【摘要】 目的 探讨果糖胺（fructosamine，FMN）与血糖、糖化血红蛋白（HbA1c）的关系。 方法 2009年5月-2009年8月，以75例糖尿病患者作为糖尿病组，36例健康志愿者作为正常对照组，进行口服糖耐量试验，检测其空腹血糖及餐后2 h血糖水平，并同时检测FMN与HbA1c水平。 结果 糖尿病组空腹血糖、餐后2 h血糖、FMN、HbA1c均高于正常对照组（Plt;0.05）。FMN与HbA1c、空腹血糖、餐后2 h血糖均呈正相关关系（Plt;0.05）。FMN与空腹血糖的相关系数高于HbA1c与空腹血糖的相关系数，FMN与餐后血糖的相关系数也高于HbA1c与餐后血糖的相关系数。 结论 果糖胺与HbA1c相比有一定的优势，可作为监测糖尿病患者血糖控制的良好指标。【Abstract】Objective To investigate the association among fructosamine (FMN) and blood glucose, glycated hemoglobin (HbA1c). Methods From May 2009 to April 2009, 75 diabetes and 36 health subjects were recruited for this study. Blood samples was collected and assayed for FMN, HbA1C, and fasting glucose.The 2-hour oral glucose tolerance test (OGTT-2h) was given. Results Fasting glucose, OGTT-2h glucose, FMN and HbA1c were all higher in diabetes group than in healthy control group (Plt;0.05) .There was positive correlation between FMN and fasting glucose, OGTT-2h glucose, and HbA1c (Plt;0.05). The correlation coefficients between FMN and glucose were higher than those between HbA1c and glucose. Conclusion Compared with HbA1c, FMN has advantage in monitoring blood glucose in diabetes and be regarded as a suitable index for blood glucose control.
Objective To analyze the clinical features and etiologic of community-acquired pneumonia (CAP) among the elderly aged 80 and over, and provide evidence for clinical diagnosis and treatment. Methods The clinical characteristics and etiology of the elderly CAP (≥80 years old) were analyzed by collecting and comparing the clinical characteristics and etiology between the very elderly CAP group (≥80 years old, 94 cases) and control group (65 to 79 years old, 100 cases). Results On clinical symptoms, there were statistical differences in dyspnea and gastrointestinal symptoms, systemic symptoms, and mental status (P<0.05) between the two groups. There was no statistically significant difference in upper respiratory tract symptoms, fever, cough, sputum, hemoptysis and chest pain between the two groups (P>0.05). On the complications, the very elderly CAP group was more prone to respiratory failure, sepsis, urinary tract infection and electrolyte metabolism than the control group (P<0.05). On the experimental indicators, anemia and abnormal renal function in the elderly CAP group were high (P<0.05). There was no statistical difference between the two groups of inflammation indicators (white blood count, procalcitonin, C-reactive protein, erythrocyte sedimentation rate, neutrophil alkaline phosphatase score). The pneumonia severity index score and CURB-65 score of the very elderly CAP group were significantly higher than those of the control group (P<0.001). On pathogen analysis, in the very elderly CAP group the number of bacterial infections (23/94), viral infections (21/94) and bacterial mixed virus infections (21/94) were probably equivalent, and the proportion of bacterial infections of two or more types accounted for 17.0% (16/94); The bacteria detection rate was Streptococcus pneumoniae (22.4%), Pseudomonas aeruginosa (19.4%), Stenotrophomonas maltophilia (16.4%), Staphylococcus aureus (14.9%). Viral infection mainly focused on influenza A virus (23/94) and human cytomegalovirus (21/94). Bacterial mixed virus infection was mainly caused by Streptococcus pneumoniae and influenza A virus infection. Comparing the two groups, the most common bacterial pathogen both of them was Streptococcus pneumoniae, but the overall proportion was dominated by gram-negative bacteria, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Acinetobacter baumannii and Klebsiella pneumoniae were more common; the gram-positive bacteria in the two groups were mainly Streptococcus pneumoniae and Staphylococcus aureus. There was no significant difference in the detection rate of above Gram-positive bacteria between the two groups (P>0.05). The two groups of virus infections were mainly influenza A virus, and the difference was not statistically significant (P>0.05). The two groups of single bacteria rate, single virus infection rate, double virus infection rate and bacterial mixed virus infection rate were similar, the difference had not been found (P>0.05). Conclusions The elderly (aged 80 and over) CAP group is prone to dyspnea, often presents with extrapulmonary atypical symptoms such as digestive tract symptoms, systemic symptoms and psychiatric symptoms, and usually accompanied with many complications. The etiological treatment mainly covers gram-negative bacteria, and we must pay attention to the possibility of combined virus infection.
Objective To establish a model for prognosis analysis of severe community-acquired pneumonia in order to find the independent risk factors for mortality. Methods The data of 88 patients with severe community-acquired pneumonia enrolled from 533 community-acquired pneumonia patients in Fujian Provincial Hospital from April 2012 to December 2015 were analyzed, they were divided into a survival group and a death group according to prognosis. The clinical materials of basic data of the population, clinical manifestation, treatment and prognosis and pulmonary severity indexes were collected. Then univariate analysis was used to screen risk factors of death before logistic multivaritae regression was applied to explore independent risk factors. Results The different pathogen groups including viral, bacterial, mixed infection, negative and other groups were compared and no differences were found in mortality (all P>0.05). Univariate analysis revealed antibiotics treatment before admission, higher APACHEⅡ score, higher Chalison's score, septicopyemia, and higher level of procalcitonin, blood urea nitrogen (BUN), blood glucose, lactate could increase death risk for the patients. While antiviral treatment and no invasive mechanical ventilation were determined as protective factors. Logistic multivaritae regression showed three factors including higher lactate and higher serum BUN and higher heart rates were independent death risk factors [OR values were 4.704 (95%CI 0.966-22.907), 1.264 (95%CI 0.994-1.606), and 1.081 (95%CI 1.003-1.165), respectively]. Whereas no invasive mechanical ventilation was protective factor (OR=0.033, 95%CI 0.001-0.764). Conclusion The patients with higher lactate and BUN, higher heart rate and accepting invasive mechanical ventilation have poor prognosis.