本文選題：前列腺增生 + 糖尿病��； 參考：《大連醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:研究探討良性前列腺增生伴糖尿病或空腹血糖調(diào)節(jié)受損患者的尿流動(dòng)力學(xué)改變,對(duì)這兩類(lèi)患者提出合理的治療和處理。方法:本研究選取從2014年10月~2016年10月在大連醫(yī)科大學(xué)附屬第二醫(yī)院泌尿外科行經(jīng)尿道前列腺電切術(shù)或經(jīng)尿道前列腺剜除術(shù),術(shù)后病理診斷為良性前列腺增生并且術(shù)前行尿流動(dòng)力學(xué)檢查的患者163例,分為前列腺增生合并糖尿病40例(研究組1)、前列腺增生合并空腹血糖調(diào)節(jié)受損(IFG)22例(研究組2),單純前列腺增生101例(對(duì)照組)。比較各組患者尿流動(dòng)力學(xué)各項(xiàng)檢查結(jié)果。結(jié)果:糖尿病組和對(duì)照組的不穩(wěn)定膀胱率比較,P值0.02;空腹血糖調(diào)節(jié)受損組和對(duì)照組的不穩(wěn)定膀胱率比較,P值0.025;糖尿病組和空腹血糖調(diào)節(jié)受損組的不穩(wěn)定膀胱率比較,P值0.499。對(duì)糖尿病組和對(duì)照組的Qmax、Pdet at Qmax、Pdet max、PVR、FDV檢測(cè)指標(biāo)進(jìn)行比較,P值分別為0.001、0.202、0.330、0.001、0.002;對(duì)空腹血糖調(diào)節(jié)受損組和對(duì)照組的Qmax、Pdet at Qmax、Pdet max、PVR、FDV檢測(cè)指標(biāo)進(jìn)行比較,P值分別為0.008、0.171、0.153、0.191、0.012;對(duì)糖尿病組和空腹血糖調(diào)節(jié)受損組的Qmax、Pdet at Qmax、Pdet max、PVR、FDV檢測(cè)指標(biāo)進(jìn)行比較,P值分別為0.006、0.165、0.052、0.005、0.001。結(jié)論:高血糖和前列腺增生都對(duì)膀胱功能影響方面具有協(xié)同作用。對(duì)于BPH伴糖尿病或空腹血糖調(diào)節(jié)受損患者應(yīng)該引起重視,積極治療BPH的同時(shí)盡早采取合理有效的治療措施控制好血糖水平。在治療癌癥方面蛋白激酶是重要的藥物靶點(diǎn)。格列衛(wèi)(Abl激酶的特殊抑制劑)這種藥物區(qū)分Abl和其它酪氨酸激酶(例如Src)的能力被廣泛研究但是沒(méi)有很大成功。本研究中,我們運(yùn)用分子動(dòng)力學(xué)模擬是基于Abl、Src和它們共同祖先(ANC-AS)以及構(gòu)建的兩個(gè)突變體系(AS→Abl和AS→Src)的晶體結(jié)構(gòu)。MD模擬揭示了在AS→Abl體系磷酸結(jié)合位點(diǎn)的loop(P-loop)發(fā)生了重要改變。DCCM的結(jié)果揭示了在AS→Abl體系突變導(dǎo)致反相關(guān)運(yùn)動(dòng)增加。動(dòng)態(tài)網(wǎng)絡(luò)分析提示P-loop在AS→Abl體系建立了特殊的連接,同時(shí)這種連接在AS→Src體系中不存在。結(jié)合自由能計(jì)算揭示了格列衛(wèi)對(duì)于AS→Abl突變體的親和力接近于Abl,同時(shí)對(duì)AS→Src突變體的親和力降低到接近于Src。個(gè)體殘基貢獻(xiàn)發(fā)現(xiàn)不同主要位于P-loop區(qū)域。本研究有助于理解格列衛(wèi)對(duì)于酪氨酸激酶的選擇性。
[Abstract]:Objective: to investigate the changes of urodynamics in patients with benign prostatic hyperplasia (BPH) with diabetes mellitus or impaired fasting blood glucose regulation (FBG). Methods: from October 2014 to October 2016, transurethral resection or transurethral enucleation of the prostate was performed in the Department of Urology, second affiliated Hospital of Dalian Medical University. There were 163 patients with benign prostatic hyperplasia diagnosed as benign prostatic hyperplasia and underwent urodynamic examination before operation. There were 40 cases of benign prostatic hyperplasia with diabetes mellitus (study group 1), 22 cases of prostatic hyperplasia with impaired fasting blood glucose regulation (study group 2) and 101 cases of simple prostatic hyperplasia (control group). The results of urodynamic examination were compared in each group. Results: the unstable bladder rate was 0.02 in diabetic group and control group, 0.025 in impaired fasting glucose regulation group and 0.025 in control group, and 0.499 in diabetic group and impaired fasting glycemic regulation group. The results of QmaxPdet at QmaxPdet at QmaxPdet maxPdet in diabetes group and control group were compared with those of control group (P = 0.001) and control group (P = 0.001), respectively (P = 0.001, 0.202, 0.330, 0.001, 0.002; P = 0.008, 0.171, 0.1530.191, 0.012, respectively, respectively), and QmaxPdet at QmaxPdet at maxPdet maxPVRFDV, respectively, in impaired fasting blood glucose regulation group and control group, respectively, in diabetic group and control group, in the diabetic group and the control group, the values of QmaxPdet at QmaxPdet and QmaxPdet in control group were compared with those in control group. The values of Pdet at QmaxPdet and PVRV FDV in impaired glucose regulation group were 0. 006 ~ 0. 165 ~ 0. 052 ~ 0. 005 ~ 0. 001, and P = 0. 006 ~ 0. 165 ~ 0. 05 ~ 0. 05 ~ 0. 005 ~ 0. 001, respectively. Conclusion: hyperglycemia and prostatic hyperplasia have synergistic effects on bladder function. Attention should be paid to patients with BPH accompanied by diabetes mellitus or impaired fasting blood glucose regulation. Reasonable and effective treatment measures should be taken to control blood glucose level as early as possible while actively treating BPH. Protein kinase is an important drug target in the treatment of cancer. The ability of the drug to distinguish Abl from other tyrosine kinases (such as SRC) has been extensively studied but has not been very successful. In this study, The molecular dynamics simulation is based on the crystal structure of Ablsrc and their common ancestor ANC-ASand two mutant systems, as Abl and as SRC). MD simulation shows that the loop-P-loop-loop-loop of phosphoric acid binding site in as Abl system is heavy. To change the results of .DCCM, it is revealed that mutations in as / Abl system lead to an increase in inversely correlated motion. Dynamic network analysis indicates that P-loop has established a special connection in as / Abl system, and this kind of connection does not exist in as / Src system. Combined with the calculation of free energy, the affinity of Glewey to as Abl mutant was close to that of Abll, while the affinity to as Src mutant was reduced to close to that of Srcc. Individual residual contribution was found to be mainly located in the P-loop region. This study is helpful to understand Glevir's selectivity to tyrosine kinase.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R697.3;R587.2;R694

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 丁見(jiàn);齊琳;祖雄兵;申鵬飛;;良性前列腺增生癥合并糖尿病患者的尿動(dòng)力學(xué)臨床價(jià)值[J];中南大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2010年07期

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本文編號(hào)：1786508