目的 观察"四位一体"干预模式对2型糖尿病患者的效果.方法 选择2019年3月至2020年6月收治确诊的116例2型糖尿病患者,随机数字表法分为对照组和干预组,每组58例.对照组采用常规糖尿病治疗管理方法,干预组在对照组的基础上采用"四位一体"即医院-社区-家庭的干预模式进行延续指导.患者出院后随访2个月,比较2组患者干预前与干预后糖尿病患者自我管理依从性评分、护理满意度评分以及血糖调控效果.结果 干预组空腹血糖和餐后2 h血糖低于对照组,差异均有统计学意义(P<0.05).干预组低血糖发生率低于对照组,差异有统计学意义(P<0.05).干预组自我管理治疗依从性评分和护理满意度高于对照组,差异有统计学意义(P<0.05).结论 在2型糖尿病患者的临床护理干预中,"四位一体"干预模式应用效果良好,不仅可以帮助患者有效降低血糖水平,提高其自我管理治疗依从性,而且还可以有效减少低血糖事件发生,有利于提高患者护理满意度及患者生活质量.

目的 评价集束化干预对糖尿病足患者血管腔内治疗的护理效果.方法 选择2014年2月到2015年8月期间收治的糖尿病足患者114例,根据患者的入院顺序分为观察组和对照组,每组57例.给予所有患者常规护理,观察组患者在此基础之上行集束化护理干预措施.对2组患者干预后疗效进行比较,采取问卷调查的方式评价护理效果,观察2组患者干预前后的情绪变化.结果 观察组患者干预后的疗效94.74%显著高于对照组84.21%,2组比较差异有统计学意义(P<0.05).干预后,观察组患者的护理满意度、饮食管理、服药情况、情绪控制、锻炼情况以及疾病认识的效果优于对照组,差异有统计学意义(P<0.05).观察组患者的SDS评分(43.12±10.76)分和SAS评分(42.15±9.98)分改善效果显著优于对照,2组比较差异有统计学意义(P<0.05).结论 对糖尿病足患者血管腔内治疗采取集束化护理干预可以缓解患者的抑郁和焦虑情绪,提高患者的满意度及临床疗效,值得推广使用.

目的 探讨集束化护理措施在经皮血管成形术联合支架植入术治疗糖尿病足中的效果.方法 选择经皮血管成形术联合支架植入术治疗的80例糖尿病足患者进行研究.根据患者入院时间的先后顺序不同随机分为对照组和观察组,每组40例.对照组给予常规护理.观察组给予集束化护理干预.治疗后,比较2组患者Wagner分级、血糖、踝肱指数、临床症状及疗效.结果 观察组Wagner分级显著低于比对照组,差异有统计学意义(P<0构.05);观察组患者血糖明显低于对照组,踝肱指数高于对照组,2组比较差异有统计学意义(P<0.05);观察组麻木、疼痛、发绀、皮肤低温患者数量均少于对照组,差异有统计学意义(P<0.05);观察组总有效率为100.00%,对照组总有效率为85.00%,2组比较差异有统计学意义(P<0.05);观察组总不良反应发生率为7.50%,明显低于对照组的25.00%,2组比较差异有统计学意义(P<0.05).结论 经皮血管成形术联合支架植入术治疗糖尿病足中给予集束化护理干预效果良好,值得临床推广.

背景:骨髓干细胞移植治疗下肢缺血性疾病近年来在临床取得较大进步,但在实践过程中也发现由于老年患者骨髓干细胞数量较少,采集困难,分化能力降低,对临床疗效产生影响.目的:探讨脐带间充质干细胞联合骨髓干细胞治疗下肢缺血的效果.方法:选择2012年3月至2015年11月在石家庄市第一医院进行干细胞移植治疗的下肢缺血性病变患者47例,根据治疗方法不同分为观察组23例和对照组24例,对照组采用骨髓干细胞移植治疗,观察组采用脐带间充质干细胞联合骨髓干细胞移植治疗.结果与结论:①观察组总有效率显著高于对照组(P=0.039);②观察组患者皮温、经皮氧分压和踝肱指数均显著高于对照组(P＜0.05):③观察组患者肢体疼痛、患肢冷感和间歇性跛行评分均显著低于对照组(P＜0.05);④由此可见脐带间充质干细胞联合骨髓干细胞治疗下肢缺血较单独采用骨髓干细胞能够更加有效提高患肢皮温、经皮氧分压和踝肱指数,改善患者疼痛及冷感等临床症状,疗效更佳.

Objective To study the effect of predictive nursing on elderly patients with diabetic foot.Methods Eighty-two cases of elderly patients with diabetes foot were divided into observation group(n=41) and control group(n=41) according to the order of admission.The control group received routine nursing care,and the observation group received predictive nursing on the basis.Diabetes foot knowledge score,foot care behavior score,treatment effect and amputation rate were compared between 2 groups before intervention and after 2 months intervention.Results After the intervention,diabetic foot awareness score and foot care behavior score were significantly higher than those before intervention.Diabetic foot knowledge score,foot care behavior score in the observation group was significantly higher than the control group(P<0.05).The clinical efficacy of the observation group was better than that of the control group.The total effective rate was higher than that of the control group,and the amputation rate was lower than that of the control group(P<0.05).Conclusion Nursing care of patients with diabetic foot can significantly improve the knowledge score,foot care behavior score and clinical curative effect,and reduce the incidence of deteriorate,improve the quality of life in patients with diabetic foot,most likely to avoid amputation,which is worthy of clinical attention.

目的 了解糖尿病视网膜病变(DR)患者泪液肿瘤坏死因子(TNF)-α水平及其与DR的关系,探讨以泪液TNF-α水平诊断DR的可行性.方法 分层随机抽样选择石家庄市9个社区,居住5年以上,年龄≥45岁的社区居民,进行横断面流行病学问卷调查,以口服糖耐量试验根据1999年WHO糖尿病(DM)诊断标准确立新诊断DM者.对新诊断及既往诊断DM者,检测泪液TNF-α水平,依据眼底检查确立DR.采用受试者工作特征曲线(ROC)进行判断,得到以泪液TNF-α水平诊断DR的最佳切点,计算阳性似然比(+LR),阴性似然比(-LR),阳性预测值(+PV),阴性预测值(-PV).结果 泪液TNF-α水平在正常糖耐量(NGT)组为(0.76±0.24)pg/ml,糖尿病无视网膜病变(NDR)组为(5.86±2.21)pg/ml,DR组为(10.69±3.67)pg/ml,组间差异有统计学意义(P<0.01).血液TNF-α在NGT组为(6.80±3.73)pg/ml,NDR组为(21.44±9.16)pg/ml,DR组为(31.16±10.43)pg/ml,组间差异有统计学意义(P<0.01).泪液TNF-α水平与血液TNF-α水平存在正相关(R=0.795,P<0.01).通过绘制ROC曲线,得到泪液TNF-α水平诊断DR相关的临界点为9.07 pg/ml,约登指数为0.600,敏感性和特异性分别为66.5%和6.5%,曲线下面积为0.867(95%CI为0.832~0.901).+LR 10.23,-LR 0.36,+PV为60.38%,-PV 54.53%.结论 石家庄市社区中老年DR患者泪液IL-6水平明显增高.泪液TNF-α水平作为DR诊断手段,有可行性.

目的：评价营养、行为干预对2型糖尿病合并肥胖症的疗效。方法依据WHO(1999年)诊断标准确诊的2型糖尿病患者200例,按照男性腰臀比>0.9,女性腰臀比>0.85的标准分为中心型肥胖组和腰臀比正常组,每组100例。测定2组患者的空腹血糖及空腹胰岛素、血脂、糖化血红蛋白(HbA1c),并计算患者胰岛素抵抗指数( HOMA-IR)。对患者进行健康宣教,营养干预,采用个性化运动处方行为干预。干预后6个月重复测定2组患者腰围、臀围及上述化验指标。结果干预后2组患者腰臀比均下降,空腹血糖及空腹胰岛素水平、HbA1c均降低,2组患者胰岛素抵抗指数(HOMA-IR)数值下降( P <0.05),血胆固醇、低密度脂蛋白、三酰甘油下降,高密度脂蛋白升高(P<0.05)。腰臀比正常组腰臀比、胰岛素抵抗指数、空腹胰岛素、HbA1c、血脂等指标下降更为明显,差异有统计学意义( P <0.05)。结论营养、行为干预是2型糖尿病合并肥胖症的有效治疗措施,尤其对于中心型肥胖者,治疗作用更加明显。

BACKGROUND:Common strategies for preventing diabetic nephropathy include effective control of blood sugar and blood pressure, inhibition of the rennin-angiotensin system and lipid-lowering therapy, but it is often difficult to get the desired results. OBJECTIVE:To investigate the effect of transplantation of bone marrow mesenchymal stem cels on levels of blood glucose and urinary total protein in diabetic nephropathy rats. METHODS: Forty-five Sprague-Dawley rats were randomly divided into three groups (n=15 per group): normal control group, diabetic nephropathy group and stem cel transplantation group. Rats in the diabetic nephropathy and stem cel transplantation groups were given single use of 60 mg/kg streptozotocin to make diabetic nephropathy models. The same dose of citric acid-sodium citrate buffer was injected in the normal control group. After modeling, 200μL of bone marrow mesenchymal stem cel solution (2×106) was injected into the left ventricle of rats in the stem cel transplantation group, and then at 7 days after the first transplantation, the cel transplantation was conducted again. The same dose of serum-free L-DMEM was injected intracardialy into the rats in the normal control and diabetic nephropathy groups. Levels of urinary total protein and blood glucose were detected. RESULTS AND CONCLUSION:At 1, 4, 8 weeks after treatment, the urinary total protein and blood glucose levels were significantly higher in the stem cel transplantation group and diabetic nephropathy group than the normal control group (P < 0.05). At 1 week after treatment, the urinary total protein and blood glucose levels were significantly lower in the stem cel transplantation group than the diabetic nephropathy group (P < 0.05). At 4 and 8 weeks after treatment, the total urinary protein and blood glucose levels were slightly higher in the diabetic nephropathy group than the stem cel transplantation group, but there was no significant difference (P > 0.05). These findings indicate that bone marrow mesenchymal stem cel transplantation in diabetic nephropathy rats can get good results in a short period, significantly improve the blood glucose and urinary total protein levels, but the long-term treatment effect is poor.

目的 探讨2型糖尿病伴干眼症患者泪液、血清中白细胞介素6(IL-6)浓度的变化.方法 纳入人群分为3组:A组为2型糖尿病不伴干眼症患者组,B组为2型糖尿病伴干眼症患者组,C组为正常对照组.用ELISA法分别检测3组人群泪液、血清中IL-6的含量.采用单因素方差分析进行数据之间比较.并对泪液、血清IL-6进行相关性分析.结果 A、B和C组泪液1L-6含量分别为:(12.90±8.30)pg/ml、(22.43±12.97)pg/ml和(4.69±3.29)pg/ml,血清IL-6含量分别为(144.85±57.52)pg/ml、(256.26±117.96)pg/ml和(97.01±51.60)pg/ml.其中A组与B组血清及泪液IL-6含量均较C组高,B组血清及泪液IL-6含量较A组高(P＜0 01);泪液IL-6与血清IL-6水平呈正相关(r=0.73,P＜0.01).结论 2型糖尿病不伴干眼症患者泪液、血清IL-6含量均较正常健康人群增高,2型糖尿病伴干眼症患者泪液、血清IL-6水平进一步升高,提示泪液、血清IL-6水平与2型糖尿病伴干眼症的发生有关.泪液IL-6与血清IL-6水平呈直线正相关,提示泪液IL-6水平监测对于糖尿病并发干眼症患者的病情监测有一定的临床价值.

目的：探讨糖尿病（ DM）及糖尿病视网膜病变（ DR）与老年患者泪液、血清白细胞介素（ IL）-6浓度的关系。方法纳入人群分为三组：A组为2型糖尿病无视网膜病变老年患者组，B组为2型糖尿病有视网膜病变老年患者组，C组为正常对照老年人组。用ELISA法分别检测三组人群泪液、血清中IL-6的含量。结果 A、B组泪液IL-6含量均较C组高，B组泪液IL-6含量较A组高（P＜0.01）；泪液IL-6与血清IL-6水平呈正相关（r＝0.655，P＜0.05）。结论老年DM患者泪液IL-6含量较正常老年人增高，老年DR患者泪液IL-6水平进一步升高，且泪液 IL-6与血清IL-6水平呈直线正相关。

BACKGROUND:Thrombospondin-1 is an important endogenous activator of transforming growth factor beta 1 in this experimental inflammatory kidney disease model. Transforming growth factor beta 1 is considered the major cytokine that causes tissue fibrosis in many different inflammatory disease processes, in particular in renal disease. <br> OBJECTIVE:To investigate the expression of thrombospondin-1 on renal fibrosis in rats. <br> METHODS:Healthy male Sprague-Dawley rats were randomly divided into sham surgery group and model group. In themodel group, right ureters of rats were ligated to construct models of renal fibrosis. 3 weeks after surgery, blood and urine were obtained weekly. Enzyme linked immunosorbent assay and Bradford method were used to detect the contents of serum creatinine,blood urea nitrogen and urinary protein. After rats were sacrificed, kidneys were fixed. Western blot assay was utilized to identify the expression of vascular endothelial growth factor, transforming growth factor beta 1 and thrombospondin-1 protein. Hematoxylin-eosin staining was applied to detect the changes in pathological structure of the kidney after surgery. <br> RESULTS AND CONCLUSION:(1) One week after model induction, urinary protein, serum creatinine and urea nitrogen levels were significantly higher in the model group than in the sham surgery group (P< 0.05). Three weeks later, the difference in each index was significant (P< 0.01), which showed that the injury of the kidney was aggravated. (2) Transforming growth factor beta 1 protein and thrombospondin-1 expression was significantly higher in the model group than in the sham surgery group, but vascular endothelial growth factor protein expression was significantly lower in the model group than in the sham surgery group. (3) Hematoxylin-eosin staining results demonstrated that severe pathological changes of renal tissue in rats were detected after ligation of renal tubule. (4) These results confirmed that thrombospondin-1 expression increased in renal tissue, and its expression was strongly associated with vascular endothelial growth factor protein and transforming growth factor beta 1, which may play an important role in the renal fibrosis.

目的 测定并比较2型糖尿病不同分期视网膜病变患者及正常人泪液中肿瘤坏死因子-α(TNF-α)的含量,探讨泪液TNF-α与糖尿病及糖尿病视网膜病变的关系.明确泪液TNF-α与血清TNF-α水平的相关关系.方法 正常对照组(NC组)50例、2型糖尿病无视网膜病变组(NDR组)50例、2型糖尿病单纯性视网膜病变组(DR组)50例,2型糖尿病增生性视网膜病变患者(PDR组)50例,用ELISA法检测四组人群泪液、血清中TNF-α的含量.结果 泪液中TNF-α的含量:NC组为(0.48±0.17)pg/ml,NDR组为(3.84±1.64)pg/ml,DR组为(6.63±2.06)pg/ml,PDR组为(7.76±3.05)pg/ml,两两组间比较均有统计学意义(P ＜0.01或P＜0.05).血清中TNF-α的含量:NC组浓度为(4.78±3.03)pg/ml,NDR组浓度为(13.68±6.66)pg/ml,DR组浓度为(18.92±5.94)pg/ml,PDR组浓度为(21.62±9.92)pg/ml,两两组间比较均有统计学意义(P＜0.01).泪液TNF-α与血清TNF-α水平有相关性(r=0.751,P＜0.05).结论 2型糖尿病患者泪液TNF-α水平明显升高.随着糖尿病视网膜病变程度的加重,泪液TNF-α含量逐渐升高,提示泪液TNF-α水平与糖尿病及不同分期糖尿病视网膜病变的发生有关.泪液TNF-α与血清TNF-α水平之间呈线性正相关关系.

Objective To investigate the relationship between intraocular pressure (IOP)fluctuations and blood glucose levels in elderly patients with type 2 diabetes.Methods 34 elderly patients with type 2 diabetes in the First People's Hospital of Shijiazhuang from Jan to Dec 2014 were selected as the observation group, while another 34 non-diabetic patients who came for routine physical examinations during the same period were selected as the control group.All patients underwent a complete ophthalmic examination, glucose testing, and intraocular pressure test under both fasting and postprandial conditions.Results There was no significant difference in fasting IOP between the two groups (P＞0.05).Blood glucose and IOP in both groups were higher under postprandial conditions than under fasting conditions (P＜0.05), and postprandial IOP was higher in type 2 diabetic patients than in the control group (P＜0.05).IOP changes were positively correlated with blood glucose levels in the two groups (R2 =0.611 and 0.303, respectively, P＜0.05).There was a positive correlation between fasting glucose levels and IOP changes in the diabetic group (R2 =0.502, P＜0.05), which was not found in the non-diabetic group (R2 =0.162, P＞0.05).Muhivariable analysis showed that IOP variations were positively correlated with blood glucose level changes, with age, baseline IOP and gender as the confounding factors (P＜0.05).Conclusions There is a significant correlation between blood glucose levels and IOP variations in elderly patients with type 2 diabetes.

BACKGROUND:Type 1 diabetes mel itus is an autoimmune disease, which is characterized as the selective destruction of pancreatic beta cel s in the body, resulting in the lack of insulin secretion. Umbilical cord blood stem cel s have the potential to differentiate into islet cel s in vitro and in vivo, which play a certain hypoglycemic effect. OBJECTIVE:To explore the effects of umbilical cord blood stem cel s on blood glucose levels and PDX-1 and MafA levels in the pancreatic tissue of type 1 diabetic rats. METHODS:Thirty Sprague-Dawley rats were randomly divided into three groups, with 10 rats in each group. In treatment and model groups, type 1 diabetes mel itus modes were established. After modeling, the treatment group was given a single tail vein injection of umbilical cord blood stem cel s;the normal control group was given the same volume of normal saline;the model group was given the same volume of umbilical cord blood stem cel buffer solution. Oral glucose tolerance test was adopted to assess the islet function of rats;hematoxylin-eosin staining was used to observe the pancreatic morphology of rats;western blot and PCR methods were employed to detect expressions of PDX-1 and MafA in pancreatic tissues at protein and mRNA levels. RESULTS AND CONCLUSION:(1) Compared with the normal control group, the levels of blood glucose in the model and treatment groups were significantly higher at 0, 30, 60, 90 minutes (P<0.05). At 120 minutes, the blood glucose level in the model group was significantly higher than that in the normal control group (P<0.05), but there was no difference between the treatment and normal control groups (P>0.05). (2) The number of islets in the model group was decreased, and the boundary was unclear and irregular;in the treatment group, the number of islets was decreased, but the boundary was stil clear. (3) The expressions of PDX-1 and MafA in the treatment group were similar to those in the normal control group (P>0.05), but significantly higher than those in the model group (P<0.05). These findings suggest that the umbilical cord blood stem cel transplantation can significantly reduce the blood glucose levels in type 1 diabetic rats, improve the function of islet and morphology of pancreas, and up-reuglate the expressions of PDX-1 and MafA.

Objective To investigate the relationship between the severity of diabetic retinopathy( DR)in middle-aged and elderly diabetes patients and the levels of tear fluid TNF-α, serum TNF-α and serum HbA1c in Shijiazhuang. Methods From April to October in 2011,we selected 9 community residents(resident years≥5,age≥45)in Shijiazhuang using stratified random sampling. According to diagnostic criteria,the patients were definitely diagnosed and determined with different phrases. Venous blood was sampled,and FPG,2 hPG,blood lipid,TNF-α and HbA1c were determined. Capillary&nbsp;glass tube method was employed,and ELISA was employed to determine TNF-αlevel. Results A total of 1 447 patients were included,among which 467 had normal glucose tolerance ( NGT ) and 593 had DM;among subjects who received fundus examination and offered tear samples,105 subjects had NGT(210 eyes,NGT group),184 subjects had diabetes without retinopathy(368 eyes,NDR group),149 had non-proliferating diabetic retinopathy(298 eyes,NPDR group),and 63 had proliferative diabetic retinopathy(126 eyes,PDR group). The 4 groups were significantly different in BMI,WHR,SBP, DBP,FPG,TC,TG,HDL-C and LDL-C( P ﹤0. 01 for all). NGT group,NDR group,NPDR group and PDR group were significantly different in the levels of tear fluid TNF-α,serum TNF-α and serum HbA1c ( P ﹤0. 05 for all). NDR group,NPDR group and PDR group were higher than NGT group in the levels of tear fluid TNF-α,serum TNF-αand serum HbA1c ( P﹤0. 05 for all);NPDR group and PDR group were higher than NDR group in the levels of tear fluid TNF-α,serum TNF-α and serum HbA1c ( P﹤0. 05 for all);PDR group was higher than NPDR group in the levels of tear fluid TNF-α, serum TNF-α and serum HbA1c ( P﹤0. 05 for all). The level of tear fluid TNF-α was positively correlated with the level of serum TNF-α(b =0. 291,t =29. 28,P ﹤0. 01). Tear fluid TNF-α was positively correlated with serum HbA1c(b =1. 480,t=7. 58,P ﹤0. 01). Multivariate Logistic regression analysis showed that age,gender,history of diabetes,BMI, WHR,TG,FPG,2 hPG, tear fluid TNF-α, serum TNF-α and HbA1c were influencing factors for DR ( P ﹤0. 05 ). Conclusion Middle-aged and elderly residents with type 2 diabetes have higher tear fluid TNF-αlevel than healthy middle-aged and elderly residents. With the exacerbation of retinopathy,the tear fluid TNF-α level increases. The levels of tear fluid TNF-α,serum TNF-α and serum HbA1c may reflect the severity of DR to some extent.

Objective To investigate the relationship between HbA1c in blood and IL-6 in tear fluid of the elderly patients with diabetic retinopathy ( DR ) in Shijiazhuang urban communities , and the relationship between IL-6 in tear fluid and the severity of DR. Methods The elderly people who lived more than 5 years , older than ≥45 year old. in nine urban communities of Shijiazhuang were stratified randomly sampled and received cross-sectional epidemiology questionnaire survey and OGTT. A total of 1 447 subjects (509 males and 938 females) were included. Each participant underwent epidemiological surveys and oral glucose tolerance test (OGTT), according to the 1999 WHO diabetes mellitus (DM) diagnostic criteria established. For patients who were newly or previously diagnosed as DM. HbA1c level, tear fluid IL-6 and serum IL-6 tested.The severity of DR was evaluated by fundus examination, the people were divided into normal group(NGT), non-diabetic retinopathy ( NDR ) , non-proliferative diabetic retinopathy ( NPDR ) , and proliferative diabetic retinopathy ( PDR ) . The correlation of serum IL-6 and tear fluid IL-6,blood HbA1c and tear fluid IL-6 were assessed by SPSS 19.0 statistical software. Results Concentrations of tear fluid IL-6 were (3.10 ± 1.25)pg/mL in the NGT group, (10.25 ± 3.22)pg/mL in the NDR group,(16.80 ± 5.76)pg/mL in the NPDR group,(25.11 ± 5.20)pg/mL in the PDR group(P < 0.01). SNK-q test revealed significant differences between every two groups (P < 0.01,P <0.05,P < 0.05) Concentrations of serum IL-6 were (88.04 ± 17.06)pg/mL in the NGT group,(126.38 ± 20.73) pg/mL in the NDR group, (239.83 ± 40.33)pg/mL in the NPDR group, (268.36 ± 27.72)pg/mL in the PDR group(P < 0.01). SNK-q test revealed significant differences between every two groups (P < 0.01). Tear fluid IL-6 level was positively correlated with serum IL-6 level(R = 0.756,P < 0.01). Tear fluid IL-6 level was positively correlated with blood IL-6 level (R = 0.338, P < 0.01). Conclusion The tear fluid IL-6 levels of the elderly patients with DM in Shijiazhuang urban communities , increased; with the increased severity of DR , the levels of tear fluid IL-6 gradually increase. The level of tear fluid IL-6, serum IL-6, HbA1c closely correlates with the severity of DR.

妊娠期糖尿病（ gestational diabetes mellitus ，GDM）是指妊娠期出现的糖代谢异常，不包括妊娠前已经存在的糖尿病（ diabetes mel-litus，DM）［1］。 GDM对母婴都有影响，孕妇血糖水平与母婴并发症的发生有密切关系。血糖控制不佳会对孕妇和胎儿产生不良影响。因此应及早发现并采取干预措施将血糖控制在正常水平，减少孕妇和胎儿并发症的发生。据文献报道［2］，胰岛泵连续皮下输注减少了多次注射的痛苦，对各类型糖尿病患者的治疗取得了很好的效果。作者自2012年7月以来共收集26例GDM患者，通过治疗和护理，取得良好效果，孕妇顺利分娩，胎儿娩出健康。下面将胰岛素泵对GDM治疗情况及胰岛素泵的护理报告如下。

Objective To observe and evaluate the impaired glucose tolerance(IGT) in essential hypertension(EH) patients with blood pressure variability(BPV) effects.Methods Select January 2011-January 2013 alone treated patients with EH 74 cases for the control group;Selected 74 cases of patients with EH and IGT as the observation group.Conducted on two groups of patients 24 h ambulatory blood pressure monitoring(ABPM),observed in patients with BPV characteristics.Results The patients of observation groups 24 h systolic blood pressure variation coefficient(0.12±.03),daytime systolic blood pressure standard deviation(15.28±2.63) and coefficient of variation(0.13±0.02),mean nighttime systolic blood pressure(131.12±10.73) were higher than those of control group(0.09±0.01),(13.19±2.25),(0.10±0.02) and(128.15±10.52),the differences were statistically significant(P0.05).Conclusion For patients with EH,IGT had a significant effect on BPV,EH combined in the treatment of patients with IGT,in addition to taking antihypertensive treatment,but also should pay attention to the regulation of BPV,and actively improve glucose metabolism abnormalities.

目的 探讨老年人群中糖化血红蛋白(HbA1c)诊断糖尿病(DM)的理想切点及可行性.方法 采用分层随机抽样方法选择石家庄市9个社区,居住5年以上年龄≥60岁的社区居民,进行横断面流行病学调查,共调查1 220例.其中符合入选条件的938例行口服75 g葡萄糖耐量试验(OGTT)；测定空腹血糖、服糖后2h血糖及HbA1c.采用受试者工作特征曲线(ROC曲线)进行判断,得到以OGTT诊断DM的HbAlc值,计算最佳切点.并与OGTT试验诊断标准比较,评价两者对于DM诊断率的差异.结果 按照1999年WHO的DM诊断标准,研究人群中糖耐量正常(NGT)440例,空腹血糖受损(IFG) 69例,糖耐量低减(IGT) 148例,合并IFG+ IGT 73例,新诊断DM (NDDM) 208例.通过绘制ROC曲线,得到HbA1c与诊断DM相关的临界点为6.2％,敏感性和特异性分别为69.8％和95.8％,曲线下面积为0.860(95％ CI0.832 ～0.898).与OGTT结果的符合率为77.5％.以HbA1c≥6.2％作为DM诊断切点,阳性似然比(-LR)16.62,阴性似然比(-LR)0.32,阳性预测值(+PV)75.4％,阴性预测值(-PV)78.1％.结论 HbA1c≥6.2％作为石家庄市老年人群筛查DM切点具有较高敏感度与特异度,可作为临床DM筛查的切点.

Objective To investigate the relationship between type 2 diabetes mellitus(T2DM) and IL-6 expression in tears.Methods ELISA method was used to detect the expressions of IL-6 in tears and serum in 40 T2DM patients without diabetic retinopathy(group A),40 patients with diabetic retinopathy(group B) and 40 healthy people(group C).Results The expression of IL-6 in tears was higher in groups of A and B than that in group C [(12.21±3.88) pg/ml and(18.86±6.56) pg/ml vs.(4.29±3.27) pg/ml](P0.01),which was higher in group B than that in group A(P0.01).The expression of IL-6 in tears was positively correlated with that in serum(r=0.731,P0.05).Conclusion The expression of IL-6 in tears is associated with diabetes and diabetic retinopathy.Detection of IL-6 expression in tears may be taken as one of the indicators for evaluating diabetes mellitus.