目的观察氨氯地平联合比索洛尔治疗舒张期高血压(IDH)的疗效和安全性。方法 76例舒张期高血压患者,根据舒张压(DBP)水平分为A组[100 mm Hg(1 mm Hg=0.133 k Pa)>DBP≥90 mm Hg,24例]、B组(110 mm Hg>DBP≥100 mm Hg,34例)和C组(DBP≥110 mm Hg,18例)。三组患者均予以氨氯地平联合富马酸比索洛尔口服治疗,6周后根据血压水平调整用药量,共治疗12周。记录三组患者治疗前和第6、12周末的DBP、心率(HR)水平,观察比较三组疗效及不良反应发生情况。结果治疗第6周末,A组及B组DBP均较治疗前明显下降(P<0.05);C组DBP与治疗前比较差异无统计学意义(P>0.05);三组患者HR均较治疗前下降,差异具有统计学意义(P<0.05)。治疗第12周末,三组DBP及HR均较治疗前明显下降(P<0.05);B组和C组HR与治疗第6周末比较差异无统计学意义(P>0.05)。A组总有效率为79.2%,B组总有效率为97.1%,C组总有效率为72.2%;B组总有效率明显高于A组和C组,差异具有统计学意义(P<0.05);A组和C组总有效率比较差异无统计学意义(P>0.05)。三组不良反应发生率比较差异无统计学意义(P>0.05)。结论氨氯地平联合比索洛尔治疗中重度舒张期高血压效果良好,对轻度舒张期高血压疗效有待进一步观察。
目的探讨GA/HbA1c比值测定在早期糖尿病肾病患者诊断中的价值。方法随机抽取2014年10月至2017年3月在该院老年科、内分泌科及肾内科住院确诊的68例2型糖尿病(T2DM)患者,按患者24小时尿蛋白定量(24 h pro)水平分为正常蛋白尿(NAU)组及糖尿病肾病(DN)组,DN组患者再分为微量蛋白尿(MAU)亚组和临床蛋白尿(CAU)亚组;另选42例健康体检者为对照组(NC组)。所有受检者均检测血清尿素氮(BUN)、肌酐(Cr)、糖化血清蛋白(GA)、糖化血红蛋白(HbA1c)及24 h pro等各项生化指标,计算GA/HbA1c比值。结果与NC组相比,NUA组、DN组GA、HbA1c、24 h pro水平及GA/HbA1c比值均显著升高(P<0.05)。在T2DM患者中,GA/HbA1c比值与24 h pro呈正相关,但在CAU组中的相关性偏低。结论 GA/HbA1c比值有望作为早期检测糖尿病肾病的潜在临床指标,但对晚期肾损害不敏感。
目的:探讨代谢综合征(MS)对泌尿系结石术后留置双J管患者附管结石发生风险的影响。方法:选取2022年10月至2023年10月本院行泌尿系结石术后留置双J管的79例患者作为研究对象,根据代谢指标检查结果将患者分为MS组(58例)与非MS组(21例),收集患者一般资料、实验室指标,返院拔除双J管时确认患者术后附管结石发生情况,采用单因素、多因素Logistic回归分析附管结石发生危险因素。结果:MS组高血压、糖尿病、高脂血症、吸烟史的患者占比体重指数及拔管时的SBP、FBG、UA、TC、TG、LDL-C、hs-CRP水平均高于非MS组,HDL-C低于非MS组(P P P P P Objective: To investigate the effect of metabolic syndrome (MS) on the risk of tubular stones in patients with postoperative urinary calculi after indentation of double J tubes. Methods: From October 2022 to October 2023, 79 patients who underwent urinary calculi surgery with double J tubes were selected as the study objects. According to the results of metabolic indexes, the patients were divided into MS group (58 cases) and non-MS group (21 cases). General data and laboratory indexes of the patients were collected. After the double-J tube was removed, the occurrence of tubular stones was confirmed, and the risk factors of tubular stones were analyzed by univariate and multivariate Logistic regression. Results: The proportion of patients with hypertension, diabetes, hyperlipidemia and smoking history in MS group and the levels of SBP, FBG, UA, TC, TG, LDL-C and hs-CRP at extubation were higher than those in non-MS group, and HDL-C was lower than those in non-MS group (P P P P P < 0.05). Conclusion: MS is closely related to the formation of tubular stones after double-J tube surgery, and can be used as an independent predictor of the occurrence of postoperative stones. In addition, long catheter indwelling time, presence of urinary protein and high level of FBG, UA and hs-CRP during extubation are risk factors for tubular stones. Early li
