尿病患者,随机分为对照组和干预组,对照组303例按照广州市基本公共卫生服务包要求进行定期随访、体检及健康教育,干预组130例进行自我管理支持干预,观察两组生化指标的变化。结果 与对照组比较,自我管理支持组的空腹血糖、总胆固醇、甘油三酯、谷丙转氨酶、尿酸控制效果较好,差异有统计学意义(P<0.05)。结论 自我管理支持对社区2型糖尿病患者生化指标控制的效果良好,值得推广。

Objective To evaluate the control effect of biochemical criterion in patients with type 2 diabetes under diabetes self-management support in community. Methods 130 patients with type 2 diabetes in community from January 2015 to December 2015 accepting the diabetes self-management support were chosen as research group, another 303 diabetic patients without the diabetes self-management support were set as control group, the effect of management was analyzed. Results There was statistically significant difference (P<0.05) in biochemical criterion including blood sugar (BS), total cholesterol (TC), triglyceride (TG), alanine aminotransferase (ALT) and uric acid (UA). Conclusion Control effect of biochemical criterion was good in the diabetes self- management support for people with type 2 diabetes, which was worth to be popularized.

目的 探讨老年2型糖尿病患者牙周病发生情况及相关因素,为开展综合预防和治疗措施提供参考。方法 选取到我院住院治疗的老年2型糖尿病患者273例,检查其牙周病患病情况,同时收集年龄、性别、文化程度、体重指数、病程、吸烟、空腹血糖、糖化血红蛋白、刷牙习惯等资料,比较牙周病患病组与未患病组之间上述资料的差异,探讨导致牙周病发生的影响因素。结果 273例研究对象中患有牙周病154例(56.41%),其中,牙龈炎60例,牙周炎94例。牙周病组平均存留牙数(18.54±6.31)颗,未患牙周病组平均存留牙数(21.62±7.48)颗(t=3.679,P<0.001)。年龄较大(P<0.001)、病程较长(P<0.001)、吸烟(P<0.001)、空腹血糖(P<0.001)和糖化血红蛋白(P<0.001)水平较高是老年2型糖尿病患者发生牙周病的危险因素,而文化程度高(P=0.017),刷牙>1次/d(P<0.001),竖刷(P=0.004),使用牙线(P=0.004)是其保护因素。结论 老年2型糖尿病患者中牙周病患病率较高,临床上应做好三级预防措施,降低牙周病发生风险因素的暴露。

Objective To explore the periodontal disease occurrence and its factors for elderly type 2 diabetes patients, providing reference for comprehensive prevention and treatment measures. Methods 273 cases of elderly in-patients with type 2 diabetes in our hospital were enrolled. We checked their periodontal disease conditions, collected information including age, sex, educational level, body mass index, disease duration, smoking, fasting blood glucose, glycosylated hemoglobin, brushing habits. These values were compared between periodontal disease group and no periodontal disease group. Results People with periodontal disease in 273 cases of the object of study included 154 patients (56.41%), among them, gingivitis 60 cases, 94 cases of periodontitis. The teeth number was (18.54±6.31) for periodontal disease group on average, with (21.62 ±7.48) for no periodontal disease group (t=3.679, P<0.001). Older (P<0.001), longer course of disease (P<0.001), smoking (P<0.001), higher fasting blood glucose (P<0.001) and higher glycosylated hemoglobin (P<0.001) were risk factors of periodontal disease for elderly patients with type 2 diabetes. And well-educated (P=0.017), brushing teeth frequency > 1 / d (P<0.001), vertical brush mode (P=0.004), the use of dental floss (P=0.004) were the protective factors. Conclusion Periodontal disease prevalence is high in elderly patients with type 2 diabetes. The three level preventive measures should be strengthened to reduce the exposure of the periodontal disease risk factors.

目的 探讨2型糖尿病肾病(DN)患者肾组织中STOML2的表达及作用。方法 免疫组化检测临床2型糖尿病肾病患者肾组织STOML2的表达及定位,采用慢病毒转染方法建立稳定过表达STOML2的HK-2细胞系,并应用Western blot检测肾小管上皮细胞钙粘蛋白(E-cadherin)、Fibronectin和STOML2的表达。结果 STOML2在DN患者肾组织的肾小管上皮细胞胞浆中表达明显升高。在高糖刺激HK-2细胞建立的EMT模型中,STOML2呈时间依赖表达上调。STOML2稳定高表达时,E-cadherin表达下调,而Fibronectin明显上调,即能促进肾小管上皮细胞发生EMT。结论 STOML2可能通过促进肾小管上皮细胞向间充质细胞分化,进而参与糖尿病肾病肾脏纤维化的发生发展。

Objective To investigate the expression and role of STOML2 in renal tissue of patients with type 2 diabetic nephropathy. Methods To detect he expression and localization of STOML2 in clinical renal tissue in patients with type 2 diabetic nephropathy by immunohistochemistry, and use lentiviral transfection method to establish a stable cell line of over-expressing STOML2, lastly apply western blot to detect the expression of E-cadherin, Fibronectin and STOML2 in renal tubular epithelial cells. Results STOML2 was significantly increased in renal tubular epithelial cytoplasm of patients with DN. In the EMT model of HK-2 cells stimulated by high glucose, STOML2 was increased in a time dependent. Overexpression of STOML2 led to E-cadherin down-regulated, while Fibronectin up-regulated, which promoted the occurrence of EMT in renal tubular epithelial cells. Conclusion STOML2 may be involved in the development and progression of renal fibrosis in diabetic nephropathy by mediating epithelial- mesenchymal transition of renal tubular epithelial cells.

目的 探讨CAl99在T2DM患者与健康人群中的差异及CAl99与糖化血红蛋白(HBAlc)的相关性。方法 收集2013年1月—9月T2DM患者382例,选择同期健康体检者90例作为对照组,分别检测血清CA199与HbA1c水平,根据HbA1c水平将T2DM患者分为血糖控制组(HbA1c<7.5%),控制不佳组(HbA1C≧7.5%),T2DM患者CA199水平与对照组比较,以体重指数、空腹血糖、HbA1c等为自变量,比较各变量对CA199的影响程度。结果 T2DM患者中CA199水平高于对照组,两者比较差异有统计学意义(t=3.45,P=0.005),血糖控制不佳组CA199阳性率(21.4%)高于血糖控制组(4%),差异有统计学意义(χ²=43.33,P=0.006),HBAlc控制组(4%)与健康体检者(0.9%)无显著差异(t=0.347,P=0.254,),CA199水平与HbA1c的相关系数最高(r=0.573,P=0.004)。结论 T2DM患者CA199水平和HbA1c存在相关性, 2型糖尿病患者CAl99升高与长期血糖控制不佳有关。

Objective To explore the differences in patients with T2DM and healthy people and to explore the correlation between CA199 and HbA1c in patients with T2DM. Methods 382 patients with T2DM and 90 healthy subjects for control group were collected from January to September in 2013.The level of CA199 and HbA1c were measured by chemiluminescence method and high performance liquid chromatography assay respectively. Accordingto the level of HbA1c,patients were divided in to blood glucose controlled group(HbA1c<7.5%) and blood glucose uncontrolled group (HbA1c≧7.5%).The level of CA199 were compared with control group. Sex, age, course of disease, body mass index, fasting blood glucose and HbA1c were included as independent variables for multiple stepwise regression analysis, to compare of influences of the variables on the CA199. Results The level of CA199 in T2DM patients was significantly higher than those of healthy subjects(t=3.45, P=0.005) and the positive rate of CA199 in blood glucose uncontrolled group(21.4%) was significantly higher than those of controlled group(4.0%)(χ²=43.33,P=0.006),there is no significant difference between in blood glucose controlled group(4.0%) and healthy people group(0.9%)(t=0.347,P=0.254).Among the many variables, the level of CA199 and HbA1c correlation coefficient was the highest (r=0.573, P=0.004. Conclusion There was a close correlation between CA199 level and HbA1c.There was a correlation between the positive level of CA199 and uncontrolled blood glucose.

目的 评价自我管理小组干预对社区2型糖尿病患者的管理效果。方法 在2013年底选取本区社区卫生服务中心100例患者研究,运用自身对照方法,管理1年后对其自我管理效能、生化指标、空腹血糖、糖化血红蛋白进行比较。结果 管理一年后饮食控制、运动控制、药物依从性、监测依从性、足部护理等指标差异有统计学意义(P<0.05)。空腹血糖、糖化血红蛋白、总胆固醇、尿酸下降,差异有统计学意义(P<0.05)。空腹血糖达标率由12%上升到37%,糖化血红蛋白达标率由10%上升到34%,差异有统计学意义(P<0.05)。结论 自我管理小组干预提高了社区2型糖尿病患者自我管理水平,改善了主要的生化指标,值得社区推广应用。

Objective To evaluate the function of self-management group program on patients with type 2 diabetes in community. Methods Self-management was carried out for one year among 100 patients with type 2 diabetes, the effect of management was analyzed. Results There was statistically significant difference in diet control, motion control, drug compliance, monitoring compliance, and foot care after one year intervention (P<0.05). GLU, HbA1c, CHOL, UA were decreased. The difference was statistically significant (P<0.05). Conclusion Self-management of group intervention is effective in patients with type 2 diabetes, is worthy of further popularization and application.

目的 探讨2型糖尿病患者发生医院感染危险因素。方法 收集2010年1月—2015年1月我院收治890例2型糖尿病患者临床资料行回顾性分析,根据是否发生医院感染分为感染组(75例)和非感染组(815例),对两组患者相关因素进行分析。结果 2型糖尿病医院感染发生率为8.43%,好发于呼吸系统感染。年龄、病程、住院时间、血糖控制差、侵袭性操作、合并并发症、合并基础疾病为2型糖尿病患者发生感染的危险因素。结论 2型糖尿病患者发生医院感染危险因素较多,临床针对高危患者应重点进行预防,降低感染率,提高患者治疗效果。

目的 探讨DPP-4抑制剂联合二甲双胍治疗2型糖尿病的临床疗效及安全性。方法 选取医院近3年收治的糖尿病病人70例,随机分为对照组(35例)和治疗组(35例),对照组给予二甲双胍治疗,治疗组给予二甲双胍联合DPP-4抑制剂控制血糖,经3个月治疗,比较治疗后血糖指标、胰岛功能指标及低血糖、不良反应情况。结果 对照组和治疗组治疗后FPG、2hPG、HbA1c水平均有降低,治疗组治疗后血糖检测指标优于对照组(P＞0.05)。胰岛功能监测显示治疗组治疗后空腹胰岛素、服糖后2小时胰岛素浓度升高优于对照组,胰高血糖素水平降低幅度大于对照组,治疗前后胰岛素及胰高血糖素均有变化,组间比较P＞0.05,有临床意义。治疗期间两组患者均未发生低血糖、药物不良反应。结论 DPP-4抑制剂联合二甲双胍可显著提高降糖效果,改善胰岛功能,并且无低血糖、药物不良反应发生。