目的 探讨舒洛地特对糖尿病肾病(DN)患者足细胞损伤的影响.方法 选择2018年3月至2020年2月阜外华中心血管病医院收治的136例DN患者为研究对象,按照随机数字表法将患者分为观察组和对照组,每组68例.2组患者均给予皮下注射胰岛素或口服降糖药降低血糖、血管紧张素转换酶抑制剂和血管紧张素Ⅱ受体拮抗剂降血压、他汀类药物降血脂等常规治疗措施,观察组患者在常规治疗基础上给予舒洛地特治疗,2组患者均连续治疗4个月.对2组患者治疗前后24 h尿蛋白定量及血清肌酐(Scr)、血尿素氮(BUN)、血管生成素样蛋白4(ANGPTL4)和尿沉渣中podocin、mindin及nephrin蛋白水平进行比较,并观察治疗期间2组患者的不良反应.结果 2组患者治疗前24 h尿蛋白定量及Scr、BUN水平比较差异无统计学意义(P>0.05),2组患者治疗后24 h尿蛋白定量及Scr、BUN水平显著低于治疗前(P<0.05);治疗后,观察组患者24 h尿蛋白定量及Scr、BUN水平显著低于对照组(P<0.05).治疗前2组患者尿沉渣中podocin、mindin、nephrin蛋白水平比较差异无统计学意义(P>0.05),2组患者治疗后尿沉渣中podocin、mindin、nephrin蛋白水平显著低于治疗前(P<0.05);治疗后,观察组患者尿沉渣中podocin、mindin、nephrin蛋白水平显著低于对照组(P<0.05).2组患者治疗前血清ANGPTL4水平比较差异无统计学意义(P>0.05),2组患者治疗后血清ANGPTL4水平显著高于治疗前(P<0.05);治疗后,观察组患者血清ANGPTL4水平显著高于对照组(P<0.05).治疗期间,对照组和观察组患者不良反应发生率分别为8.82％(6/68)、11.76％(8/68),2组患者治疗期间不良反应发生率比较差异无统计学意义(χ2=0.319,P>0.05).结论 舒洛地特可有效减轻DN患者肾小球足细胞损伤,改善肾功能.

目的:研究红景天苷对高糖条件下血管内皮细胞凋亡和氧化应激的调节作用.方法:培养人脐静脉内皮细胞(HUVECs)后分组处理,对照组用低糖培养基(5.5mmol/L葡萄糖)处理,高糖组用高糖培养基(33mmol/L葡萄糖)处理,红景天苷组用含有10μg/ml红景天苷的高糖培养基处理.处理24h后,检测细胞凋亡率、凋亡及氧化应激基因的mRNA表达水平及蛋白表达水平、氧化应激产物的含量.结果:处理24h后,高糖组的细胞凋亡率、细胞中Bax、Caspase-3、NOX2、NOX4的mRNA表达水平及蛋白表达水平、培养基中MDA的含量均明显高于对照组,细胞中Bcl-2的mRNA表达水平及蛋白表达水平、培养基中SOD及GSH-Px的含量均明显低于对照组;红景天苷组的细胞凋亡率、细胞中Bax、Caspase-3、NOX2、NOX4的mRNA表达水平及蛋白表达水平、培养基中MDA的含量均明显低于高糖组,细胞中Bcl-2的mRNA表达水平及蛋白表达水平、培养基中SOD及GSH-Px的含量均明显高于高糖组.结论:红景天苷对高糖条件下血管内皮细胞的凋亡和氧化应激具有抑制作用.

Objective:To explore the clinical value of adenosine stress myocardial contrast echocardiography in detecting myocardial blood perfusion abnormalities in patients with type 2 diabetes mellitus.Methods:Twenty-six patients with type 2 diabetes mellitus clinically diagnosed from May 2019 to January 2020 in the endocrinology department of Fuwai Central China Cardiovascular Hospital and 28 healthy examinees with gender and age matched during the same period were enrolled. Routine echocardiography, rest and adenosine stress myocardial contrast echocardiography were performed, the plateau signal intensity(A value), curve rising slope(K value) and A×K value of the myocardial perfusion time-intensity curve were obtained by offline analysis. And general data such as age, gender, disease course, body mass index and glycated hemoglobin were collected, and results of the two groups were compared statistically.Results:In the rest state, the A value of the myocardial perfusion parameter in the diabetic group was not significantly different from that of the control group, both in whole and in segments ( P>0.05), while the K value and A×K value of the myocardial perfusion parameters in the diabetic group were significantly lower than those in the control group ( P<0.05). In the stress state, the A value, K value and A×K value of myocardial perfusion parameters in the diabetic group were significantly lower than those in the control group, both in whole and in segments ( P<0.05). The detection rate of myocardial perfusion abnormality in the stress state was significantly higher than that in the rest state, and the difference was statistically significant ( P<0.05). The myocardial blood flow reserve in the diabetic group was negatively correlated with the course of disease and the level of glycated hemoglobin ( r=-0.580, P=0.020; r=-0.481, P=0.013). Conclusions:Adenosine stress myocardial contrast echocardiography can be used for detection of left ventricular myocardial perfusion abnormalities in patients with type 2 diabetes mellitus, which has great clinical application value.

Objective: To investigate the expression of microRNA-133b (miR-133b) in esophageal squamous cell carcinoma (ESCC), and explore its effect and the underlying molecular mechanisms on cell proliferation and invasion. Methods: Real-time quantitative PCR (qPCR) was used to examine miR-133b expression in 63 ESCC tissues and paired adjacent non-cancerous tissues, several ESCC cells (Eca109, EC9706, EC1, TE1, KYSE70) and normal esophageal epithelial cell Het-1A. MiR-133b mimic, inhibitor and negative control (NC) were transfected into TE1 cells. The effect of miR-133b on cell proliferation and invasion were determined by CCK-8 and Transwell assays, respectively. Subsequently, the target gene of miR-133b was predicted by online tools TargetScan and miRDB, which was verified by dual luciferase reporter assays. Finally, Western blot was utilized to detect the effects of miR-133b overexpression on expression of target gene TAGLN2 as well as EMT-related proteins E-cadherin, N-cadherin, Snail, Slug and Vimentin. Results: Relative levels of miR-133b in ESCC tissues (0.295±0.040) were significantly lower than those in adjacent non-cancerous tissues (1.002±0.011, P<0.001). The expression of miR-133b was tightly associated with clinical staging, lymph node metastasis and prognosis. Moreover, relative levels of miR-133b in ESCC cells Eca109, EC9706, EC1, TE1 and KYSE70 (0.679±0.031, 0.391±0.008, 0.236±0.016, 0.031±0.005 and 0.099±0.020) were evidently lower than that in normal esophageal epithelial cell Het-1A (1.005±0.016, all P<0.001). In TE1 cells, miR-133b mimic significantly increased the level of miR-133b to 6.199±0.627, and suppressed cell proliferation and invasion, whereas miR-133b inhibitor obviously decreased its expression to 0.182±0.023, and promoted cell proliferation and invasion. Most notably, the relative luciferase activities of miR-133b-mimic group (0.320±0.018) in TE1 cells transfected with TAGLN-3'UTR-WT were markedly lower than that in NC group (1.010±0.036, P<0.001), whereas those in TAGLN-3'UTR-MUT transfection cells were 1.019±0.056 and 1.008±0.021, respectively, showing no significantly statistical difference (P>0.05). Furthermore, miR-133b overexpression markedly downregulated TAGLN2, N-cadherin, Snail, Slug and Vimentin levels, and increased E-cadherin expression. Conclusion: MiR-133b plays an important role in the proliferation and invasion of ESCC cells by regulating TAGLN2 expression, and it may be a potential therapeutic target for ESCC patients.

Objective To investigate the risk factors for osteoporosis in elderly patients with type 2 diabetes mellitus (T2DM).Methods The levels of bone mineral density (BMD) of lumbar spine,femur neck and hip bone were measured by dual-energy X-ray absorptiometry in 202 T2DM patients aged 60 years and over (102 males and 100 females).Based on the level of BMD,all patients were divided into 3 groups,including the normal group,the osteopenia group and the osteoporosis group.The markers of glucose,lipid and bone metabolism were examined and compared among groups.Results In males,patients from the osteoporosis group showed shorter duration of T2DM (F=4.184,P=0.018),lower levels of uric acid (F =4.101,P=0.019) and 25-(OH)D (F =5.712,P=0.004),and higher levels of HbA1c (F =3.621,P =0.030) among groups.In females,patients in the osteoporosis group had markedly decreased levels of body mass index (F =8.056,P=0.001) and total cholesterol (F=4.787,P=0.011),increased levels of triglyceride (F=3.502,P =0.034) and osteocalcin (F =3.724,P =0.028).Additionally,Logistic regression analysis revealed that duration of T2DM (β=-0.059,P =0.044) and uric acid (β=0.006,P =0.012) were the risk factors for osteoporosis in males patients with T2DM.And age (β=0.287,P=0.017),HbA1c (β=2.193,P =0.002) and osteocalcin (β=0.447,P =0.003) were associated with osteoporosis in T2DM females patients.Conclusions The risk factors for osteoporosis in T2DM males are the duration of diabetes and uric acid,while in females are age,H bA1 c,and osteocalcin.

Recombinant human insulin,a milestone of diabetes treatment,has been put into clinical practice for over 30 years since 1980s.Its efficacy,safety and cost-effectiveness have been confirmed by clinical practice and clinical studies.Based on evidences,recombinant human insulin,among many antidiabetic agents,still remains one of the core hypoglycemic drugs recommended by authoritative guidelines for the prevention and treatment of diabetes.This review summarized the development,clinical efficacy,safety profiles and guideline recommendations of recombinant human insulin to lay the cornerstone of individualized insulin therapy.

Objective To investigate the changes of fetal cardiac function and the function of echocardiographic Tei index in evaluation of fetal cardiac function of pregnant women with gestational diabetes mellitus (GDM).Methods To-tally 108 cases of pregnant women with GDM were divided into the well-controlled group (GDM1 group,56 cases)and poorly-controlled group (GDM2 group,52 cases)according to their blood glucose levels.Meanwhile,we selected 50 cases of age,gestational age and BMI-matched normal pregnant women as the controls (control group).The fasting plasma glu-cose (FPG),postprandial glucose (2 h PG)and glycosylated hemoglobin (HbA1c )were measured in these three groups. The fetal cardiac structure,left and right ventricular Tei indexes in each group were measured by Doppler echocardio-graphy.Results FPG,2 h PG and HbA1c of the GDM2 group were higher than those of the GDM1 group and control group (all P <0.05).The fetal left ventricular wall thickness (LVWT),right ventricular wall thickness (RVWT),right ven-tricular end-diastolic diameter (RVDd),left ventricular fractional shortening (LVFS),right ventricular fractional shorten-ing (RVFS)and left ventricular ejection fraction (LVEF)of GDM2 group were significantly higher than those of the control group (all P <0.05).The fetal RVDd,right ventricular end-systolic diameter,LVFS and LVEF of the GDM2 group were higher than those of the GDM1 group (all P <0.05).The GDM1 group's fetal LVFS was higher than that of the control group (P <0.05).The Tei index of fetal left and right ventricular of GDM2 group and GDM1 group was significantly higher than that of the control group,and the difference was statistically significant (all P <0.05).The average Tei index of fetal left and right ventricular of GDM2 group was higher than that of the GDM1 group and control group (all P <0.05).Con-clusions Tei index,which is associated with fetal cardiac function in GDMpregnant women,can be used as a simple and&nbsp;reliable indicator in the clinical comprehensive evaluation of fetal cardiac involvement.

Objective To disscuss the pathogenesis of idiopathic hypogonadotropic hypogonadism with type 1 diabetes.Methods Analyzed two cases of IHH with type 1 diabetes,which is scarce.Results There is a tendency to hypogonadotropic hypogonadism in the patient of type 1 diabetes.The risk of developing diabetes increase during the patient with hypogonadotropic hypogonadism.Conclusion The hormones,metabolism and gene may participate in the coexistence of idiopathic hypogonadotropic hypogonadism and type 1 diabetes.

目的：探讨快速平稳控制难治性脆性糖尿病患者血糖的有效方法。方法选择脆性糖尿病患者12例，禁食状态下调整胰岛素泵基础率，使血糖稳定且不需调整基础率24 h后进食，进食后调整餐前量。血糖稳定后和禁食前均进行连续血糖监测，比较治疗前后各项指标的变化。结果治疗前后24 h平均血糖、血糖标准差、最大血糖波动幅度、平均血糖波动幅度、日间血糖平均绝对差等指标比较差异有统计学意义（P均＜0．01）。治疗前后全天9个时点比较，除中餐后2 h时点外，其余时点血糖差异均有统计学意义（P＜0．05或＜0．01）。与治疗前比较，治疗后低血糖发生率降低，全天胰岛素用量减少（P均＜0．05）。结论超空腹状态下调整胰岛素泵基础率对控制难治性脆性糖尿病患者血糖水平有良好疗效。

Objective To compare the use of 16G and 18G biopsy needles in percutaneous ultrasound- guided renal biopsy. Methods Four hundred and eighty six patients undergoing percutaneous ultrasound- guided renal biopsy were as-signed to use 16G Cru- cut biopsy needle (n=216) or 18G needle (n=270). Two specimens of renal tissue were required to be taken for 16G group and 3 specimens were required for 18G group. Results The overal success rate of biopsy was 94.4%, that was 93.6%in 16G group and 95.2%in 18G group (P>0.05). The average biopsy times in 16G group was 2.57±0.34 and that in 18G group was 2.84±0.51(P<0.01). The complication rate in G16 group was 8.80%(gross hematuria 5.56%, subcapsular renal hematoma 3.24%) and that in G18 group was 5.56%(gross hematuria 4.07%, subcapsular renal hematoma 1.48%) (P>0.05). The average number of glomerulum under light microscope in 16G group was 19.33 ±4.91and that in 18G group was 25.27±6.23 (P<0.05). Conclusion Ultrasound- guided renal biopsies using 18G Cru- cut biopsy needle does not increase the incidence of complications, although one more specimen need to be taken compared to using 16G. The specimens of renal tis-sue taken using both needles meet standard of light, immunofluorescence and electron microscopic examinations.

目的 探讨单纯性肥胖青少年血脂紊乱、胰岛素抵抗与血管弹性的关系.方法 选取80例单纯肥胖青少年,按照血脂水平分为血脂正常组45例,血脂紊乱组35例.空腹抽取静脉血检测空腹血糖(FPG)、空腹胰岛素(FINS)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平,计算稳态模型胰岛素抵抗指数(HOMA-IR).彩色多普勒超声诊断仪测定颈动脉内膜中层厚度(IMT)、颈动脉血管硬化值(β)、血管弹性系数(Ep)、血管顺应性(AC)、增大指数(AI)、脉搏波传播速度(PWVβ),测量颈动脉收缩期血管内径(Ds)和颈动脉舒张期血管内径(Dd).结果 血脂紊乱组TG、TC、LDL-C和HOMA-IR均明显高于血脂正常组,HDL-C低于血脂正常组,差异均有统计学意义(P＜0.05)；两组体质指数(BMI)、IMT、FPG、餐后2h血糖(2h PG)差异均无统计学意义(P＞0.05).两组颈动脉弹性参数β、Ep和AI差异均有统计学意义(P＜0.05).相关性分析显示,BMI、TG、LDL-C、HOMA-IR分别与β、Ep、AI、PWVβ呈正相关,与AC呈负相关,与Ds、Dd无明显相关性.TC、HDL-C、SBP、DBP与颈动脉各弹性参数无明显相关性(P＞0.05).结论 肥胖青少年存在血脂代谢紊乱、胰岛素抵抗和动脉内膜增厚等血管病变；血脂紊乱和胰岛素抵抗与动脉血管弹性密切相关,高甘油三酯血症和HOMA-IR是影响血管弹性的高危因素.

目的 探讨血清脂联素(APN)、高敏C反应蛋白(hs-CRP)及胰岛素抵抗与肥胖青少年2型糖尿病颈动脉内膜中层厚度(IMT)的关系.方法 选择60例肥胖青少年,其中单纯肥胖38例(肥胖1组)、伴2型糖尿病22例(肥胖2组),另择30例体质量正常的健康青少年作为对照组.测量各组身高、体质量、血压、腰围(WC)、IMT,实验室检测空腹血糖(FPG)、空腹胰岛素(HNS)、APN、hs-CRP及血脂,计算BMI和HOMA-IR.分析APN、hs-CRP、HOMA-IR与IMT的相关性.结果 肥胖1、2组血清APN水平均显著低于对照组(P＜0.05或＜0.01),肥胖2组APN水平明显低于肥胖1组(P＜0.05).肥胖1、2组BMI、IMT、hs-CRP、FINS、HOMA-IR及WC明显高于对照组(P均＜0.05),IMT与APN呈负相关(r=-2.532,P＜0.05),IMT与BMI、HOMA-IR、WC、hs-CRP呈正相关(r=-0.253,P＜0.05),与BMI、HOMA-IR、WC、hs-CRP呈正相关(r分别为0.187、0.366、0.218、0.224,P均＜0.05).结论 肥胖青少年血清APN显著降低,IMT与APN降低、胰岛素抵抗、hs-CRP升高密切相关.

目的:观察甲状腺功能正常的2型糖尿病(T2DM)患者中甲状腺激素水平与各代谢组分的相关性.研究方法:对75例甲状腺功能正常的T2DM患者进行血压、生化学指标及甲状腺功能测定.Pearson相关分析及多元线性回归分析评估甲状腺激素水平与各代谢组分的相关性.研究结果:FT3与舒张压(DBP,P=0.011)及同型半胱氨酸(HCY,P=0.020)相关.TSH与体重指数(BMI,P=0.024)相关.校正了年龄、性别及糖尿病病程的影响后,FT3与HCY及TSH与BMI的相关仍具有统计学显著性.结论:本研究结果显示,在甲状腺功能正常的T2DM 患者中,血清FT3水平与HCY独立相关,TSH与BMI独立相关.这提示即使血清甲状腺素在正常水平内的变异仍可能与2型糖尿病患者肥胖及心脑血管疾病的发病相关.

Objective To investigate the role of depression and C-reaction protein (CRP)in the early development of vascular disease in the elderly patients with type 2 diabetes. Methods Totally 396 patients with type 2 diabetes were recruited in the study,including 196 cases with depression and 200 cases without depression.Depression was evaluated by Hamilton depression scale (HAMD),and CRP was measured using rate nephelometry.The related parameters of wave intensity (WI) such as accelerating wave intensity (W1),decelerating wave intensity (W2),arterial stiffness β,pressure-strain elasticity modulus (Ep),arterial compliance (AC),pulse wave velocity -wave intensity(PWVWI),pulse wave velocity (PWV) and argumentation index (AI) were detected and compared between the groups. Results The levels of CRP [(8.1±2.8)mg/L vs. (3.9±3.2) mg/L,t=6.411,P=0.000],W2 [(4.82±1.33) mm Hg· m-1 · s-3 vs.(2.27±1.28)mm Hg · m-1 · s-3,t=4.256,P=0.021],arterial stiffness β(12.58±3.23 vs.8.96±2.24,t=4.634,P=0.019),Ep (157.90±52.64 vs.118.24±53.08,t=5.512,P=0.007),PWVβ(7.53± 1.41 vs.6.68±1.56,t=3.982,P=0.024),AI(19.26± 13.21 vs.15.34±10.23,t=3.213,P=0.037)and PWV-WI (7.59±1.67vs.6.63± 1.45,t =2.613,P =0.046) in cases with depression were higher than the cases without depression,while the AC value was reduced (0.70±0.19 vs.0.78±0.21,t=4.676,P =0.017).There was no difference in W1 value between the groups.The CRP level and HAMD score were positively associated with W2 (r=0.470,P=0.000),stiffness β (r=0.582,P=0.000),Ep (r=0.352,P=0.004),PWV-WI (r=0.233,P=0.019),PWVβ (r=0.340,P=0.007) and AI (r=0.265,P=0.015),but negatively related with AC(r=-0.457,P=0.000).HAMD score was positively correlated with CRP level(r=0.328,P=0.003). Conclusions The carotid artery wave intensity W2,blood vessel elasticity parameter β,Ep,AC,PWV-WI,PWVβ and AI determination can evaluate the risk of cardiovascular diseases in elderly diabetes,and higher CRP level and HAMD score may deteriorate its process.

Objective:To evaluate the predictive value of high sensitive C-reactive protein and heart rate recovery on the new cardiovascular events in the patients with Type 2 Diabetes Mellitus.Methods:To assay high sensitive C-reactive protein in 156 patients with Type 2 Diabetes Mellitus who performed exercise stress test at the same time or in one week.The subjects were divided into normal hsCRP and abnormal hsCRP group and normal HRR and abnormal HRR group based on the results.Then according to the value of hsCRP and HRR,the diabetics were subdivided cross-over into 4 groups:GroupⅠ with normal hsCRP and HRR,GroupⅡ with normal hsCRP and abnormal HRR,GroupⅢ with abnormal hsCRP and normal HRR,GroupⅣ with abnormal hsCRP and abnormal HRR.The new cardiovascular events were counted every half year in the follow-up 2 or 3 years.Results:1.52 of 156 patients had new cardiovascular events.The total incidence of events was 33.3%.2.The incidence of cardiovascular events in normal hsCRP and abnormal hsCRP group were 16.4% and 46.1% respectively,there was a significant difference between the two groups.Based on the value of hsCRP,the relative risk value was 2.8;3.The incidence of cardiovascular events in normal HRR and abnormal HRR group were 3.2% and 53.8% respectively,there was a significant difference between the two groups too.To regard abnormal HRR as the predictor,the relative risk level was 16.9;4.The occurrence rates of cardiovascular events in GroupⅠ,GroupⅡ,GroupⅢ,GroupⅣ were 2.9%,31.3%,3.6%,65.6% respectively,there was a significant difference among the 4 groups.Thereinto,there was no significant difference between groupⅠ and groupⅢ,while there was a significant difference between groupⅡ and Ⅳ.The incidence of events was statistically significant among groupⅠ,groupⅢ and group Ⅱ,and also among groupⅠ,groupⅢ and group Ⅳ;compared with groupⅠ,the relative risk values of group Ⅱ,groupⅢ,group Ⅳ were 10.9,1.3,23 respectively.Conclusion:Both abnormal HRR and abnormal hsCRP are predictors of cardiovascular risk in diabetics while the indicative value of HRR is much higher;Combining HRR with hsCRP can improve the accuracy of risk assessment on screening cardiovascular risk in diabetics,which is of clinical significance.

目的 观察二甲双胍对男性性功能的影响.方法 60例糖耐量异常患者随机分为两组:二甲双胍组(M组,30例),M组又分为治疗前组(MO组)和治疗后组(M1组)；生活方式干预组(L组,30例).监测患者血糖、糖化血红蛋白、血脂、血压、体质量指数、腰臀比、尿酸等指标的变化；以国际男性性功能问卷评价患者的性功能并检测血清总睾酮和性激素结合蛋白的含量,随访24周.结果 M组治疗后性欲积分值稍有增高,但差异无统计学意义(P＞0.05),两组治疗前后血糖、糖化血红蛋白、血压、勃起功能障碍的发生率、睾酮、性激素结合蛋白比较差异均无统计学意义(P＞0.05).结论 二甲双胍对男性性功能无影响.

目的应用超声瞬时波强(WI)研究儿童青少年体质量指数(BMI)对颈动脉血管弹性的影响及其相关性。方法应用WI对单纯肥胖组及正常对照组内中膜厚度在正常范围的颈动脉血管进行检测,所测各参数与BMI做相关性分析。结果与正常对照组相比,单纯肥胖组瞬时减速度波强、僵硬度(β)、压力应变系数(Ep)、瞬时波强脉搏波传导速度、脉搏波传导速度值增高,顺应性值降低(P<0.05)。瞬时加速度波强、脉搏波反射增强指数、瞬时波强负向波面积值在2组间依次增高,但差异不具有统计学意义。相关分析显示,总人群中BMI与β及Ep间存在单因素相关关系(P<0.05)。多元线性回归分析显示,BMI可以独立对血管弹性进行预测。结论 BMI对颈动脉血管弹性有明显影响,可独立对血管弹性进行预测。WI为检测血管弹性的较好技术手段。

目的 了解妊娠合并甲状腺功能亢进症(甲亢)患者的焦虑及抑郁状况特点.方法 采用焦虑自评量表(SAS)、抑郁自评量表(SDS)测试甲状腺功能亢进合并妊娠的患者及无妊娠合并症患者的心理健康水平,并作相关性分析.结果 本研究选取合并妊娠的甲状腺功能亢进患者及无妊娠合并症患者各46例,均进入结果分析,无脱落者.在两组的生化指标对比中,各项指标均无显著差异(P＞0.05)；妊娠期甲亢患者SAS总分明显高于正常妊娠孕妇(P＜0.01),SDS总分亦高于正常妊娠孕妇(P＜0.01)；妊娠合并甲亢患者抑郁、焦虑状态发生率分别为67.4％ (31/46)、52.2％ (24/46),抑郁和焦虑共存的发生率为47.8％(22/46).结论 甲亢合并妊娠患者的焦虑与抑郁症状均较正常妊娠者高,甲亢患者妊娠期情绪障碍与甲亢的发生具有一定的关联.

目的观察糖尿病足患者的认知功能,分析其相关性因素。方法采用简易智能状态检查量表(MMSE)评定糖尿病足患者和非糖尿病足患者的认知功能,比较二者的差异;对认知功能障碍与血糖、血脂、血压等的关系进行相关性分析。结果糖尿病足和非糖尿病足患者的MMSE总分无统计学差异(P>0.05),在记忆力、注意力亚测试分值上差异有统计学意义(P均<0.05)。认知功能障碍与家族史、高血压病史、生活方式、糖尿病足有相关性。结论糖尿病足患者认知功能障碍与多种因素相关,明确其病因对预防其发生有积极意义。

Objective To understand the features of cognitive impairment in patients with subclinical hypothyroidism. Methods The cognitive function of the patients with subclinical hypothyroidism and the healthy controls was tested using Mini-Mental State Examination (MMSE) and Wechsler Memory Scale (WMS). The change in cognitive function was observed and analyzed before and after L-T4 treatment. Results Fifty-seven patients with subclinical hypothyroidism and the same number of healthy controls were enrolled in this study. There were no significant differences between two groups in biochemical indexes and MMSE score (all P＞0.05). But there were significant differences between two groups in WMS score, including pictures, memories, learning, touch, understanding memory and back several test scores (all P＜0.05). There existed certain degree of cognitive dysfunction mainly displayed in memory, attention, etc. After three months of L-T4 treatment, all had significant improvement (all P＜0.05). Conclusions Patients with subclinical hypothyroidism have cognitive dysfunction, when the thyroid stimulating hormone is restored to normal level, cognitive function is also improved.