Narrative medicine is defined as a medical approach that utilizes the power of stories, both patients' illness narratives and healthcare providers' reflective accounts, to promote healing, foster empathy, and enhance the therapeutic relationship through close attention to the language, metaphor, and meaning embedded in illness experiences. Despite its growing importance in contemporary healthcare, comprehensive bibliometric analyses of narrative medicine research trends remain limited. This study aims to systematically map global research patterns, identify key contributors, and analyze thematic evolution in narrative medicine literature over the past two decades. We conducted a comprehensive bibliometric analysis using the Citexs platform to examine narrative medicine research published from 2004 to 2024. The PubMed database was systematically searched using Boolean search terms: "narrative medicine OR medical storytelling OR clinical narrative OR patient-centered narrative OR healthcare narrative OR personalized medicine narrative". Inclusion criteria encompassed English-language articles only. Publication trends, geographic distribution, institutional productivity, author contributions, and thematic analysis were evaluated using advanced bibliometric techniques and the BioBERT biomedical language representation model for disease entity analysis. A total of 28,029 English-language articles were identified, demonstrating exponential growth with a peak output of 5,063 articles in 2024. The United States led global research productivity with 7,933 articles (28.3%), followed by the United Kingdom (4,704 articles, 16.78%) and Italy (2,743 articles, 9.79%). The University of Toronto emerged as the most productive institution (432 publications). Keyword analysis revealed "systematic review", "COVID-19", "treatment", and "artificial intelligence" as the most frequent terms, indicating the field's responsiveness to contemporary healthcare challenges and technological integration. Disease entity analysis identified "Neoplasms" (5,282 articles), "Death" (4,948 articles), "Pain" (4,345 articles), "Inflammation" (4,338 articles), and "Depressive Disorder" (3,933 articles) as the most commonly studied conditions. This bibliometric analysis demonstrates narrative medicine's transformation from a niche concept to a mainstream healthcare approach with substantial academic recognition. The exponential publication growth reflects increasing institutional support and clinical integration of narrative approaches. Geographic concentration in developed healthcare systems suggests opportunities for global expansion, particularly in culturally diverse contexts. The emergence of artificial intelligence as a research hotspot indicates the field's adaptive capacity to incorporate technological advances while maintaining humanistic principles. The predominance of cancer, death, pain, and mental health conditions underscores narrative medicine's particular relevance in addressing complex psychosocial dimensions of patient care that traditional biomedical approaches cannot fully capture. These findings emphasize narrative medicine's critical role in humanizing modern medical practice and its essential contribution to patient-centered care delivery.

This narrative review assesses the effectiveness of hand gesture analogy teaching in clinical medical education, addressing the growing demand for innovative pedagogical strategies. Through a comprehensive analysis of existing literature, it evaluates the theoretical foundations, implementation strategies, and practical applications of this method across various domains of medical education. Hand gesture analogy teaching significantly enhances student learning by improving engagement, spatial reasoning, and procedural knowledge retention more effectively than conventional instructional methods. The integration of modern educational technologies and standardized implementation frameworks further amplifies its effectiveness. Despite challenges in standardization and faculty development, this method shows promising potential for transforming medical education by bridging the gap between theoretical knowledge and clinical practice. Evidence-based recommendations are provided for incorporating hand gesture analogy teaching into clinical training programs, supporting its adoption as an innovative pedagogical tool in contemporary medical education.

目的 为推动住院医师规范化培训思政教育全面贯彻落实,充分掌握住培学员对思政教育认知情况以及当前开展思政教育的满意度,以期为推动住院医师规范化培训思政教育进程提供参考.方法 采用自设问卷对住培学员进行问卷调查,调查内容包括住培学员基本信息、住培学员对思政教育的认知情况及满意度等方面.采用SPSS 25.0软件进行数据统计分析.结果 共收集调查问卷262份,在住院医师规范化培训中开展思政教育的必要性认知方面,大部分住培学员认为开展思政教育有必要,对住院医师规范化培训帮助很大,且在培训过程中的思政教育内容会引发自身在课后进行有关方面的思考;住培学员对思政教育的价值认识整体表现较好,更倾向于老师以典型案例分享、讲授式教学、讨论式教学、参与式教学以及日常工作中言传身教的教学等教学模式;对已开展思政教育相关内容、开展思政教育后的收获以及住培与思政教育结合效果比较满意.结论 住院医师规范化培训中开展思政教育初见成效,住培学员对思政教育的认知度和满意度总体较高,今后还需不断探索、持续改进,深入推进住院医师规范化培训思政教育机制创新改革,持续发挥思政教育的铸魂育人作用.

目的 探讨短期胰岛素泵强化治疗联合自我血糖监测(SMBG)对 2 型糖尿病(T2DM)患者血糖控制的效果及相关因素.方法 回顾性分析82 例T2DM患者一般临床资料,均给予短期胰岛素泵强化治疗联合SMBG,记录患者治疗前后糖脂代谢变化,并根据血糖控制情况分为控制良好组与控制欠佳组,对比两组临床资料,分析影响其血糖控制效果的相关因素.结果 治疗后1 w T2DM患者空腹血糖(FBG)、胰岛素抵抗指数(HOMA-IR)、餐后2h血糖(2 h PBG)、糖化血红蛋白(HbA1c)水平较治疗前显著降低(P＜0.05),稳态模型胰岛β细胞功能指数(HOMA-β)较治疗前显著升高,但治疗后 6 个月FBG、HOMA-IR、2 h PBG、HbA1c水平较治疗后1w有所升高,HOMA-β降低,但仍明显优于治疗前(P＜0.05);治疗后1w总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平较治疗前显著降低(P＜0.05),HDL-C较治疗前显著升高,但治疗后6 个月TC、TG、LDL-C水平较治疗后1w有所升高,高密度脂蛋白胆固醇(HDL-C)降低,但仍明显优于治疗前(P＜0.05);治疗后6 个月,30 例血糖控制良好,52 例血糖控制欠佳,且经Logistic回归分析发现,体质量指数、糖尿病饮食、HbA1c、胰岛素剂量、2 h PBG是影响T2DM患者血糖控制欠佳的独立危险因素,运动时间、复诊频率、血糖监测频率是保护因素(P＜0.05).结论 短期胰岛素泵强化治疗联合SMBG在T2DM患者短期血糖控制中效果较佳,对改善糖脂代谢有积极作用,但体质量、糖尿病饮食、运动时间、复诊频率、血糖监测频率、胰岛素剂量及HbA1c、2 h PBG水平均会对血糖控制情况产生影响,临床需给予针对性措施进行干预,稳定血糖水平.

Numerous studies have reported the striking result that aspirin use is associated with higher bone mineral density (BMD), suggesting its potential as a population-wide osteoporosis prevention measure. Therefore, this study aimed to examine the impact of chronic low-dose aspirin use on bone remodeling biomarkers and BMD in an aging population. Between September and November of 2019, clinical data regarding the medication use, serum bone remodeling biomarkers, and BMD of 567 consecutively hospitalized patients, a minimum of 50 years old with type 2 diabetes mellitus (T2DM), were collected. The cross-sectional associations between chronic low-dose aspirin use and serum concentrations of bone remodeling biomarkers and BMD were estimated separately using linear regression. Potential confounding variables were controlled for, including age, sex, and comorbidities. Low-dose aspirin users had significantly lower serum bone alkaline phosphatase (BAP) concentrations than non-users (82.44 ± 28.03 U/L vs 90.71 ± 32.79 U/L, p = 0.025). On the other hand, low-dose aspirin users had insignificantly higher vertebral BMD (0.95 ± 0.19 vs 0.91 ± 0.21, p = 0.185), femoral neck BMD (0.80 ± 0.15 vs 0.78 ± 0.17, p = 0.309) and Ward’s triangle BMD (0.46 ± 0.14 vs 0.44 ± 0.13, p = 0.209), regardless of adjustment. This cross-sectional study demonstrated that chronic use of low-dose aspirin was associated with significantly lower serum concentrations of BAP in hospitalized patients with T2DM. The mechanism causing the insignificantly higher BMD observed in chronic aspirin users in this study and the significant increments in BMD reported in previous studies requires further clarification in other clinical trials.

目的 探讨2 型糖尿病合并周围神经病变的危险因素,并基于少数类样本合成过抽样技术(SMOTE)算法构建2 型糖尿病合并周围神经病变的风险预警模型.方法 选取自 2020 年 1 月至 2021 年 12 月芜湖市第二人民医院收治的 205 例2 型糖尿病患者为研究对象.根据周围神经病变发生情况将患者分为周围神经病变组(n =70)和无周围神经病变组(n = 135).收集并记录患者的年龄、性别、病程、居住地、婚姻状态、体质量指数、文化程度、饮酒史、吸烟史、糖化血红蛋白、高血压、空腹血糖及合并糖尿病视网膜病变(DR)等资料.采用Logistic回归分析筛选2 型糖尿病合并周围神经病变的危险因素,应用SMOTE算法构建2 型糖尿病合并周围神经病变的预警模型.采用受试者工作特征(ROC)曲线对预警模型的预测效能进行分析.结果 Logistic回归分析结果显示,年龄、病程、婚姻状态、体质量指数、文化程度、糖化血红蛋白、高血压及合并DR是2 型糖尿病合并周围神经病变的危险因素(P<0.05).原始预警模Logit(P1)H-L检验结果(决定系数R2 =0.352,P =0.328),提示Logistic回归模型的拟合度良好.基于SMOTE算法的预警模型Logit(P2)H-L检验结果(决定系数R2 = 0.371,P =0.635),提示基于SMOTE算法的预警模型拟合度良好.原始预警模型的ROC曲线下面积为 0.809,基于SMOTE算法的预警模型的ROC曲线下面积为0.927.结论 年龄、病程、婚姻状态、体质量指数、文化程度、糖化血红蛋白、高血压及合并DR是2 型糖尿病合并周围神经病变的危险因素,基于SMOTE算法的预警模型能够对2 型糖尿病合并周围神经病变进行准确预测,可帮助临床制定周围神经病变的相关防治对策.

目的:探究2型糖尿病(T2DM)患者并发颈动脉斑块与维生素D水平以及T细胞亚群水平的相关性.方法:收集并测定41例住院的T2DM患者一般临床和生化指标、总25羟维生素D[25(OH)D]水平以及淋巴细胞亚群水平,采用颈动脉彩超测量有无颈动脉斑块形成,并根据有无斑块分为斑块组(24例)和对照组(17例).结果:斑块组患者年龄大于对照组(P＜0.05),总25(OH)D水平和CD3+CD4+T细胞比例均低于对照组(P＜0.05).多因素Logistic回归分析显示,总25(OH)D水平(OR=1.176,95％CI:1.011～1.368)及 CD3+CD4+T 细胞比例低(OR=1.129,95％CI:1.007～1.266)是颈动脉斑块形成的独立危险因素(P＜0.05).结论:总25(OH)D水平低是T2DM患者颈动脉斑块形成的独立危险因素,可作为颈动脉斑块的预测指标.

在“医教协同”背景下根据住院医师规范化培训（以下简称：住培）的基本要求，完成住培常规教学的同时，探索将思政教育逐步贯穿融入住培的教学工作中。本文结合作者所在住培基地实际，通过提高重视程度、构建住培特色的思政工作体系和将思政教育融入住培全过程等方式提高住培质量，并针对住培思政教育体系构建的难点问题明确下一步探索方向，以推动住培思政教育工作开创新局面。

报道1例就诊于华东师范大学附属芜湖医院（芜湖市第二人民医院）内分泌科新诊断2型糖尿病合并代谢综合征的患者，经胰岛素泵强化治疗后转化为德谷胰岛素利拉鲁肽注射液治疗的诊疗经过及后期随访结果。患者为43岁男性，因消瘦3年，多尿、口干1个月，发现血糖升高1 d入院。患者体重指数（BMI）29.1 kg/m 2，腰围94 cm，糖化血红蛋白（HbA 1c）为11.10%，甘油三酯3.52 mmol/L，高密度脂蛋白胆固醇0.83 mmol/L，诊断为2型糖尿病、代谢综合征、脂肪肝。入院后以空腹血糖4.4~6.0 mmol/L、餐后2 h血糖<8.0 mmol/L为目标，予以胰岛素泵强化治疗。血糖控制稳定后遂换用德谷胰岛素注射液14 U（1次/d）皮下注射，联合门冬胰岛素注射液（早10 U、中6 U、晚8 U）及二甲双胍缓释片0.5 g（2次/d）口服。患者服用二甲双胍缓释片后出现上消化道不适，并且不愿接受每日多次胰岛素皮下注射，最终换为德谷胰岛素利拉鲁肽注射液16 U（1次/d）皮下注射，血糖控制满意后出院。患者3个月后随访，体重为78 kg，BMI为26.7 kg/m 2，腹围下降4 cm（目前90 cm）。HbA 1c为6.5%。复查胰岛素分泌功能得到了改善，腹部脂肪减少，治疗效果满意。对于伴有代谢综合征的新诊断的2型糖尿病患者，可使用德谷胰岛素利拉鲁肽注射液治疗，在降糖的同时还有助于胰岛功能恢复和体重减轻，腹部脂肪囤积减少，且注射次数少，患者依从性高。

Background This study aimed to explore the association of the presence and number of components of metabolic syndrome (MetS) with carotid atherosclerosis by measuring the presence of carotid plaque and total plaque area (TPA) in a population from a low-income area with high incidence of stroke of northern China. Methods A cross-sectional study was conducted in a rural area of Tianjin, China from April 2014 to January 2015. The presence of plaque and TPA measurement was determined by carotid ultrasound. The presence and number of components of MetS was ascertained using the modified International Diabetes Federation criteria for the Asian population. Results Among a total of 3,583 individuals aged ≥ 45 years, the overall prevalence of MetS was 54.5%. MetS and its components were related to the presence of carotid plaque as well as TPA. Multivariate analysis showed MetS was associated with a 20% higher risk of carotid plaque presence (95% confidence interval: 1.01, 1.42; P = 0.036) and an 18% increase in TPA (95% confidence interval: 0.08, 0.27; P < 0.001). The number of MetS components showed an increasing trend with the risk of carotid plaque presence and increased TPA. Among single components of MetS, high BP accounted for the largest proportion and was an independent risk factor of carotid plaque and increased TPA. Conclusions Among individuals aged 45 years or more, we confirmed MetS and its components were associated with carotid atherosclerosis in a low-income population of northern China. The presence of MetS and a higher number of MetS components exacerbated the risk of carotid atherosclerosis; among the five MetS components, high blood pressure was associated with the greatest risk. Targeted atherosclerosis prevention and intervention should include identification and treatment of MetS, especially high blood pressure.

Retrospective matched-cohort comparative study. Cortical bone trajectory screw (CBT) technique is a new insertion technique in terms of fixation strength and less invasiveness. The purposes of this study were to compare the clinical and radiological outcomes of percutaneous CBT fixation (PCBT) with traditional open posterior pedicle screw fixation (OPPS) technique. Between September 2019 and October 2020, patients undergoing posterior stabilization were matched for age, sex, diagnosis, fractured level, and AO classification. 24 control patients with OPPS were identified and appropriately matched to 24 consecutive patients with PCBT technique. Clinical outcomes and radiographic assessments including vertebral wedge angle (VWA) and sagittal index were recorded and compared between the two groups. Incision length, intraoperative blood loss and hospital stay in the PCBT group were significantly better than the OPPS group (P < 0.05). The VAS scores 5 days after operation for PCBT patients were significantly lower than those for OPPS patients (P = 0.003), but these differences lost significance at last follow-up. There was no significant difference in VWA and sagittal index between OPPS and PCBT group (P > 0.05). While no complications were noted in the PCBT group, there were four cases with complications in the traditional OPPS group. The present study showed that PCBT is a safe and feasible method for the treatment of thoracolumbar fractures without neurological deficits. This new surgical treatment was more minimally invasive, yet yielded equivalent or superior clinical and radiographic outcomes compared to the traditional open pedicle screw fixation surgery.

With multi-drug-resistant bacteria being more prevalent over years, diabetic foot complicated with multi-drug-resistant bacteria infection emerges as a significant challenge for clinicians and patients. Diabetic foot is predisposed to multi-drug resistant bacterial infection. Growing body of evidence shows that ulcer type, ulcer grade, ulcer area, history of antibiotics treatment, previous hospitalization history, osteomyelitis, and proliferative retinopathy are risk factors. Among multi-drug-resistant bacteria, methicillin-resistant Staphylococcus aureus and extended-spectrum β-lactamase-producing bacteria are the most common strains. Infection with multiple drug-resistant bacteria contributes to the amputation rate and mortality in patients with diabetic foot ulcers. The aim of this review is to give an update on multi-drug resistant bacteria infection and clinical outcome of diabetic foot, with a goal to improve clinical awareness and management.

目的:探讨糖化血红蛋白(glycosylated hemoglobin,HbA1c)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)与2型糖尿病(type 2 diabetes mellitus,T2DM)患者下肢动脉血管病变(lower extremity arterial disease,LEAD)的相关性.方法:选取2018年5月至2021年5月华东师范大学附属芜湖医院收治的T2DM患者96例,根据双下肢彩超是否有斑块将患者分为单纯T2DM组(n=47)与T2DM合并LEAD组(n=49).比较两组血清HbA1c、LDL-C等指标差异,对HbA1c、LDL-C水平与双下肢血管病变的相关性进行多元逐步回归分析,采用受试者工作特征(receiver operating characteristic,ROC)曲线评价HbA1c、LDL-C对LEAD的诊断能力.结果:两组空腹血糖、HbA1c、总胆固醇、三酰甘油、LDL-C水平差异均有统计学意义(t=?3.345、5.022、?2.721、?2.494、2.462,均P<0.05).多元逐步回归分析显示:血清HbA1c、LDL-C水平与T2DM患者发生LEAD相关(t=?3.823、?2.493,P<0.05).ROC曲线分析显示:HbA1c的ROC曲线下面积为0.680,诊断LEAD的敏感度为60.0％,特异度为70.6％;LDL-C的ROC曲线下面积为0.727,敏感度为61.2％,特异度为76.5％.结论:T2DM合并LEAD患者血清HbA1c、LDL-C水平显著增高,HbA1c、LDL-C有望作为LEAD的诊断指标.

报道安徽省芜湖市第二人民医院内分泌科1例健康状态中等的老年2型糖尿病患者应用德谷门冬双胰岛素简化治疗方案得到满意效果的诊疗过程，并进行文献复习。患者为82岁独居女性，因“近2个月来不明原因血糖控制不佳”入院，入院前应用甘精胰岛素U100联合门冬胰岛素注射液治疗，但血糖出现不明原因异常升高，后发现血糖波动原因为患者存在一定程度用药障碍，无法辨别门冬胰岛素与甘精胰岛素，每次注射时随机使用其中一种。经简化治疗方案，改为德谷门冬双胰岛素注射液一日2次注射。更换治疗方案后，胰岛素用量减少，达到中等老年综合状态2型糖尿病患者血糖控制目标。德谷门冬双胰岛素的使用对老年糖尿病患者简化治疗方案，减少胰岛素使用错误导致的低血糖和血糖波动，减轻治疗负担起到了积极作用。

目的:描述分析芜湖市新型冠状病毒肺炎(COVID-19)患者的临床特征及其转归,总结临床治疗方案,并分析COVID-19患者预后的影响因素.方法:收集芜湖市已出院的31例COVID-19患者的临床资料,总结其临床表现、实验室检查结果以及影像学表现,回顾性分析影响患者临床预后的各种可能因素.结果:31例患者的年龄中位数为39(32～54)岁,入院时白细胞减少5例(16.1％),淋巴细胞减少9例(29％),其中29例(93.5％)胸部CT有异常表现,20例(64.5％)为双侧病灶.从发病到住院的中位时间为4(2～6)d,使用糖皮质激素11例(35.5％),三联抗病毒治疗患者5例(16.1％).病毒清除时间14(11.5～16)d,症状持续时间7(5～10.5)d,住院时间18.5(16～21)d.多元线性回归分析显示激素治疗对患者临床预后影响无统计学意义(P>0.05),三联抗病毒治疗可能缩短病毒清除时间(-3.86,95％CI:-7.59,-0.19,P=0.040)及住院时间(-5.57,95％CI:-10.24,-0.90,P=0.022).结论:所有轻症COVID-19患者均预后良好,三联抗病毒治疗可能缩短病毒清除时间及住院时间.

Background: The prevalence of skin diseases and diabetes mellitus (DM) are prominent around the world. The current scope of knowledge regarding the prevalence of skin diseases and comorbidities with type 2 DM (T2DM) is limited, leading to limited recognition of the correlations between skin diseases and T2DM. Methods: We collected 383 subjects from the Da Qing Diabetes Study during the period from July 9th to September 1st, 2016. The subjects were categorized into three groups: Normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and T2DM. The prevalence and clinical characteristics of skin diseases were recorded and investigated. Results: In this cross-sectional study, 383 individuals with ages ranging from 53 to 89-year-old were recruited. The overall prevalence of skin diseases was 93.5%, and 75.7% of individuals had two or more kinds of skin diseases. Additionally, there were 47 kinds of comorbid skin diseases in patients with T2DM, of which eight kinds of skin diseases had a prevalence >10%. The prevalence of skin diseases in NGT, IGT, and T2DM groups were 93.3%, 91.5%, and 96.6%, respectively; stratified analysis by categories showed a statistically significant difference in “disturbances of pigmentation” and “neurological and psychogenic dermatoses”. The duration of T2DM also significantly associated with the prevalence of “disturbances of pigmentation” and “neurological and psychogenic dermatoses”. Subsequently, the prevalence of “disturbances of pigmentation” was higher in males than females in NGT ( P < 0.01) and T2DM ( P < 0.01) groups. In addition, the difference in the prevalence of “disturbances of pigmentation” was also significant in NGT and T2DM groups ( P < 0.01). Conclusions: There was a high prevalence of skin diseases in the Da Qing Diabetes Study. To address the skin diseases in the Da Qing Diabetes Study, increased awareness and intervention measures should be implemented.

Objective:To investigate the effect of virtual-simulation laparoscopic training system in the training of basic skills of endoscopic surgery in trainees with different clinical experience.Method:s Eight refresher physicians, eight residents who received standardized residency training, and eight undergraduate interns in five-year clinical medicine were selected. All of them received the training of endoscopic operations with the laparoscopic training box and the virtual-simulation laparoscopic training system for 30 minutes every day for 4 weeks. Data analyses were performed using SPSS 19.0 and t-test was adopted to compare the scores before and after training among the three groups.Result:s Before training, there were significant differences in endoscopic operations between the undergraduate intern group and the other two groups ( P<0.05); after 4 weeks of training, all three groups had significant increases in the scores and spent less time on training items ( P<0.05). There was no significant difference in simple operations among the three groups ( P>0.05), and the undergraduate intern group had a significantly higher score of complex operations than did the standardized residency training group and the refresher physician group ( P<0.05). Conclusion:The virtual-simulation laparoscopic training system can improve the laparoscopic skills of clinical trainees at different levels, therefore, it is worth being promoted in the teaching of clinical skills.

目的 以市级三甲医院芜湖市第二人民医院为例,总结其在实施安徽省卫生适宜技术推广工作中的经验、做法,分析目前存在的一些问题,为下一阶段的卫生适宜技术全面推广提供参考性建议.方法 总结、分析我国及安徽省卫生适宜技术推广工作的现状,回顾性分析芜湖市第二人民医院于2017年申报的安徽省第二批卫生计生适宜技术推广项目,实施推广工作中的措施、方法(包括思想建设、项目选题、组织保障、项目实施及推进等方面),分析目前存在的问题,提出了持续性改进建议.结果 安徽省第二批卫生计生适宜技术推广项目“胆囊结石的临床策略与个体化治疗”(项目编号:2017-RK05)顺利完成,在项目推广实施过程中获得了一定的经验,并提出了下一阶段的卫生适宜技术推广的改进建议:①建立技术目录、满足基层需求;②注重行政干预、加强督导统筹;③开发网络资源、丰富学习手段;④建立示范基地、发挥示范辐射;⑤加强考核评价、建立评价制度;⑥建立奖惩机制、加强激励措施.结论 市级三甲医院对安徽省卫生适宜技术推广工作进行了有益地探索及实践,分析了存在的问题,总结了现行卫生适宜技术推广工作中的经验,提高了卫生适宜技术的转化效率,提升了基层医疗服务和技术水平,为卫生适宜技术全面推广提供了一定的参考和借鉴意义.

目的 探讨血清25-羟胆骨化醇[25(0H)VD]水平对2型糖尿病(T2DM)患者视网膜病变及糖尿病肾病(DN)发生风险的影响.方法 选取2017年9月～2019年9月本院内分泌科收治的60例T2DM患者作为观察组,门诊健康体检者60例作为对照组,检测两组血清25(OH)VD水平,采用多元Logistic回归分析影响T2DM患者糖尿病视网膜病变(DR)及DN发生的相关因素.结果 观察组与对照组比较,BMI、HbA1c、FPG、SBP、DBP更高,25(OH)VD水平更低(P＜0.05);经多元Logistic分析结果显示:病程延长、25(OH)VD水平下降及HbA1c、SBP、CRE、UA水平上升是影响T2DM患者DN发生的相关因素(P＜0.001);病程延长、25(OH)VD水平下降及HbA1c、SBP、LDL-c水平上升是影响T2DM患者DR发生的相关因素(P＜0.001).结论 T2DM患者存在不同程度的25(OH)VD水平下降,25(OH)VD水平下降是T2DM患者发生视网膜病变及DN的重要影响因素之一.

目的 探讨老年T2DM病人Hb、HbA1c水平与视网膜病变风险的关系.方法 选取2016年1月至2019年6月于我院接受治疗的92例老年T2DM病人为研究对象,根据眼底检查结果将病人分为2组,42例发生视网膜病变的病人为观察组,50例未发生视网膜病变的病人为对照组.观察并比较2组病人的基线资料,对可能影响T2DM病人发生视网膜病变的因素进行多因素Logistic回归分析.结果 观察组的贫血发生率及FPG、HbA1c水平显著高于对照组,Hb水平显著低于对照组,差异均有统计学意义(P<0.05).单因素分析显示,Hb<130 g/L、贫血、HbA1c≥8.5％是老年T2DM病人发生视网膜病变的影响因素(P<0.01).多因素Logistic回归分析显示,Hb和HbA1c是老年T2DM病人发生视网膜病变的独立危险因素.结论 高水平的Hb可降低视网膜病变的风险,而HbA1c水平越高,病人发生视网膜病变的风险就越高.