Objective:To investigate the effect of dapagliflozin on aldosterone to renin ratio (ARR) in patients with type 2 diabetes mellitus (T2DM) complicated with hypertension.Methods:Patients with T2DM and hypertension who were admitted to the Department of Endocrinology, Beijing Huairou Hospital from September 2019 to December 2020 were enrolled. Body weight, fasting blood glucose (FPG), glycosylated hemoglobin (HbA 1c), uric acid, plasma renin concentration, aldosterone level and other indicators were measured and recorded before treatment, and ARR was calculated. Patients were treated with dapagliflozin for 12 weeks, and hematologic indicators were collected again while ARR was also calculated. Paired t test or Mann-Whitney U test were used to compare the ARR and related indexes before and after treatment of dapagliflozin. Results:A total of 20 patients were enrolled. ARR before and after treatment were 0.86 (0.73, 1.20) and 0.95 (0.72, 1.32), respectively. However, there was no significant difference between them ( Z=1.12, P=0.263). After 12 weeks of dapagliflozin, FPG ( Z=-3.62, P<0.001), HbA 1c ( Z=-3.76, P<0.001), body weight ( Z=-3.19, P=0.001) and uric acid ( Z=-2.71, P=0.014) decreased significantly compared with baseline. Conclusions:Dapagliflozin has no effect on ARR in patients with T2DM complicated with hypertension, but it has good effects on reducing FPG, uric acid and weight loss.
目的 分析血清25羟维生素D〔25(OH)VD〕、全段甲状旁腺素(iPTH)与2型糖尿病患者颈动脉粥样硬化的相关性.方法 选择300例2型糖尿病患者为研究对象,抽取空腹状态下外周静脉血,检测其血清25(OH)VD、iPTH、血脂、尿酸等水平;同时测量患者血压,行颈动脉彩超检查,将患者分为无斑块组、小斑块组与中大斑块组,对比3组患者一般情况及血清25(OH)VD、iPTH水平,分析检验血清25(OH)VD水平及iPTH与患者颈动脉粥样硬化的相关性.结果 全部纳入的300例2型糖尿病患者经查,102例无斑块,79例小斑块,119例中大斑块.3组不同颈动脉粥样硬化斑块2型糖尿病患者性别、年龄、体重指数、收缩压、尿酸、血脂等一般情况比较差异均无统计学意义(P>0.05).3组患者中,血清25(OH)VD水平无斑块组>小斑块组>中大斑块组,血清iPTH水平无斑块组<小斑块组<中大斑块组,组间各指标比较差异有统计学意义(P<0.05).经等级资料Spearman相关性分析检验证实,血清25(OH)VD、iPTH与2型糖尿病患者颈动脉粥样硬化均明显相关,前者呈负相关(r=-0.471,P<0.05),后者呈正相关(r=0.551,P<0.05).结论 在2型糖尿病患者中血清25(OH)VD降低、iPTH水平升高的患者易发生颈动脉粥样硬化,且25(OH)VD水平越低、iPTH水平越高的患者,发生颈动脉粥样硬化的风险越大,情况越严重.
目的 观察探讨二甲双胍应用到治疗2型糖尿病患者的临床疗效,特别是对于糖尿病患者胰岛素抵抗的改善作用.方法 回顾分析了该院2014年11月—2016年11月收治的2型糖尿病患者78例,该78例均为定量随机抽样选取.通过查阅统计患者的临床病历资料与记录信息,根据患者临床治疗方法的差异性,分为实验组38例和对照组40例.实验组38例2型糖尿病患者实施甘精胰岛素联合二甲双胍的治疗方案,对照组40例2型糖尿病患者则是甘精胰岛素联合其他口服降血糖类药物.统计评估比较两组患者的临床治疗实效性,重点观察患者胰岛素抵抗水平的变化与改善.结果 采用甘精胰岛素联合二甲双胍治疗下的实验组38例2型糖尿病患者,与对照组40例比较,糖化血蛋白、空腹胰岛素、胰岛素抵抗水平等主要临床指标较优,差异有统计学意义(P<0.05).结论 二甲双胍用于2型糖尿病临床治疗领域,可有效改善和恢复患者胰岛素抵抗水平,安全性好、实效性高.
本文通过探讨慢性阻塞性肺疾病急性加重发生静脉血栓栓塞症(VTE)的风险,得出结论:COPD患者VTE发生率为8.5%,以下肢DVT为主要表现,尤其多发生于慢性阻塞性肺疾病急性加重期。慢性阻塞性肺疾病急性加重是发生静脉血栓栓塞的危险因素。
