Objective: To investigate the effects of liraglutide on blood lipids and carotid plaque in type 2 diabetes mellitus with obesity.Methods: 100 obese diabetic patients with carotid plaque were randomly divided into an observation group and a control group. Metformin, aspirin and atorvastatin were given in control group, metformin, liraglutide, aspirin and atorvastatin were given in the observation group. Have high blood pressure patients to control blood pressure, OSAHS patients with noninvasive positive pressure ventilation therapy. The blood glucose, blood pressure, HbA1c, blood lipid, BMI, AHI, and LSpO2 of two groups were determined after 12 weeks and 24 weeks of treatment, respectively. Carotid artery intima-media thickness and plaque before treatment and after 24 weeks of treatment were calculated by neck vascular ultrasound.Results: HbA1c, TC, LDL-C, BMI, IMT and carotid artery plaque were decreased significantly in the two groups after treatment, BMI, IMT and carotid artery plaque area were decreased more significantly in the observatio group than control group (P<0.05).Conclusion: The treatment of liraglutide in type 2 diabetes mellitus with obesity combined OSAHS can improve LSpO2, reduce the AHI, and reduce the obese patients with type 2 diabetes of TC,LDL-C and the BMI, and reduce IMT and plaque area.

Objective To discuss the effect of insulin interview tool on the health education of type 2 diabetes patients. Methods Six hundred confirmed diabetic patients from the endocrine department were divided into experimental group and control group randomly. Patients of experimental group received health education by using insulin interview tool. While patients of control group were provided with routine health education. Patients’ compliance to insulin therapy, levels of blood glucose and hemoglobin A 1C were compared between the two groups. Results After intervention, compared to patients of control group, patients of experimental group behave better in compliance to insulin therapy, meanwhile, levels of blood glucose and hemoglobin A 1C in experimental group were lower than that of control group, with statistical significance (all P<0.05). Conclusion The promotion of insulin interview tool is beneficial for patients of type 2 diabetes. It prompts them to have a correct understanding of insulin therapy and improves their compliance to insulin therapy, which plays a positive role in control of blood glucose and hemoglobin A 1C. What’s more, it’s helpful to prevent or slower the occur of complication of diabetes, so as to extend and improve the live quality of patients. In other words, insulin interview tool is worthy of wide clinical application.

目的探讨顿服甲巯咪唑治疗儿童甲亢的短期疗效及安全性。方法将首诊的甲亢患儿分为两组,服用固定剂量的甲巯咪唑(20mg/d)6周观察疗效及安全性,顿服组(观察组)每天一次服药,分次服用组(对照组)每天两次服药,观察不同服药方法的疗效及安全性。结果观察组与对照组的短期疗效显著,但观察组效果更佳,有统计学意义。两组的不良反应率几乎无差异。结论顿服甲巯咪唑治疗儿童甲亢的短期疗效较分次服用更好。

Objective To correctly judge hypoglycemia induced by chronic proliferative hematonosis to direct clinical treatment.Methods After biochemical blood glucose parameters were obtained,fingertip blood glucose testing was performed in 10 patients with serum glucose levels less than 2.8 mmol·L-1 and without hypoglycemic symptoms(7 cases of chronic myelocytic leukemia and 3 cases of polycythemia rubra vera) who did not receive special treatment.Oral glucose tolerance test,C-peptide releasing test and insulin releasing test were improved to evaluate insulin release and insulin resistance.Results The levels of C-peptide were normal in all patients.Oral glucose tolerance test showed lower fasting blood glucose levels,which returned to normal levels 60 and 120 minutes after sugar treatment.Blood glucose levels were(6.25±0.35),(95.79±0.46),(4.78±0.43),(3.27±0.48) and(1.68±0.54)mmol·L-1after blood samples were set aside for 0,30,60,120 and 180 minutes,respectively.There results demonstrated that long-time blood sample shunt decreased the detection levels of blood glucose and pseudohypoglycemia was confirmed in all the 10 patients.Conclusion Both chronic myelocytic leukemia and polycythemia rubra vera can induce pseudohypoglycemia.Therefore,correct clinical judgment is needed to avoid blind treatment.

目的:进一步做好糖尿病的防治工作,探索出一套适合本地区防治糖尿病的新工作模式。方法:应用美国强生公司的"OTDMS糖尿病管理软件"对本地区糖尿病患者实施计算机软件管理。结果:通过对计算机管理的118例糖尿病患者进行详细的观察,糖尿病患者的规律服药率、糖尿病防治知识知晓率有了明显的提高,治疗的有效率、显效率、血糖控制率得到明显提高。结论:利用计算机管理系统对糖尿病患者进行管理,是防治糖尿病的一种较为理想的工作模式。

目的观察盐酸丁咯地尔注射液联合怡开治疗2型糖尿病周围神经病变的疗效。方法将56例2型糖尿病并周围神经病变患者随机分为治疗组28例,对照组28例,治疗组予以盐酸丁咯地尔200mg溶于250ml生理盐水中静脉滴注,每日1次;并联合怡开120u口服,每日3次。对照组仅予以盐酸丁咯地尔200mg溶于250ml生理盐水中静脉滴注每日1次。结果入选患者治疗两周后两组神经症状及体征均得到改善,治疗组四肢震动感觉阈值均明显改善,与对照组比有显著差异(P<0.05)。结论盐酸丁咯地尔注射液联合怡开治疗2型糖尿病周围神经病疗效满意,值得临床广泛推广应用。

探索新增空腹血糖受损切割点下患者糖代谢状况。结果:当患者空腹血糖介于5.6～6.1mmol/L时,OGTT2h血糖正常者只有32.9%,37.3%的患者已经存在糖尿量减低,并且高达29.8%的患者已经达到糖尿病的诊断标准,也就是说空腹血糖在此范围内有高达67.1%的患者存在糖代谢异常。结论:空腹血糖受损的切点应下调至5.6mmol/L,空腹血糖大于或等于此值者应行OGTT试验。

Objective To investigate the correlation factor of diabetes mellitus ketoacidosis(DKA) appeared hyperamylasemia.Methods Retrospective anylasis the clinical data of 58 cases DKA complicating hyperamylasemia.Results Twenty-five cases of DKA hemodiastase raised less than three times of normal value.19 cases of DKA complicating acute pancreatitis(AP) hemodiastase raised exceed three times of normal value.The hemodiastase,fasting plasma glucose(FPG),triglyceride(TG),total cholesterol(TC) of DKA with hemodiastase less than three times of normal lower than the patient of DKA and AP(P0.05 or P0.01).After fluid infusion,retrieve acidosis and ketosis,the hyperamylasemia of DKA all recover normal,average days (5±3).Conclusion The DKA could appear hemodiastase rasied,but usually less than three times of normal value;along with ketoacidosis retrieved can snap back normal.

目的观察胰岛素强化治疗对2型糖尿病颈动脉内膜中层厚度(CIMT)的影响。方法将96例初诊2型糖尿病患者随机分为两组,一组采用口服降糖药治疗(Ⅰ组48例),一组采用4次/d皮下注射胰岛素(Ⅱ组48例),均治疗12个月后,比例两组治疗前后CIMT、血糖、糖化血红蛋白、血脂。结果胰岛素强化治疗组的CIMT、血糖、糖化血红蛋白的降低程度均好于口服降糖药组,而血脂比较无差异性。

目的:观察胰岛素泵对初诊2型糖尿病的临床疗效.方法:将52例初诊2型糖尿病患者随机分为两组,一组采用胰岛素泵持续皮下注射(CSII组27例),一组采用多次皮下注射胰岛素(MSII组25例),比例两组治疗前后血糖、胰岛素用量、降糖所需时间的变化以及低血糖发生率.结果:胰岛素泵强化治疗组治疗后各时段血糖显著下降,且平均血糖低于多次皮下注射组,血糖控制所需时间明显缩短,胰岛素用量及低血糖发生率也明显减少,说明短期胰岛素强化治疗对初诊2型糖尿病是一种满意的治疗方法.

目的:观察银杏注射液联合依帕司他治疗糖尿病周围神经病变的临床疗效。方法:将70例糖尿病周围神经病变患者随机分为两组,治疗组38例,服用依帕司他50mg,每日3次,同时将银杏注射液15ml,配入0.9%生理盐水250ml中,每日1次;对照组32例,服用依帕司他50mg,每日3次,两组疗程均为12周,观察两组患者前后神经系统症状及体征变化,测定治疗前后四肢神经感觉和运动的传导速度变化及空腹血糖等。结果:治疗组:显效12例,有效20例,无效6例,总有效率84.2%。对照组:显效8例,有效12例,无效12例,总有效率62.5%,治疗组总有效率明显高于对照组的总有效率。结论:银杏注射液联合依帕司他应用可明显提高糖尿病周围神经病变的疗效。

Objective To study interventional strategies and risk factors for death due to hyperglycemic nonketotic hyperosmolar syn- drome(HNHS).Methods 40 HNHS patients were divided into two groups(survivors and non-survivors).The acute physiology and chron- ic health evaluation(APACHE Ⅱ)scoring system were used in all of the patients.Logistic regression were undertaken to explore the risk fac- tors for non-survivors with HNHS.Results The mean serum osmotic pressure levels in the survivors group(348.4±14.4 mOsm/L)was significantly lower than that in the non-survivors group(360.6±17.4 mOsm/L)(P0.05).The mean APACHE Ⅱ score in the survivors group(15.4±5.5 score)was also signiticantly lower than that in the non-survivors group(28.0±4.5 score)(P0.001).There was positive correlation between the serum osmotic pressure and APACHE Ⅱ score(r=0.422,P0.01).Multiple factors Logistic regression analysis showed the hyperosmolality and coma were the main risk factors for death due to HNHS.Conclusion The higher the osmotic pres- sure was.the more the severity of illness,the higher the mortality.The hyperosmolality and coma are the main risk factors for death due to HNHS.There fore more atlention should be paid to prevent and treat these factors so as to improve its outcome.