本文選題：糖尿病 + 2型��； 參考：《安徽醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的通過(guò)酶聯(lián)免疫吸附測(cè)定(Enzyme linked immunosorbent assay,ELISA)方法,在受試者用藥前后,分別檢測(cè)血清脂聯(lián)素(adiponectin,APN)、瘦素(leptin,LEP)水平,并計(jì)算其比值,進(jìn)而評(píng)價(jià)中老年2型糖尿病(Type 2 diabetes mellitus,T2DM)合并高脂血癥患者給予阿托伐他汀治療后血清APN、LEP及其比值的變化。方法于2015年6月至2016年3月期間,收集安徽省立醫(yī)院干部病房及內(nèi)分泌科住院患者及體檢中心體檢的50~90歲受試者的臨床資料,經(jīng)過(guò)排除標(biāo)準(zhǔn)篩選,共140例納入研究,男54例,女66例,年齡50~86歲,平均年齡(64.7±9.4)歲。其中包括100例T2DM合并高脂血癥患者和40例同期體檢的健康中老年人。所有入選者均詢問(wèn)高血壓、糖尿病等相關(guān)病史,測(cè)量患者血壓,了解現(xiàn)服用藥物情況,收集一般資料,包括姓名、性別、年齡等,并通過(guò)測(cè)量其身高、體重,從而計(jì)算體質(zhì)量指數(shù)(Body mass index,BMI)。100例入選患者中,因失訪及未遵醫(yī)囑按時(shí)進(jìn)行治療等原因排除共20例,有效研究病例共80例,設(shè)為觀察組,另40例入選健康中老年人設(shè)為對(duì)照組。對(duì)照組直接抽取空腹靜脈血,觀察組給予阿托伐他汀10 mg/d,連服12周,于用藥前后分別于空腹時(shí)抽取靜脈血,兩組均采用全自動(dòng)生化分析儀測(cè)定空腹血糖(Fasting plasma glucose,FPG)、糖化血紅蛋白(Hemoglobin A1c,Hb Alc)、總膽固醇(Total cholesterol,TC)、甘油三酯(Triglyceride,TG)、高密度脂蛋白膽固醇(High density lipoprotein cholesterol,HDL-C)、低密度脂蛋白膽固醇(Low density lipoprotein cholesterol,LDL-C)等指標(biāo),使用ELISA法測(cè)定APN、LEP,并計(jì)算脂聯(lián)素與瘦素比值(adiponectin/leptin,A/L)。將以上所測(cè)指標(biāo)在觀察組治療前和對(duì)照組之間及觀察組治療前后進(jìn)行相關(guān)統(tǒng)計(jì)學(xué)分析。結(jié)果(1)觀察組治療前和健康對(duì)照組組間比較:對(duì)比觀察組治療前和健康對(duì)照組的年齡、性別、體重等一般資料,兩組間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),觀察組治療前TC(t=-2.309,P0.05)、TG(t=-11.050,P0.001)和LDL-C(t=-2.185,P0.05)水平均高于對(duì)照組,HDL-C(t=4.535,P0.001)水平低于對(duì)照組,APN水平低于對(duì)照組(t=27.006,P0.001),LEP水平高于對(duì)照組(t=-12.415,P0.001),A/L水平低于對(duì)照組(t=8.861,P0.001)(2)觀察組治療前后血脂、APN、LEP及其比值變化:用藥12周后,患者TG(t=11.124,P0.001)、TC(t=24.816,P0.001)、LDL-C(t=21.508,P0.001)明顯降低,HDL-C明顯升高(t=-12.011,P0.001),APN略有升高,但差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.064),LEP水平略有降低,但差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.068),但A/L明顯升高(t=-2.741,P0.05)。結(jié)論1.中老年T2DM合并高脂血癥患者與中老年健康人群相比較,TC、TG、LDL-C水平較高,HDL-C水平較低,APN水平較低,LEP水平較高,A/L水平較低。2.中老年T2DM合并高脂血癥患者經(jīng)阿托伐他汀治療后可明顯降低TC、TG、LDL-C水平,升高HDL-C水平,并能夠升高A/L水平,但對(duì)APN、LEP的影響不明顯。
[Abstract]:Objective to detect the serum levels of adiponectin (APNN) and leptin (leptinophane) by enzyme linked immunosorbent assay (Elisa), and to calculate the ratio of leptin in serum before and after treatment. To evaluate the changes of serum APNL P and its ratio in elderly patients with type 2 diabetes mellitus (type 2 diabetes mellitusus T2DM) and hyperlipidemia after treatment with Atto vastatin. Methods from June 2015 to March 2016, the clinical data of 50 ~ 90 year old subjects in cadre ward, endocrine department and physical examination center of Anhui Provincial Hospital were collected and selected by exclusion criteria. A total of 140 cases (54 males) were included in the study. 66 females, aged 50 to 86 years, with an average age of 64.7 鹵9.4 years. These included 100 T2DM patients with hyperlipidemia and 40 healthy adults who underwent physical examination at the same time. All participants were asked about their history of hypertension and diabetes, measured their blood pressure, were informed about their current drug use, collected general information, including name, sex, age, etc., and measured their height, weight, etc. Thus, the body mass index BMI.100 patients were included in the study, 20 patients were excluded for reasons of missing visit and not following the doctor's instructions, 80 cases were effectively studied as the observation group, and 40 cases were selected as the control group. In the control group, fasting venous blood was extracted directly. The observation group was given Atto vastatin 10 mg / d for 12 weeks, and venous blood was taken before and after treatment. In both groups, fasting plasma glucose levels, hemoglobin A1cU HbAlcCU, total cholesterol total cholesterolen TCU, triglyceride-triglyceride TGG, high density lipoprotein cholesterol high density lipoprotein cholesterolHDL-Cand low density lipoprotein cholesterol (LDL-C) were measured by automatic biochemical analyzer, and the results were compared with those of the control group, and were used for the determination of fasting blood glucose, hemoglobin A 1cn, HbAlc, total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol and low density lipoprotein cholesterol. The ELISA method was used to determine APNN LEP and the adiponectin / leptin ratio was calculated. The above indexes were statistically analyzed between the observation group and the control group before treatment and before and after treatment in the observation group. Results 1) comparison between the observation group and the healthy control group before treatment: the general data of age, sex, body weight were compared between the observation group and the healthy control group before treatment. There was no significant difference between the two groups (P 0.05). Before treatment, the levels of TCctti-2.309P0.05P0.05P0.001 and LDL-CtU -2.185P0.05) in the observation group were higher than those in the control group (HDL-Ct4.535P0.001) lower than that of the control group (P 0.001LEP). The levels of TCntU -2.309P0.001LLEP in the observation group were higher than those in the control group before and after treatment. The levels of plasma APA / L in the observation group were lower than those in the control group before and after treatment. Changes of LEP and its ratio in APNU: 12 weeks after treatment, The level of HDL-C increased slightly, but the difference was not statistically significant (P 0.064), but there was no significant difference between the two groups, but A / L was significantly higher than 2.741% (P 0.05), but there was no significant difference between the two groups in the level of APN (P 0.064, P 0.001, P 0.001), but there was no significant difference between the two groups in the level of APN, but there was no significant difference between the two groups in terms of the level of APN, but A / L was significantly higher than that of the control group (P < 0.05). Conclusion 1. The level of TGG LDL-C in middle aged and elderly patients with hyperlipidemia was higher, HDL-C was lower, APNs were lower, T2DM levels were higher than those in middle and old people with hyperlipidemia, and the levels of A- / L were lower than those of healthy controls. In the middle-aged and elderly patients with T2DM combined with hyperlipidemia, Atto vastatin treatment significantly decreased the level of TGG LDL-C, increased the level of HDL-C, and increased the level of A / L, but the effect on APNL was not obvious.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R587.1;R589.2

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 桂平,王清琴;高脂血癥43例治療體會(huì)[J];中國(guó)實(shí)用內(nèi)科雜志;2000年08期

2 ;高脂血癥[J];廣西中醫(yī)藥;2000年04期

3 李學(xué)英;中小學(xué)教師高脂血癥情況調(diào)查[J];中國(guó)校醫(yī);2000年03期

4 ;高脂血癥[J];中國(guó)健康教育;2000年06期

5 宋玉茹,李淑云,齊建強(qiáng);自擬清脂湯治療高脂血癥的臨床研究[J];中醫(yī)藥學(xué)報(bào);2000年02期

6 劉巨華,蘇海祿;不同年齡女性高脂血癥發(fā)病特點(diǎn)分析——附2318例報(bào)告[J];嶺南心血管病雜志;2001年03期

7 傅善來(lái);;哪種人容易患高脂血癥?[J];鄉(xiāng)鎮(zhèn)企業(yè)科技;2002年03期

8 王洪倫,索有瑞,李天才;紅珍珠血脂康膠囊治療高脂血癥的療效觀察[J];西北藥學(xué)雜志;2003年05期

9 郭新瑛,郭文建;氟伐他丁治療高脂血癥35例[J];實(shí)用醫(yī)藥雜志;2003年12期

10 趙燕,王海安;高脂血癥的危害及防治[J];社區(qū)醫(yī)學(xué)雜志;2003年03期

相關(guān)會(huì)議論文 前10條

1 蔣曉婷;周永列;劉建棟;;高脂血癥與急性壞死性胰腺炎關(guān)系研究[A];2004年浙江省檢驗(yàn)醫(yī)學(xué)學(xué)術(shù)會(huì)議論文匯編[C];2004年

2 易忠群;程新憲;陳燕妮;張婧;孫敏;何穎;;低鎂、低膽紅素水平在高脂血癥中的臨床意義探討[A];第十屆全軍檢驗(yàn)醫(yī)學(xué)學(xué)術(shù)會(huì)議論文匯編[C];2005年

3 楊為民;饒可;杜廣輝;;高脂血癥與男性勃起功能障礙[A];湖北省性學(xué)會(huì)第二屆第二次學(xué)術(shù)年會(huì)論文集[C];2005年

4 湯軍;朱雅芳;孫潔;宋嘉;;3140名醫(yī)務(wù)人員高脂血癥分析[A];浙江省醫(yī)學(xué)會(huì)健康管理學(xué)分會(huì)成立大會(huì)暨首屆學(xué)術(shù)年會(huì)論文集[C];2008年

5 茹利敏;;高脂血癥患者的健康教育[A];河南省護(hù)理健康教育學(xué)術(shù)會(huì)議暨神經(jīng)系統(tǒng)疾病護(hù)理健康教育研修班論文集[C];2013年

6 田芳;劉景芳;陸冬梅;;高脂血癥并發(fā)多器官損害的高齡患者低熱能飲食治療1例[A];中國(guó)營(yíng)養(yǎng)學(xué)會(huì)第12屆全國(guó)臨床營(yíng)養(yǎng)學(xué)術(shù)會(huì)議資料匯編[C];2009年

7 常亞霖;張琳;顧崇梅;楊鋮;;中西醫(yī)結(jié)合治療高脂血癥160例臨床觀察[A];甘肅省中醫(yī)藥學(xué)會(huì)2010年會(huì)員代表大會(huì)暨學(xué)術(shù)年會(huì)論文匯編[C];2010年

8 龐曉軍;;治療高脂血癥藥物的合理應(yīng)用[A];全國(guó)第三屆心腦血管疾病學(xué)術(shù)會(huì)議論文集[C];2003年

9 依巴代提·阿塔吾拉;阿不力孜·阿不都拉;;增強(qiáng)肝功能藥物治療39例高脂血癥[A];第五屆全國(guó)民族醫(yī)藥學(xué)術(shù)交流大會(huì)論文集[C];2006年

10 趙厚熙;;中藥對(duì)高脂血癥的治療和研究近況[A];中華中醫(yī)藥學(xué)會(huì)心病分會(huì)第十一屆學(xué)術(shù)年會(huì)論文精選[C];2009年

相關(guān)重要報(bào)紙文章 前10條

1 廖藝;專家呼吁：重視和防治高脂血癥[N];江蘇科技報(bào);2000年

2 王玉澤;耳聾多因高脂血癥[N];衛(wèi)生與生活報(bào);2007年

3 河北醫(yī)大一院 主任醫(yī)師 楊秀芬 醫(yī)師 蘇冠麗;高脂血癥也“傷心”[N];家庭醫(yī)生報(bào);2009年

4 武漢大學(xué)中山醫(yī)院主任醫(yī)師 李定國(guó);撩開(kāi)高脂血癥的面紗[N];醫(yī)藥經(jīng)濟(jì)報(bào);2010年

5 ;調(diào)整膳食結(jié)構(gòu) 遠(yuǎn)離高脂血癥[N];保健時(shí)報(bào);2005年

6 安徽省皖南醫(yī)學(xué)院 黃文斌;兒童也患高脂血癥[N];大眾衛(wèi)生報(bào);2003年

7 ;高脂血癥：沉默的殺手[N];人民政協(xié)報(bào);2004年

8 白靜 羅云;高脂血癥有什么危害[N];醫(yī)藥養(yǎng)生保健報(bào);2004年

9 馬月娥;兒童也有高脂血癥[N];中國(guó)中醫(yī)藥報(bào);2006年

10 ;高脂血癥的化驗(yàn)分型[N];農(nóng)村醫(yī)藥報(bào)（漢）;2008年

相關(guān)博士學(xué)位論文 前10條

1 尚菊菊;黃麗娟教授學(xué)術(shù)思想臨床經(jīng)驗(yàn)總結(jié)及治療高脂血癥的臨床研究[D];北京中醫(yī)藥大學(xué);2016年

2 聶文強(qiáng);健脾調(diào)脂方治療高脂血癥的基礎(chǔ)研究與臨床研究[D];廣州中醫(yī)藥大學(xué);2015年

3 林利娟;臺(tái)中地區(qū)高脂血癥虛實(shí)主次關(guān)系及其理化基礎(chǔ)的研究[D];福建中醫(yī)藥大學(xué);2014年

4 江曙光;降脂消斑片對(duì)高脂血癥痰瘀互結(jié)證的臨床觀察及對(duì)高脂血癥鵪鶉的實(shí)驗(yàn)研究[D];湖南中醫(yī)藥大學(xué);2010年

5 林巧云;周仲瑛教授從“痰瘀”辨治高脂血癥的臨床經(jīng)驗(yàn)及學(xué)術(shù)思想研究[D];南京中醫(yī)藥大學(xué);2017年

6 江麗霞;針刺對(duì)高脂血癥模型大鼠干預(yù)作用的研究[D];廣州中醫(yī)藥大學(xué);2010年

7 金英姬;脂蛋白（a）及高脂血癥長(zhǎng)期作用對(duì)冠狀動(dòng)脈粥樣硬化發(fā)生的影響：利用轉(zhuǎn)基因家族性高脂血癥家兔模型的病理學(xué)分析[D];吉林大學(xué);2006年

8 孟偉;清脂六通丸治療高脂血癥氣滯血瘀痰濁內(nèi)阻證多中心臨床研究[D];北京中醫(yī)藥大學(xué);2006年

9 韓榮;高脂血癥中醫(yī)“血脈微型ve瘕”論及其軟堅(jiān)散結(jié)法方藥的研究[D];新疆醫(yī)科大學(xué);2011年

10 吳峻;高脂血癥與內(nèi)皮功能障礙相關(guān)性研究及貝特類干預(yù)治療機(jī)制探討[D];中南大學(xué);2003年

相關(guān)碩士學(xué)位論文 前10條

1 葉秀卿;澤瀉調(diào)脂顆粒方治療脾虛痰瘀型高脂血癥的臨床療效觀察[D];福建中醫(yī)藥大學(xué);2015年

2 魏剛;脂血清膠囊對(duì)高脂血癥豚鼠的血脂調(diào)節(jié)及肝臟保護(hù)作用研究[D];河北醫(yī)科大學(xué);2015年

3 段曉偉;培菲康治療非酒精性脂肪性肝病伴高脂血癥的作用分析[D];安徽醫(yī)科大學(xué);2015年

4 張科翼;青島市城陽(yáng)區(qū)65歲及以上老年人肥胖與血壓及血脂的關(guān)聯(lián)性研究[D];山東大學(xué);2015年

5 孫敬雯;新疆不同民族高脂血癥患者中醫(yī)辨證分型規(guī)律初探[D];新疆醫(yī)科大學(xué);2015年

6 劉美;清脂湯治療高脂血癥（痰瘀阻絡(luò)型）的臨床研究[D];新疆醫(yī)科大學(xué);2015年

7 楊康敏;敘利亞金黃地鼠高脂血癥和動(dòng)脈粥樣硬化模型快速建立及藥效學(xué)評(píng)價(jià)關(guān)鍵技術(shù)研究[D];北京協(xié)和醫(yī)學(xué)院;2013年

8 劉嘉;高脂血癥胃癌患者血清PGE2和VEGF水平、組織VEGF表達(dá)及其與腫瘤臨床病理特征的關(guān)系[D];天津醫(yī)科大學(xué);2015年

9 岳樹(shù)豪;高血壓病合并高脂血癥的中醫(yī)證候特點(diǎn)研究[D];北京中醫(yī)藥大學(xué);2016年

10 王驍騰;新疆高脂血癥中醫(yī)證候及相關(guān)因素的臨床研究[D];新疆醫(yī)科大學(xué);2016年

，

本文編號(hào)：1877795