目的 分析乙型肝炎病毒(HBV)感染患者并发2型糖尿病(T2DM)相关风险因素。方法 研究收集2024年1月~2025年5月期间,于周口市传染病医院(周口市结核病防治所、周口市第五人民医院)接受治疗的HBV感染患者临床资料,共纳入患者95例,根据HBV感染后是否并发T2DM分组,合并T2DM患者纳入并发组(n=21),非合并T2DM患者纳入对照组(n=74),比较两组患者基线资料及实验室检查数据,逻辑回归分析HBV感染患者并发T2DM风险因素。结果 并发组年龄、体重指数(BMI)、甘油三酯(TG)高于对照组(P<0.05),年龄≥45岁、BMI肥胖、HBV感染时间≥6个月、TG≥1.7mmol/L、吸烟、乙型肝炎表面抗原(HBsAg)阳性及纤维化-4(FIB-4)指数≥2.67例数占比高于对照组(P<0.05)。年龄≥45岁[OR=21.599(95%CI:2.875-162.262)]、BMI(肥胖)[OR=16.729(95%CI:1.443-193.981)]、HBV感染时间≥6个月[OR=6.199(95%CI:1.101-34.904)]、吸烟[OR=9.429(95%CI:1.344-66.141)]、TG≥1.7mmol/L[OR=71.834(95%CI:7.060-730.897)]是HBV感染患者并发T2DM危险因素(P<0.05)。结论 HBV感染患者并发T2DM受人口学特征年龄、BMI、临床病程HBV感染时间、共病血脂异常及生活方式吸烟的共同影响。
Abstract: Objective To analyze risk factors associated with the development of type 2 diabetes mellitus (T2DM) in patients with hepatitis B virus (HBV) infection. Methods Clinical data were collected from HBV-infected patients treated at the Zhoukou City Infectious Disease Hospital (Zhoukou City Tuberculosis Prevention and Control Institute)between January 2024 and May 2025. A total of 95 patients were included in the study, Patients were grouped based on the presence or absence of T2DM following HBV infection. Patients with T2DM were included in the T2DM group (n=21), while those without T2DM were included in the control group (n=74). Baseline characteristics and laboratory test data were compared between the two groups, and logistic regression analysis was performed to identify factors associated with the development of T2DM in HBV-infected patients. Results The age, body mass index (BMI), and triglycerides (TG) in the intervention group were higher than those in the control group (P < 0.05); The proportion of cases with age ≥45 years, obese BMI, HBV infection duration ≥6 months, TG ≥1.7 mmol/L, smoking, hepatitis B surface antigen (HBsAg) positivity, and a FIB-4 score ≥2.67 was higher than that in the control group (P < 0.05). Age ≥ 45 years [OR = 21.599 (95% CI: 2.875–162.262)], BMI (obesity) [OR = 16.729 (95% CI: 1.443–193.981)], duration of HBV infection ≥ 6 months [OR = 6.199 (95% CI: 1.101–34.904)], smoking [OR=9.429 (95% CI: 1.344–66.141)], and TG ≥ 1.7 mmol/L [OR=71.834 (95% CI: 7.060–730.897)] were risk factors for T2DM in patients with HBV infection (P < 0.05). Conclusion The development of T2DM in patients with HBV infection is influenced by a combination of demographic factors (age and BMI), clinical course (duration of HBV infection), comorbid dyslipidemia, and lifestyle factors (smoking).
目的:分析尿毒症维持性血液透析(MHD)患者红细胞相关指标、铁代谢指标水平及其同肾性贫血的关系。方法:选取我院2024年10月-2025年10月期间尿毒症MHD患者70例为研究对象,依照其是否发生肾性贫血分为贫血组(49例)、无贫血组(21例),对比两组患者红细胞相关指标以及等铁代谢指标,同时对比不同贫血严重程度患者各项指标水平差异,并分析尿毒症MHD患者肾性贫血的相关影响因素。结果:贫血组、无贫血组患者红细胞血红蛋白浓度(MCHC)、总铁结合力(TIBC)水平无较大差异(P>0.05),贫血组患者网织红细胞计数(Ret)、血清铁蛋白(SF)、转铁蛋白(TRSF)水平低于无贫血组、平均红细胞体积(MCV)水平高于无贫血组(P<0.05);轻度组、中度组、重度组患者Ret、MCV、SF、TRSF差异显著(P>0.05);不同贫血严重程度患者MCHC、TIBC水平比较,差异无统计学意义(P>0.05);多因素Logistic回归结果显示,Ret(OR=0.2063)、MCV(OR=4.152)、SF(OR=0.341)、TRSF(OR=0.281)是尿毒症MHD患者发生肾性贫血的重要影响因素(P<0.05)。结论:尿毒症MHD患者存在较高的肾性贫血风险,且不同贫血程度患者的Ret、MCV及SF、TRSF等指标水平存在差异性,亦是患者发生肾性贫血的重要影响因素。
To analyze the levels of red blood cell related indicators, iron metabolism indicators and their relationship with renal anemia in uremic patients with maintenance hemodialysis (MHD). Methods: 70 cases of uremic MHD patients in our hospital from October 2024 to October 2025 were selected as the research object, and were divided into anemia group (49 cases) and non anemia group (21 cases) according to whether renal anemia occurred. The red blood cell related indexes and iron metabolism indexes of the two groups were compared, and the differences of various indexes in patients with different anemia severity were compared, and the related influencing factors of renal anemia in uremic MHD patients were analyzed. Results: there was no significant difference in the levels of erythrocyte hemoglobin concentration (MCHC) and total iron binding capacity (TIBC) between anemia group and non anemia group (P>0.05). The levels of reticulocyte count (RET), serum ferritin (SF), transferrin (trsf) in anemia group were lower than those in non anemia group, and the level of mean corpuscular volume (MCV) was higher than that in non anemia group (P<0.05); There were significant differences in RET, MCV, SF and trsf among mild group, moderate group and severe group (P>0.05); There was no significant difference in MCHC and TIBC levels among patients with different anemia severity (P>0.05); Multivariate logistic regression results showed that RET (or=0.2063), MCV (or=4.152), SF (or=0.341), trsf (or=0.281) were important influencing factors of renal anemia in uremic MHD patients (P<0.05).Conclusion: Uremic MHD patients have a higher risk of renal anemia, and there are differences in the levels of Ret, MCV, SF, TRSF and other indicators among patients with different degrees of anemia, which are also important influencing factors for the occurrence of renal anemia in patients.
目的 基于生物—心理—社会模式分析精神专科住院患者负荷现状及其关联因素。 方法 选取某三级精神专科医院住院患者为研究对象,构建涵盖住院天数、费用、护理风险、联合用药、危机干预及出院准备难度的住院负荷综合评分,采用多元线性回归和Logistic回归分析影响因素。 结果 患者住院负荷评分为57.16±15.36分,高负荷患者约占三分之一;生物、心理、社会因素联合模型可解释68.4%的负荷变异;明显睡眠问题、既往住院次数≥3次、治疗依从性差、家庭支持低、社会功能重度受损及缺乏社区衔接资源等为高住院负荷危险因素。 结论 精神专科住院负荷具有复合性和多因素累积特征,应建立多维评估与分层干预机制,以优化资源配置和连续照护。
Objective To analyze the current status of inpatient burden and its associated factors among psychiatric inpatients based on the biopsychosocial model. Methods Inpatients from a tertiary psychiatric hospital were selected as study subjects. A comprehensive inpatient burden score was developed, incorporating length of stay, cost, nursing risk, polypharmacy, crisis intervention, and difficulty in discharge preparation. Multivariate linear regression and logistic regression analyses were used to identify influencing factors. Results The mean inpatient burden score was 57.16 ± 15.36 points, with approximately one-third of patients experiencing high burden. The combined model of biological, psychological, and social factors explained 68.4% of the variance in burden. Significant sleep problems, prior hospitalizations ≥3 times, poor treatment adherence, low family support, severe impairment in social functioning, and lack of community follow-up resources were identified as risk factors for high inpatient burden. Conclusion Psychiatric inpatient burden is complex and characterized by cumulative multifactorial influences; therefore, a multidimensional assessment and tiered intervention system should be established to optimize resource allocation and ensure continuous care.
目的 分析2021-2025年某社区卫生服务中心失眠患者用药趋势,为社区失眠规范化管理提供参考。方法 回顾性收集某社区卫生服务中心2021年1月至2025年12月失眠相关药物处方数据,共纳入处方18,042张,涉及患者3,805人。统计处方量、药物种类、患者年龄、性别、伴随疾病等信息。根据处方次数及平均处方间隔天数将患者分为三类:偶发就诊型(1次)、短期治疗型(2~10次且平均间隔≥60天)和长期用药型(>10次或平均间隔<60天),分析各类患者的用药特征及伴随疾病分布。结果 处方量从2021年2,688张增至2025年5,734张,增长2.1倍,就诊人数增长1.6倍。艾司唑仑占比从66.22%降至41.75%,右佐匹克隆从13.28%升至54.99%,2024年为关键转折点;各年龄组右佐匹克隆使用均呈上升趋势,2025年组间差异趋于消失(48%~61%)。患者平均年龄从73.2岁降至69.5岁(Tukey HSD,P<0.05),≥80岁组占比从29.36%降至14.28%。偶发就诊型占42.6%,短期治疗型占25.9%,长期用药型占31.6%。长期用药型消耗全部处方的68.2%,平均处方间隔37.3 d(中位34 d),右佐匹克隆占比43.2%。高血压是最常见伴随疾病,患病率随年龄升高(28.17%~68.17%);高血脂和焦虑呈倒U型分布。结论 社区失眠就诊需求快速增长,药物结构向新型非苯二氮?类药物明显转变。失眠患者呈年轻化趋势。长期用药型患者消耗了大部分处方资源,其用药管理模式需结合处方间隔特征进行精准分层,并重视老年患者心血管代谢共病的综合管理。
To analyze the medication trends and characteristics of insomnia patients in a community health service center from 2021 to 2025, and to provide evidence for standardized community-based insomnia management. METHODS A retrospective analysis was conducted on insomnia-related prescription data from a community health service center between January 2021 and December 2025. A total of 18,042 prescriptions involving 3,805 patients were included. Prescription volume, drug types, patient age, sex, and comorbidities were analyzed. Patients were classified into three types based on prescription count and average prescription interval: episodic consultation type (1 prescription), short-term treatment type (2–10 prescriptions with interval ≥60 days), and long-term medication type (>10 prescriptions or interval <60 days). RESULTS Prescriptions increased from 2,688 in 2021 to 5,734 in 2025 (2.1-fold), with a 1.6-fold increase in patient visits. Estazolam decreased from 66.22% to 41.75%, while eszopiclone increased from 13.28% to 54.99%, with 2024 as the turning point. Eszopiclone usage increased across all age groups, converging to 48%–61% by 2025. Mean age decreased from 73.2 to 69.5 years (Tukey HSD, P<0.05), and the proportion of patients aged ≥80 years dropped from 29.36% to 14.28%. Episodic consultation type accounted for 42.6%, short-term treatment type 25.9%, and long-term medication type 31.6%. The long-term type consumed 68.2% of all prescriptions, with an average prescription interval of 37.3 days (median 34 days) and eszopiclone accounting for 43.2%. Hypertension was the most common comorbidity, increasing with age (28.17%–68.17%). Hyperlipidemia and anxiety showed an inverted U-shaped distribution. CONCLUSION Community insomnia treatment demand is growing rapidly, with a significant shift toward newer non-benzodiazepines and a trend toward younger patient demographics. Long-term medication patients consume the majority of prescription resources and require precise stratification based on prescription interval patterns, along with integrated management of cardiometabolic comorbidities in older adults.
目的 探讨子午流注穴位按摩联合颈椎功能康复训练对神经根型颈椎病(CSR)患者的康复效果。方法 以2023年1月-2025年6月我院收治的CSR患者(154例)为研究对象进行回顾性分析,根据干预方案分为参照组(77例,采取颈椎功能康复训练)、研究组(77例,采取子午流注穴位按摩联合颈椎功能康复训练)。比较两组临床疗效、复发率及干预前、后中医证候积分、疼痛视觉模拟评分(VAS)与颈椎功能障碍指数量表评分(NDI)、颈椎功能活动度、血液流变学指标[血浆黏度(PV)、全血低切黏度(LSWBV)、纤维蛋白原(FIB)、全血高切黏度(HSWBV)]。结果 与参照组总有效率(83.12%)相比,研究组(96.10%)明显升高(P<0.05);研究组干预后各中医证候积分均较参照组低(P<0.05);干预后,研究组VAS、NDI评分均低于参照组(P<0.05);研究组干预后颈椎活动度高于参照组(P<0.05);干预后,研究组LSWBV、PV、FIB、HSWBV水平均较参照组低(P<0.05);研究组干预后3个月复发率为2.72%(2/74),低于参照组的14.06%(9/64)(χ2=4.588,P<0.05)。结论 子午流注穴位按摩联合颈椎功能康复训练可提高CSR患者康复效果,改善临床症状、颈椎功能、颈椎活动度,调节血液流变学,降低颈椎疼痛程度、复发率。
Objective To explore the rehabilitation efficacy of midnight-noon ebb-flow acupoint massage combined with cervical function rehabilitation training on patients with cervical spondylotic radiculopathy (CSR). Methods A retrospective analysis was conducted on CSR patients (154 cases) admitted to our hospital from January 2023 to June 2025, who were selected as the research subjects. According to the intervention plan, they were divided into reference group (77 cases, received cervical functional rehabilitation training) and study group (77 cases, received midnight-noon ebb-flow acupoint massage combined with cervical functional rehabilitation training). The clinical efficacy and recurrence rate were compared between the two groups, as well as the TCM syndrome scores, pain visual analogue score (VAS) and cervical dysfunction index score (NDI) scores, cervical spine function activity, hemorheology indexes [plasma viscosity (PV), whole blood low shear viscosity (LSWBV), fibrinogen (FIB), whole blood high shear viscosity (HSWBV)] before and after intervention. Results Compared with the total effective rate of the reference group (83.12%), the study group (96.10%) was significantly higher (P<0.05); after intervention, the scores of all?TCM syndromes in the study group were lower than those in the reference group (P<0.05), after intervention, the VAS and NDI scores of the study group were lower than those in the reference group (P<0.05); the cervical spine activity of the study group was higher than that of the reference group after intervention (P<0.05); after intervention, the levels of LSWBV, PV, FIB and HSWBV in the study group were lower than those in the reference group (P<0.05); the recurrence rate of the study group at 3 months after intervention was 2.72% (2/74), which was lower than 14.06% (9/64) in the reference group (χ2=4.588, P<0.05). Conclusion Midnight-noon ebb-flow acupoint massage combined with cervical function rehabilitation training can improve the rehabilitation efficacy of CSR patients, improve clinical symptoms, cervical function, cervical mobility, regulate hemorheology, and reduce cervical pain and recurrence rate.
目的 探讨子午流注穴位按摩联合颈椎功能康复训练对神经根型颈椎病(CSR)患者的康复效果。方法 以2023年1月-2025年6月我院收治的CSR患者(154例)为研究对象进行回顾性分析,根据干预方案分为参照组(77例,采取颈椎功能康复训练)、研究组(77例,采取子午流注穴位按摩联合颈椎功能康复训练)。比较两组临床疗效、复发率及干预前、后中医证候积分、疼痛视觉模拟评分(VAS)与颈椎功能障碍指数量表评分(NDI)、颈椎功能活动度、血液流变学指标[血浆黏度(PV)、全血低切黏度(LSWBV)、纤维蛋白原(FIB)、全血高切黏度(HSWBV)]。结果 与参照组总有效率(83.12%)相比,研究组(96.10%)明显升高(P<0.05);研究组干预后各中医证候积分均较参照组低(P<0.05);干预后,研究组VAS、NDI评分均低于参照组(P<0.05);研究组干预后颈椎活动度高于参照组(P<0.05);干预后,研究组LSWBV、PV、FIB、HSWBV水平均较参照组低(P<0.05);研究组干预后3个月复发率为2.72%(2/74),低于参照组的14.06%(9/64)(χ2=4.588,P<0.05)。结论 子午流注穴位按摩联合颈椎功能康复训练可提高CSR患者康复效果,改善临床症状、颈椎功能、颈椎活动度,调节血液流变学,降低颈椎疼痛程度、复发率。
Objective To explore the rehabilitation efficacy of midnight-noon ebb-flow acupoint massage combined with cervical function rehabilitation training on patients with cervical spondylotic radiculopathy (CSR). Methods A retrospective analysis was conducted on CSR patients (154 cases) admitted to our hospital from January 2023 to June 2025, who were selected as the research subjects. According to the intervention plan, they were divided into reference group (77 cases, received cervical functional rehabilitation training) and study group (77 cases, received midnight-noon ebb-flow acupoint massage combined with cervical functional rehabilitation training). The clinical efficacy and recurrence rate were compared between the two groups, as well as the TCM syndrome scores, pain visual analogue score (VAS) and cervical dysfunction index score (NDI) scores, cervical spine function activity, hemorheology indexes [plasma viscosity (PV), whole blood low shear viscosity (LSWBV), fibrinogen (FIB), whole blood high shear viscosity (HSWBV)] before and after intervention. Results Compared with the total effective rate of the reference group (83.12%), the study group (96.10%) was significantly higher (P<0.05); after intervention, the scores of all?TCM syndromes in the study group were lower than those in the reference group (P<0.05), after intervention, the VAS and NDI scores of the study group were lower than those in the reference group (P<0.05); the cervical spine activity of the study group was higher than that of the reference group after intervention (P<0.05); after intervention, the levels of LSWBV, PV, FIB and HSWBV in the study group were lower than those in the reference group (P<0.05); the recurrence rate of the study group at 3 months after intervention was 2.72% (2/74), which was lower than 14.06% (9/64) in the reference group (χ2=4.588, P<0.05). Conclusion Midnight-noon ebb-flow acupoint massage combined with cervical function rehabilitation training can improve the rehabilitation efficacy of CSR patients, improve clinical symptoms, cervical function, cervical mobility, regulate hemorheology, and reduce cervical pain and recurrence rate.
目的 探讨靶向治疗前晚期非小细胞肺癌(NSCLC)患者血清肿瘤特异性生长因子(TSGF)、乳酸脱氢酶(LDH)、同型半胱氨酸(Hcy)水平与靶向治疗无效的相关性,并分析其对靶向治疗无效的预测价值。方法 选取2023年1月~2025年1月于本院就诊的晚期NSCLC患者108例作为研究组,另选取同期健康志愿者108例作为对照组。比较两组血清TSGF、LDH、Hcy水平。研究组予以靶向治疗(治疗3个疗程),依据靶向治疗无效将其分为无效亚组36例、有效亚组72例,比较其血清TSGF、LDH、Hcy水平。分析血清TSGF、LDH、Hcy与靶向治疗无效的相关性,并分析其对靶向治疗无效的预测价值。结果 研究组血清TSGF、LDH、Hcy水平高于对照组(P<0.05);无效亚组血清TSGF、LDH、Hcy水平高于有效亚组(P<0.05);校正吸烟史、分化程度、TNM分期后,治疗1个疗程后血清TSGF、LDH、Hcy水平仍与靶向治疗无效独立相关(P<0.05);靶向治疗前血清TSGF、LDH、Hcy水平预测靶向治疗无效的AUC值明显大于各指标单独预测(P<0.05)。结论 晚期NSCLC患者血清TSGF、LDH、Hcy水平升高与靶向治疗无效独立相关,检测其水平对靶向治疗无效具有一定预测价值,且联合预测的效能更高,可指导临床制定及调整诊治方案。
目的:分析血脑屏障标志物闭合蛋白(Occludin,OCLN)、密封蛋白-5(Claudin-5,CLDN5)与帕金森病(PD)患者神经功能损伤程度及不良预后的关联。方法:研究对象选择2024年6月~2025年6月就诊于我院的180例PD患者,及同期接受检查的180例健康志愿者,将其分别列为病例组、对照组,比较两组OCLN、CLDN5间差异。依据病情严重程度不同,将PD患者分别列为早期组(50例)、中期组(65例)和晚期组(65例),比较三组患者OCLN、CLDN5,神经损伤标志物间差异,分析晚期组患者OCLN、CLDN5与神经损伤标志物的相关性。统计入组患者不良预后发生情况,比较不同预后患者OCLN、CLDN5及神经损伤标志物间差异,分析PD患者预后影响因素,验证OCLN、CLDN5对PD患者不良预后的预测效能。结果:病例组的外周血OCLN、CLDN5均高于对照组(t=50.450,51.670;P<0.05)。晚期组外周血OCLN、CLDN5、神经元特异性烯醇化酶(NSE)、泛素羧基末端水解酶L1(UCH-L1)、神经丝轻链蛋白(NfL)、胶质纤维酸性蛋白(GFAP)均高于中期组、早期组(F=280.611,378.453,82.254,122.413,185.272,257.733;P<0.05)。晚期组的OCLN、CLDN5均与NSE、UCH-L1、NfL、GFAP正相关(r=0.411,0.457,0.505,0.494,0.465,0.425,0.491,0.503;P<0.05)。180例PD患者的不良预后发生率为28.89%(52/180)。预后不良组的外周血OCLN、CLDN5、NSE、UCH-L1、NfL、GFAP均高于预后良好组(t=17.096,14.405,7.632,6.903,11.695,10.702;P<0.05)。Logistic多因素回归分析结果显示,外周血OCLN、CLDN5、NfL、GFAP高表达为PD患者发生不良预后的危险因素。经ROC检验,外周血OCLN、CLDN5联合检测对于PD不良预后的预测AUC高于外周血OCLN、CLDN5单独检测(DeLong检验,P<0.05)。结论:外周血OCLN、CLDN5可随PD患者神经损伤程度加剧而不断升高,联合检测外周血OCLN、CLDN5或可作为预测患者不良预后的重要辅助手段。
Objective:To analysis of the association between blood-brain barrier markers Occludin (OCLN), Claudin-5 (CLDN5) and the degree of neurological damage and poor prognosis in PD patients.Methods:The research subjects selected 180 PD patients who visited our hospital from June 2024 to June 2025, as well as 180 healthy volunteers who underwent examinations during the same period. They were divided into a case group and a control group, and the differences between the two groups in terms of OPLN and CLDN5 were compared. According to the severity of the disease, PD patients were divided into early group (50 cases), middle group (65 cases), and late group (65 cases). The differences in OCLN, CLDN5, and nerve injury markers among the three groups of patients were compared, and the correlation between OCLN, CLDN5, and nerve injury markers in the late group of patients was analyzed. Statistically analyze the occurrence of poor prognosis in enrolled patients, compare the differences in OCLN, CLDN5, and nerve injury markers among patients with different prognoses, analyze the factors affecting the prognosis of PD patients, and verify the predictive power of OCLN and CLDN5 for poor prognosis in PD patients.Results:The peripheral blood levels of OCLN and CLDN5 in the case group were higher than the control group (t=50.450,51.670; P<0.05). The levels of OCLN, CLDN5 NSE,UCH-L1,NfL, and GFAP in peripheral blood of the late stage group were higher than those of the mid stage and early stage groups (F=280.611,378.453,82.254,122.413,185.272,257.733; P<0.05). The OCLN and CLDN5 in the late stage group were positively correlated with NSE, UCH-L1, NfL, and GFAP (r=0.411,0.457,0.505,0.494,0.465,0.425,0.491,0.503; P<0.05). The incidence of poor prognosis in 180 PD patients was 28.89% (52/180). The peripheral blood levels of OCLN, CLDN5, NSE, UCH-L1, NfL, and GFAP in the poor prognosis group were higher than those in the good prognosis group (t=17.096,14.405,7.632,6.903,11.695,10.702; P<0.05). The results of logistic multiple regression analysis showed that high expression of peripheral blood OCLN, CLDN5, NfL, and GFAP were risk factors for poor prognosis in PD patients. According to ROC test, the combined detection of peripheral blood OCLN and CLDN5 has a higher AUC for predicting poor prognosis of PD than the detection of peripheral blood OCLN and CLDN5 alone (DeLong test, P<0.05).Conclusion:Peripheral blood OCLN and CLDN5 can exacerbate and continuously increase the degree of nerve damage in PD patients. Combined detection of peripheral blood OCLN and CLDN5 may serve as an important auxiliary tool for predicting poor prognosis in patients.
目的:初步探索羧基麦芽糖铁(FCM)治疗非透析慢性肾脏病(ND-CKD)贫血患者的有效性与安全性,为FCM在我国ND-CKD贫血患者中的临床应用提供参考。方法:本研究为单中心、前瞻性、单臂研究,纳入25例ND-CKD贫血患者,给予FCM 500 mg或1000 mg单次静脉输注,分别于基线和 FCM治疗的1周后、1月后采集患者外周血,检测血红蛋白、血清铁蛋白、转铁蛋白饱和度,同时观察、记录不良事件发生情况。结果:(1)患者经FCM单次输注后,1周后及1月后的血红蛋白、血清铁蛋白、转铁蛋白饱和度均显著升高(P<0.05)。与FCM治疗1周后相比,1月后的血红蛋白显著升高(P<0.05),血清铁蛋白、转铁蛋白饱和度均显著降低(P<0.05)。(2)2例患者发生低磷血症,1例患者出现过敏性皮疹,1例患者出现输注侧上肢酸胀不适。结论:FCM作为新型快速补铁制剂,可有效改善ND-CKD患者的贫血及铁代谢,短期安全性整体可控。
Objective: To preliminarily explore the efficacy and safety of ferric carboxymaltose (FCM) in the treatment of anemia in patients with non-dialysis chronic kidney disease (ND-CKD), and to provide a reference for the clinical application of FCM in Chinese ND-CKD patients with anemia. Methods: This was a single-center, prospective, single-arm study. A total of 25 ND-CKD patients with anemia were enrolled and received a single intravenous infusion of FCM at a dose of 500 mg or 1000 mg. Peripheral blood samples were collected from the patients at baseline, 1 week, and 1 month after FCM treatment to measure hemoglobin, serum ferritin, and transferrin saturation. Meanwhile, adverse events were observed and recorded. Results: (1) After a single infusion of FCM, the levels of hemoglobin, serum ferritin, and transferrin saturation were significantly increased at one week and one month post-treatment (P<0.05). Compared with the values at one week after FCM treatment, hemoglobin levels at one month were significantly higher (P<0.05), while serum ferritin and transferrin saturation levels were significantly lower (P<0.05). (2) Two patients developed hypophosphatemia, one patient experienced an allergic rash, and one patient reported soreness and discomfort in the upper limb on the infusion side. Conclusion: As a novel and rapid iron supplement preparation, FCM can effectively improve anemia and iron metabolism in patients with ND-CKD, with overall manageable short-term safety.
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.