目的 探讨达格列净在行经皮冠状动脉介入治疗（Percutaneous Coronary Intervention，PCI）后2型糖尿病（Type 2 Diabetes Mellitus,T2DM）伴不稳定型心绞痛（Unstable Angina，UA）患者中的应用价值及短期心功能改善效果。方法 本研究为单中心、随机对照试验，纳入90例PCI术后2型糖尿病合并不稳定型心绞痛患者，随机分为达格列净组（n=43）和二甲双胍组（n=47），规范调整降糖药物保证降糖强度一致。治疗期间及治疗后6-12个月通过心脏彩超测量左心室射血分数（Left Ventricular Ejection Fraction，LVEF）、左室舒张末期内径（Left Ventricular End-Diastolic Diameter，LVEDD），并采集静脉血样检测N端B型利钠肽前体（N-terminalpro-Brain Natriuretic Peptide，NT-proBNP）水平，以评估心功能变化。 结果 PCI治疗后的6-12个月随访中，观察组NT-proBNP（P<0.01）显著降低，左心室射血分数LVEF（P<0.01）显著提升。与对照组相比：观察组NT-ProBNP水平明显下降（P<0.01），且低于对照组。结论 在PCI术后合并不稳定型心绞痛的T2DM患者中，加用达格列净治疗可显著改善NT-proBNP和LVEF等心功能替代指标，且安全性良好。

Objective:To explore the application value of dapagliflozin and its short-term cardiac function improvement effect in patients with type 2 diabetes mellitus (T2DM) combined with unstable angina (UA) after percutaneous coronary intervention (PCI). Methods: This was a single-center, randomized controlled trial. A total of 90 patients with type 2 diabetes mellitus (T2DM) complicated with unstable angina (UA) after percutaneous coronary intervention (PCI) were enrolled and randomly assigned to a dapagliflozin group (n=43) and a metformin group (n=47). Hypoglycemic agents were adjusted routinely to ensure consistent glycemic control intensity between the two groups. During treatment and at 6–12 months after treatment, left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) were measured by echocardiography, and venous blood samples were collected to determine the level of N-terminal pro-Brain Natriuretic Peptide (NT-proBNP) for the evaluation of cardiac function changes. Results: During the 6-month follow-up after PCI treatment, the N-terminal pro-brain natriuretic peptide (NT-proBNP) level in the observation group decreased significantly (P<0.01), and the left ventricular ejection fraction (LVEF) increased significantly (P<0.01).Compared with the control group, the NT-proBNP level in the observation group was notably lower (P<0.01) and also remained below that of the control group. Conclusion: For type 2 diabetes mellitus (T2DM) patients complicated with unstable angina pectoris after PCI, adjuvant treatment with dapagliflozin for 6 months can significantly improve cardiac function surrogate markers such as NT-proBNP and LVEF, with favorable safety profile.

目的 探讨达格列净辅助治疗老年心力衰竭合并2型糖尿病(T2DM)患者的效果。方法 将我院2020年9月—2022年2月期间收治的82例老年心力衰竭合并T2DM患者按照随机数字表法分为观察组和对照组,对照组41例予以常规降糖及抗心力衰竭药物治疗,观察组41例在对照组基础上予以达格列净治疗,观察2组患者血糖水平、心肌损伤标志物、心室结构以及不良反应。结果 治疗3个月后,观察组空腹血糖、餐后2小时血糖、糖化血红蛋白水平低于对照组(P<0.05);观察组NT-proBNP、AngⅡ水平低于对照组(P<0.05);观察组LAVI、LVESd、LVEDd低于对照组,观察组LVEF高于对照组(P<0.05);观察组不良反应发生率(12.20%)与对照组(7.32%)对比差异无统计学意义(P>0.05)。结论 达格列净辅助治疗老年心力衰竭合并T2DM患者有效降低血糖,减轻心肌损伤,改善心脏结构和功能,且不增加患者不良反应发生率。

目的 观察2型糖尿病大鼠肝脏组织中circRNA-0003340的表达,并探讨与糖尿病的关系。方法 选取健康雄性SD大鼠30只,随机分为2组,正常对照组（NC组,n=10）与2型糖尿病组（T2DM组,n=20）,检测FPG、FINs、HbA1c、TC、TG、HDL-C、LDL-C、AST、ALT;行腹腔注射糖耐量实验和胰岛素耐量实验,计算胰岛素抵抗指数（HOMA-IR）;HE染色观察胰岛细胞形态;RT-PCR检测大鼠肝脏组织circRNA-000334的表达量。结果 与NC组比较,T2DM组的AST、ALT、FPG、HAb1c、FINs、HOMA-IR、TG、TC、LDL-C均升高（P<0.05）,HDL-C降低（P<0.05）。circRNA-0003340在T2DM组肝脏组织中的表达较NC组肝脏组织中的表达是下调的,差异有统计学意义（P<0.05）。Sperman相关分析示大鼠肝脏组织中circRNA-0003340表达水平与FPG、TG及TC呈负相关（P<0.05）。结论 circRNA-003340的表达水平可能与T2DM大鼠的糖脂代谢密切相关,circRNA-003340在肝脏组织中的表达水平下调可能参与T2DM的发生发展。

Objective To observe the expression of circRNA-0003340 in the liver tissue of type 2 diabetes mellitus （T2DM）rats and to explore its relationship with diabetes．Methods A total of 30 healthy male SD rats were randomly divided into two groups,normal control group（NC group,n=10）and T2DM group（n=20）,and fasting plasma glucose（FPG）,fasting insulins（FINS）,glycated hemoglobin（HbA1c）,total cholesterol（TC）,triglyceride (TG）,high-density lipoprotein cholesterol（HDL-C）,low-density lipoprotein cholesterol（LDL-C）,aspartate aminotransferase（AST）,alanine aminotransferase（ALT）levels were detected．Intraperitoneal glucose tolerance test and insulin tolerance test were performed to calculate the insulin resistance index（HOMA-IR）,HE staining was used to observe islet cell morphology,the expression of circRNA-000334 in rat liver tissue was detected by RT-PCR．Results Compared with the NC group,the T2DM group had increased AST,ALT,FPG,HAb1c,FINs,HOMA-IR,TG,TC,LDL-C（P<0.05）and decreased HDL-C（P<0.05）．The expression of circRNA-0003340 in liver tissue in T2DM group was down-regulated compared with that in NC group,with statistically significant difference（P<0.05）．Sperman correlation analysis showed that the expression level of circ-0003340 in rat liver tissue was negatively correlated with FPG,TG and TC（P<0.05）．Conclusions The expression level of circRNA-003340 may be closely related to the glycolipid metabolism of T2DM rats,and the downward regulation of the circRNA-003340 expression level in liver tissues may be involved in the occurrence and development of T2DM．

目的 探究2型糖尿病患者的肾糖阈(RTG)及相关因素。方法 本院对2014年12月—2018年9月466例2型糖尿病患者为研究对象,正常肾糖阀值为8.9～10 mmol/L,据此将患者分为高阀值组、中等阀值组以及低阀值组,不同组肾糖范围分别为RTG＞10 mmol/L、8.9 mmol/L≤RTG≤10 mmol/L、RTG＜8.9 mmol/L,以此对各组生化特征进行分析。结果 高阀值组与中等阀值组相比,RTG值、年龄、病程、空腹血糖(FPG)、体质量指数(BMI)、总胆固醇(TC)、血糖均值(MBG)、24 h血糖对比差异明显,P＜0.05。高阀值组与低阀值组相比,RTG值、性别、FPG、BMI、TC、MBG、糖化血红蛋白(HbA1C)对比有差异,P＜0.05。性别、年龄、BMI、HbA1C、TC以及低密度酶蛋白胆固醇(LDL-C)与2型糖尿病相关,且呈正比关系,P＜0.05;通过多元线性回归分析发现,2型糖尿病的影响因素主要有BMI、HbA1C、LDL-C,数据具有统计学意义,P＜0.05。结论 较多2型糖尿病患者肾糖阀值较高,且肾糖阀值与HbA1C、LDL-C相关。

目的 分析25羟维生素D[25(OH)D]在新疆汉族及维吾尔族老年男性2型糖尿病(T2DM)合并骨质疏松(OP)患者中的水平及与骨密度(BMD)的相关性。方法 收集住院的汉族、维吾尔族老年男性T2DM患者281例,根据民族及骨密度值将其分为汉族非骨质疏松(NOP)组127人(A组)、汉族骨质疏松(OP)组21人(B组)、维族NOP组103人(C组)、维族OP组30人(D组),记录四组患者的25(OH)D水平并进行比较,分析25(OH)D与BMD的相关性。结果 同一民族中,B组的25(OH)D低于A组(P<0.05),D组的25(OH)D低于C组(P<0.05); T2DM合并OP患者中,D组的25(OH)D低于B组(P<0.05); 相关性分析显示,25(OH)D与BMD呈正相关。结论 维吾尔族老年男性T2DM合并OP患者较汉族患者的25(OH)D水平低,25(OH)D水平低的T2DM患者更易合并OP,25(OH)D检测有助于识别T2DM患者合并OP的风险。

Objective To analysis the level of 25 hydroxy vitamin D[25(OH)D] in Xinjiang Han and Uyghur elderly male patients with T2DM and osteoporosis, and the correlation between 25(OH)D levels and bone mineral density(BMD). Methods We collected 281 cases of T2DM patients from Hans and Uyghurs, divided them into four groups according to the nationality and BMD: Han non-osteoporosis(NOP) group including 127 cases(group A), Han osteoporosis(OP) group 21 cases(group B), Uyghur NOP group 103 cases(group C), Uyghur OP group 30 cases(group D). Recorded and compared their 25(OH)D levels, and analyzed the correlation between 25(OH)D levels and BMD. Results In the same nationality,the level of 25(OH)D in group B were lower than those in group A(P<0.05), and group D were lower than those in group C(P<0.05); In T2DM patients combined with OP, the levels of 25(OH)D in group D were lower than those in group B(P<0.05); Correlation analysis showed that 25(OH)D was positively correlated with BMD. Conclusion The level of 25(OH)D in elderly male patients with T2DM combined with osteoporosis, those of Uyghurs are lower than those of Hans. T2DM patients with lower 25(OH)D level are more likely to combine OP. The 25(OH)D level test may help to identify the risk of combining OP in T2DM patients.