病例 王先生50多岁,刚被确诊为糖尿病.他在饮食控制和加强运动的同时,还服用医生开具的二甲双胍和文迪雅.1周后,口干、多饮、多尿等症状有所好转,但多次检查血糖仍未达标.

糖尿病大血管病变主要是指在中等或较大的动脉发生了粥样硬化,主要累及主动脉、冠状动脉、脑动脉、肾动脉和周围血管等大血管,临床常见疾病是冠心病、脑卒中和下肢动脉硬化、坏疽等.糖尿病大血管并发症是糖尿病患者致死、致残的最主要原因之一,尤其是并发各种形式的心血管疾病时,其死亡率是非糖尿病人群的2～8倍,75%～80%的糖尿病患者死于大血管病变.

Objective To assess clinical efficacy and quality of life (QOL) for patients of type 2 diabetes treated with controlled-release-gliclazide, as compared with those with ordinary gliclazide tablets, in a randomized controlled clinical trial stageⅡ. Methods Forty-eight eligible patients suffered from type 2 diabetes were randomly allocated to controlled-release-gliclazide group ( group A) and ordinary gliclazide tablets group ( group B) , respectively. Patients in group A received two tablets of controlled-release-gliclazide (30 mg) before breakfast and two tablets of placebo before dinner every day. Patients in group B received one tablets of ordinary gliclazide (80 mg) and one tablets of placebo two times daily. All patients were treated for 12 weeks. Blood plasma levels of glucose, C peptide and glycosylated hemoglobin A1c (HbA1c) were measured for all patients. The patients were interviewed with a specific questionnaire of quality of life and 36-item short form for health survey (SF36). Results Fasting and 2-hour postprandial plasma levels of glucose and HbA1c reduced significantly and the level of C-peptide increased significantly in both groups after treatment, as compared with those before treatment (P 0. 01). No significant difference in all clinical indicators and quality of life between the two groups was found after treatment. Scores of somatic pain and social function in SF36 improved significantly in both groups after treatment, as compared with those before treatment (P 0. 01). Rate of adverse reaction was significantly higher in group A (20. 8% ) than that in group B (8. 3% , P 0. 05) , but consequently no patients withdrew from the study. Conclusion Controlled-release-gliclazide had the similar effect on the patients with type 2 diabetes as ordinary gliclazide tablets did in improving their clinical manifestation and quality of life.

Objective:To assess clinical efficacy and safety in type 2 diabetes patients with controlled release-gliclazide therapy,camparing with gliclazide.Methods:48 patients with type 2 diabetes had been randomly allocated into controlled-release-gliclazide group(A) or gliclaz- ide group(B).Patients in group A received controlled-release-gliclazide 30 mg and placebo two times a day.Patients in group B received gli- clazide 80mg and placebo two times a day.All the patients had been treated for 12 weeks.Blood plasma glucose,HbA1c and C peptide were measured.Results:The efficacy rates were 100% and 95． 83%,respectively.No significant difference was found between the two groups. Both groups had similar improvement in blood plasma glucose,HbA1c and C peptide.Conclusion:Controlled-release-gliclazide has similar efficacy and safety to gliclazide in treatment of type 2 diabetes.

目的:通过分析糖尿病合并感染的临床类型及危险因素,进一步预防和控制糖尿病的感染.方法:对导致糖尿病并发感染的众多危险因素进行Logistic回归模型多因素分析.结果:回顾性分析该院收治的846例糖尿病病例,并发感染269例,其中住院前感染234例,住院后感染35例.感染的临床类型以肺部及上呼吸道最为多见,其次为尿路感染及胆道感染.引起感染的病原菌以奈瑟氏菌及草绿色链球菌最为多见,其次为肺炎克雷伯杆菌、白色念珠菌、金黄色葡萄球菌等.结论:发现年龄≥60岁 ,女性患者、住院天数和空腹血糖高为糖尿病并发感染的危险因素.