目的 对2型糖尿病患者胰岛素抵抗指数(HOMA-IR)、脂联素(APN)、瘦素(LEP)、骨密度(BMD)进行分析,以探讨HOMA-IR、APN、LEP在糖尿病性骨质疏松发病中的作用.方法 124例2型糖尿病患者,根据股骨颈Lunar双能X线骨密度仪(DEXA)测量结果 分为糖尿病并骨质疏松组(55例)及糖尿病无骨质疏松组(69例);另选取42例体检的健康人作为对照组.检测三组的APN、LEP、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、甘油三酯(TG)、腰椎BMD、左股骨BMD、HOMA-IR、糖化血红蛋白(HbA1c)水平并进行比较.结果 三组LDL-C、HDL-C、TC、TG比较差异无统计学意义(P>0.05).糖尿病并骨质疏松组、糖尿病无骨质疏松组的腰椎和左股骨BMD分别为(0.71±0.16)、(0.84±0.13)g/cm2及(0.65±0.14)、(0.76±0.16)g/cm2,均明显低于对照组的(0.95±0.09)、(0.86±0.17)g/cm2,差异有统计学意义(P<0.05).糖尿病并骨质疏松组、糖尿病无骨质疏松组的HbA1c高于对照组,差异具有统计学意义(P<0.05).糖尿病并骨质疏松组LEP、HOMA-IR、APN高于糖尿病无骨质疏松组和对照组,差异有统计学意义(P<0.05);且糖尿病无骨质疏松组LEP、HOMA-IR、APN高于对照组,差异有统计学意义(P<0.05).HOMA-IR、APN、LEP与BMD呈负相关(r=-0.372、-0.442、-0.399,P<0.05).结论 HOMA-IR和APN、LEP作为2型糖尿病发病的重要因素,同时对糖尿病性骨质疏松的发病起到重要作用,测定其水平可以预测糖尿病性骨质疏松.

目的 探讨分析糖尿病患者体脂分布与骨质疏松的相关性,为该疾病预防治疗提供参考价值.方法 80例2型糖尿病患者,根据是否合并骨质疏松分为A组(合并骨质疏松)与B组(未合并骨质疏松),每组40例.检测两组患者生化指标、双股骨密度及L1～4骨密度.比较两组患者骨密度情况,分析骨密度与各体脂分布指标的相关性.结果 A组双股骨密度(0.96±0.02)g/cm2、L1～4骨密度(0.83±0.04)g/cm2均低于B组的(1.16±0.31)、(1.09±0.17)g/cm2,差异具有统计学意义(P<0.05).患者全身脂肪、躯干脂肪、四肢脂肪含量与双股骨密度、L1～4骨密度均呈正相关(r=0.488、0.569、0.425、0.453、0.571、0.043;P<0.05),其中,与躯干脂肪含量相关性最大.患者瘦肉组织含量与双股骨密度、L1～4骨密度无相关性(P>0.05).结论 糖尿病患者的体脂分布与骨质疏松有较大相关性,特别是躯干脂肪组织含量.

垂体促甲状腺激素(TSH)瘤是一种极其罕见的能引起甲状腺功能亢进的垂体肿瘤 , 仅占垂体瘤的 1.1％～2.0％[1, 2], 1960年Jailer报道首例 TSH 瘤病例[3], 至今为止已报道的例数超过 450 例[3].该病起病隐匿 , 进展缓慢 , 多数者以甲状腺功能亢进症 ( 甲亢 ) 为首发表现就诊 , 临床易误诊为甲亢并采用抗甲状腺药物治疗 , 甚至行 131I 治疗或甲状腺次全切除术治疗 , 这不仅不能使中枢性甲亢得到有效控制 , 反而可能加剧疾病进展 , 使患者出现严重的并发症.

Objective To investigate application value of dual-energy X-ray absorptiometry (DEXA), and relationship between body fat distribution and carotid intima-media thickness (IMT). Methods Dual-energy X-ray absorptiometry was applied to detect body fat in 110 type 2 diabetes mellitus patients (diabetes mellitus group) and 79 normal people (control gorup), along with waistline diagnosis standard for consistency check. Diabetes mellitus patients were divided into diabetes mellitus central obesity (DMOB) group with 53 cases and diabetes mellitus non central obesity (DMNOB) group with 57 cases, according to waistline as golden standard for abdominal obesity and cut point of body fat percentage. Normal healthy people were divided into control central obesity (COB) group with 46 cases and control non central obesity (CNOB) group with 33 cases. Glycosylated hemoglobin and blood lipid were detected. B ultrasound was applied to detect carotid intima-media thickness for investigation of relationship between central obesity and atherosclerosis. Results DEXA had good consistency for detecting body fat distribution and waistline. There were statistically significant differences of carotid intima-media thickness in DMOB group, DMNOB group and control group (P<0.05). Conclusion Dual-energy X-ray absorptiometry in detection of body fat distribution can evaluate central obesity. There is a close relationship between body fat distribution and atherosclerosis in diabetes mellitus patients.

Objective To investigate application value of dual-energy X-ray absorptiometry (DEXA) in detection of body fat, and relationship of body fat distribution in diabetes mellitus patients with leptin and insulin resistance.Methods Dual-energy X-ray absorptiometry was applied to detect body fat in 124 patients with type 2 diabetes mellitus (diabetes mellitus group) and 71 normal healthy people (normal control group), and this detection was in consistency test with waist diagnostic criteria. Point of tangency in body fat percentage was found and divided into groups under golden standard as abdominal girth for abdominal obesity. Blood lipid, leptin, adiponectin, and fasting insulin were detected for investigation of relationship between central obesity and metabolic index in diabetes mellitus patients.Results Application of DEXA had good consistency with waist detection for body fat distribution. There were statistically significant differences of insulin resistance in diabetic central obesity group, diabetic non-central obesity group and normal control group (P<0.05). The diabetic central obesity group had higher leptin level than the diabetic non-central obesity group and control non-central obesity group (P<0.05).Conclusion Dual-energy X-ray absorptiometry can be applied in detection of body fat for evaluation of central obesity. There is a close relationship between obesity, diabetes mellitus and leptin and insulin resistance.

Objective To study the value of dual-energy X-ray absorptiometry in the detection of body fat distribution and the relariongship between body fat distribution and the carotid atherosclerosis in type 2 diabetic mellitus(T2DM)patients.Methods Body fat distribution was measured by dual energy x-ray absorptiometry in 78 T2DM patients and 79 normal controls.The consistency between the body fat distribution and the standard waistline for abdominal obesity was verified.The carotid intima-media thickness was measured by B type ultrasound.The plaque in the cephalic artery and carotid sinus was also measured.The plaque index was calculated with the Crouse method. Results Carotid intima-media thickness and Crouse score were statistically differently among the subgroups. Reasonable consistence between the body fat distribution and the standard waistline for abdominal obesity was obtained.The cutoff point of trunk fat ratio in abdominal obesity was 38.46%.Conclusion Dual energy x-ray absorptiometry could be used to assess body fat distribution. Body fat distribution is closely related to the carotid atherosclerosis in T2DM patients.

急性酒精中毒为常见的急诊病例,可以引起多种严重并脏损害报道及研究较少,尤其是并发急性肾功能衰竭者报道较发症,文献报道神经,肝脏及等系统损害的病例较多,但对肾少.我们科最近收治2例急性酒精中毒后并发急性肾功能衰竭的病例,为强化急性酒精中毒对肾功能影响的认识,及早做出诊断并给予及时治疗,提高治愈率,现报道如下.

对我院2001-12～2004-03肾综合征出血热(HFRS)住院患者中血小板参数进行检查,对其变化及临床意义探讨如下.

我院于2001年6月收治1例急性重度有机磷中毒合并急性心肌梗死(AMI)患者,经治疗后痊愈出院,现报道如下. 1 临床资料