奥扎格雷钠联合黄芪注射液治疗糖尿病肾病的疗效观察

目的：观察奥扎格雷钠与黄芪注射液联合治疗糖尿病肾病的疗效。方法：将84例早期糖尿病肾病患者随机分为3组，每组28例，在常规治疗的基础上，A组加用黄芪注射液，B组加用奥扎格雷钠注射液，C组加用黄芪注射液与奥扎格雷钠注射液，疗程均为20d。观察治疗前后各组尿白蛋白排泄率（UAER），血尿素氮（BUN），血清肌酐（SCr），糖化血红蛋白（HbAlc）的变化。结果：糖化血红蛋白，血清肌酐，血尿素氮，尿白蛋白排泄取：3组治疗后均比治疗前显著下降（P〈0．01），C组下降幅度优于A组和B组（P〈0．05）。结论：奥扎格雷钠联合黄芪注射液治疗糖尿病肾病能降低糖化血红蛋白，显著降低尿白蛋白排泄率，同时改善肾功能。     

尿微量白蛋白在糖尿病肾损伤早期诊断中的价值

目的：分析尿微量白蛋白与糖尿病早期肾脏损害的关系。方法：测定尿微量采用快速金标法。结果：116例2型糖尿病病人早期尿微量白蛋白检出61例,阳性率占52．5％,结论：尿微量白蛋白检测对糖尿病人早期肾损害诊断有较重要的临床价值。     

复方丹参滴丸治疗早期糖尿病性视网膜病变的临床研究

目的：观察复方丹参滴丸对早期糖尿病性视网膜病变的治疗效果。方法：收集Ⅰ～Ⅲ期糖尿病视网膜病变患者107例，其中治疗组50例，对照组57例。治疗组服用复方丹参滴丸10粒／次，3次／d，对照组服用维生素B120mg／次、维生素C0．2g／次、维生素E0．1g／次、肌苷片0．2g／次，3次／d，连续用药6个月。观察治疗前后患者视力、视野及跟底血管造影的变化情况。结果：治疗组服药半年后与治疗前相比视力明显提高，P〈0．01；视野灰度值（MD）降低，P〈0．01；眼底微动脉瘤及出血斑数量减少，P〈0．01；两组间治疗后结果比较差异显著。结论：复方丹参滴丸对早期糖尿病性视网膜病变有明显的治疗作用，较传统复合维生素治疗效果有明显提高。     

四黄汤对实验性糖尿病大鼠肾脏保护作用的研究

目的:探讨四黄汤对实验性糖尿病(DM)大鼠肾脏保护作用的机理.方法:Wistar大鼠40只,链脲佐菌素(STZ)注射方法造模,将造模成功的32只大鼠随机分为模型组、四黄汤大剂量组、四黄汤小剂量组、开博通组4组,每组8只.另选8只性别、体重配对的大鼠做正常对照组.大剂量组给予四黄汤液40g/kg/d,小剂量组给予四黄汤液20g/kg/d,开博通组给予开博通混悬液10mg/kg/d,以上均每日一次,总疗程6周.实验过程中记录动物一般状态,并在最后一次给药后,禁食8h,称重后断头取血检测血糖、胰岛素、血脂、尿微量白蛋白、内皮素、血栓素等各项指标.取左肾称重,右肾固定,按常规制作石蜡切片和超薄切片,在光镜和电镜下观察肾脏病理变化.结果:四黄汤大剂量组的血糖、血脂、尿微量白蛋白、胰岛素、内皮素、血栓素各项指标均有明显改善.结论:四黄汤对实验性糖尿病(DM)大鼠肾脏有保护作用.     

Elevated skin autofluorescence is strongly associated with foot ulcers in patients with diabetes: a cross-sectional, observational study of Chinese subjects

Objective  

This study was designed to evaluate the association between skin autofluorescence (AF), an indicator of advanced glycation end-products (AGEs), and foot ulcers in subjects with diabetes.     

Influence of HbA1c on short-term blood pressure variability in type 2 diabetic patients with diabetic nephropathy

The aim of this study was to understand the characteristics of blood pressure(BP)variability in subjects with diabetic nephropathy(DN),and identify the probable predictors affecting BP variability.Fifty-one chronic kidney disease(CKD)-hypertensive patients without diabetes(NDN group)and sixty type 2 diabetic patients with overt DN(DN group)were enrolled in this study.The values of short-term BP variability were obtained from 24 h ambulatory BP monitoring(ABPM).Variance analysis or nonparametric analysis revealed that 24-h systolic BP variability and nighttime systolic BP variability of the DN group were significantly higher than those of the NDN group[(12.23±3.66)vs.(10.74±3.83)mmHg,P<0.05;(11.23±4.82)vs.(9.48±3.69)mmHg,P<0.05].Then the patients of the DN group were divided into two groups according to glycated hemoglobin(HbA1c)level:Group A(HbA1c<7%)and Group B(HbA1c≥7%),and the t-test showed that patients in Group B had larger 24-h diastolic,daytime diastolic,and nighttime systolic/diastolic BP variability compared with Group A.In the DN group,partial correlation analysis revealed that HbA1c exhibited a strong association with 24-h diastolic,daytime diastolic,nighttime systolic and diastolic BP variability(P<0.001,P<0.001,P<0.05,and P<0.001,respectively).Taken together,larger short-term BP variability was detected in hypertensive type 2 diabetic patients with overt nephropathy and renal insufficiency.It may imply that the optimal BP variability level could benefit from a better glycaemic control.     

Effect of irbesartan on streptozotocin induced diabetic nephropathy: An interventionary study

Effect of irbesartan, an angiotensin II receptor antagonist, was studied in streptozotocin (STZ) induced diabetic nephropathy. Polyuria, proteinuria, blood urea, creatinine clearance, and urinary electrolytes were determined to assess kidney damage. There was a significant increase in urine volume, urinary protein and blood urea in STZ induced diabetic rats. On the other hand, irbesartan treatment resulted in a significant reduction in urinary protein and blood urea in these rats. Irbesartan treatment also improved creatinine clearance and exhibited a natriuretic effect in these animals. Results suggest that irbesartan treatment ameliorate STZ induced diabetic nephropathic changes, in rats.     

未受控制的高血糖对2型糖尿病患者粘附分子的影响（英文）

目的:评估可溶性血管细胞间黏附分子(s VCAM-1)、可溶性细胞间黏附分子(s ICAM-1)、可溶性选择素E和可溶性血栓调节蛋白在血糖控制良好和不受控制的2型糖尿病患者中的水平。创新点:对2型糖尿病患者的血管内皮炎症标记物进行评估。方法:62例糖尿病患者分成两组:第一组包括35个血糖控制良好的糖尿病患者,第二组包括27个未控制血糖并伴有微蛋白尿的糖尿病患者。对照组由25名健康志愿者组成。测定血浆中s VCAM-1、s ICAM-1、可溶性选择素E和可溶性血栓调节蛋白的浓度,同时测定血清肌酐及血浆中空腹血糖和糖化血红蛋白(Hb A1c)的浓度。结论:与血糖控制良好的糖尿病组相比,未控制血糖组具有相对低的ICAM-1水平和更高的VCAM-1水平。未控制血糖组中患者的糖化血红蛋白和ICAM-1之间呈正相关,肾小球滤过率和可溶性选择素E之间呈正相关,而肌酐和ICAM-1之间呈负相关。研究证实2型糖尿病的发病机理中炎症过程的出现与血管内皮功能受损有关。未受控制的高血糖对粘附分子的反向作用表明,在糖尿病的并发症中VCAM-1和ICAM-1具有不同功能。     

Diabetic cardiomyopathy and reactive oxygen species (ROS) related parameters in male and female rats: A comparative study

Studies were carried out to examine and compare the effects of alloxan-diabetes on reactive oxygen species (ROS) related parameters in the heart from male and female rats. Effects of insulin treatment were also evaluated. The diabetic state severely compromised the ROS defense mechanism in the cardiac tissue and the effects were more pronounced in the female than in the male rats. There was several fold increase in the xanthine oxidase (XO) activity in general and the magnitude of increase was higher in the females; insulin treatment resulted in further increase in the XO activity. The glucose-6-phosphate dehydrogenase (G6PDH) and catalase activities decreased and the reduced glutathione (GSH) content in mitochondria was completely depleted in diabetic state with significant decrease in the GSH levels in the post-mitochondrial fraction; the effect was more pronounced in the females. The superoxide dismutase (SOD) and glutathione peroxidase (GPox) activities increased in the diabetic state to a greater extent in male rats. Insulin treatment had restorative action only on some parameters. In conclusion, our results suggest that diabetic state may further compromise the weak ROS defense systems in the heart thus initiating a lesion at the level of mitochondria which ultimately leads to cardiomyopathy and the effects are especially more pronounced in the females. Our results also pointed out that insulin treatment was ineffective in restoring ROS related parameters.     

Oxidative Stress Correlates with Complications Among Diabetic Patients Attending a Diabetic Clinic in Muhimbili National Hospital, Dar es Salaam, Tanzania

In diabetes, persistent hyperglycemia results in increased production of free radicals especially oxygen free radicals, which can cause cell destruction and tissue injury resulting in cell dysfunction. With the premise that oxidative stress is a major cause of diabetic complications, we conducted a controlled laboratory based investigation on level of lipid peroxide levels in the serum of Type 1 and Type 2 diabetic patients attending Muhimbili National Hospital. From our clinical data it was observed that majority of the patients had higher waist to hip ration and body mass index, which suggests that the patients were either overweight or obese. The enrolled diabetic patients had higher lipid peroxide levels than controls and also Type 2 patients had higher lipid peroxide levels than Type 1 patients. Moreover, patients with known complications had higher lipid peroxide levels than patients without complications. The lipid peroxide levels in the diabetic patients were significantly different from that of the control subjects enrolled in the study. A majority of the diabetic patients had a poorly controlled blood sugar. Our finding hints that despite the fact that diabetic patients in our clinic are on follow up, they are at a risk of developing coronary heart diseases, neuropathy and other secondary diabetic complications.