王新军
副主任医师 副教授
科主任
营养科陈小盼
主任医师 教授
科主任
内分泌科宋钦华
主任医师 教授
3.4
内分泌科陈竑
主任医师 教授
3.4
内分泌科王转锁
主任医师 副教授
3.4
内分泌科王海凤
主任医师 教授
3.4
内分泌科吴月平
主任医师 教授
3.4
内分泌科谭丽玲
主任医师 教授
3.4
内分泌科孙胜花
主任医师 教授
3.4
内分泌科郑海龙
副主任医师 副教授
3.3
李大伟
副主任医师 讲师
3.3
内分泌科云川
副主任医师 助教
3.2
内分泌科韩倩菲
主治医师 助教
3.2
内分泌科曾维新
主治医师 讲师
3.2
内分泌科曹晓琳
主治医师
3.2
内分泌科王平
主治医师
3.2
内分泌科潘婳
主治医师
3.2
粉剂:4U/支 69元/支10U/支 131元/支水剂(每晚睡前打一次,需购买注射笔660元/支):30U/支 1245.9元/支周制剂(每星期打一次):9mg/支 4300元/支(聚乙二醇重组人生长激素注射液,0.2mg/kgbw)优缺点:粉剂:价格便宜,但需家长自行用生理盐水配制,每晚打一次。水剂:不需自行配制,每晚打一次,但需购买注射笔一支,660元。粉剂:每星期只需要打一次,但价格昂贵。费用:以20公斤体重的患者为例每月所需粉剂:每月约需1300元水剂:每月约需3600元周制剂:每月约需7000元
海南医学院附属医院内分泌科 王新军 孙胜花人类文明虽已5000年,但在人类与糖尿病搏斗的艰苦征程中,征服糖尿病的历史只有90年。90年前,即1922年,加拿大科学家班亭(banting)和他的学生拜斯
Dietary Salt Intake and Mortality in Patients With Type 2 Diabetes2型糖尿病患者食盐摄入量与死亡率的关系OBJECTIVE Many guidelines recommend that patients with type 2 diabetes should aim to reduce their intake of salt. However, the precise relationship between dietary salt intake and mortality in patients with type 2 diabetes has not been previously explored. 目的 许多指南建议,2型糖尿病患者应该减少盐的摄入量。然而,2型糖尿病患者中食盐摄入量与死亡率的确切关系尚未见研究。 RESEARCH DESIGN AND METHODS Six hundred and thirty-eight patients attending a single diabetes clinic were followed in a prospective cohort study. Baseline sodium excretion was estimated from 24-h urinary collections (24hUNa). The predictors of all-cause and cardiovascular mortality were determined by Cox regression and competing risk modeling, respectively. 研究设计与方法 本研究为一前瞻性队列研究,对在一个糖尿病门诊就诊的638例糖尿病患者进行随访。收集24小时尿,估计基线钠排泄(24hUNa)。分别用Cox回归和竞争风险模型确定全因死亡和心血管死亡的预测因素。 RESULTS The mean baseline 24hUNa was 184 ± 73 mmol/24 h, which remained consistent throughout the follow-up (intraindividual coefficient of variation [CV] 23 ± 11%). Over a median of 9.9 years, there were 175 deaths, 75 (43%) of which were secondary to cardiovascular events. All-cause mortality was inversely associated with 24hUNa, after adjusting for other baseline risk factors (P < 0.001). For every 100 mmol rise in 24hUNa, all-cause mortality was 28% lower (95% CI 6–45%, P = 0.02). After adjusting for the competing risk of noncardiovascular death and other predictors, 24hUNa was also significantly associated with cardiovascular mortality (sub-hazard ratio 0.65 [95% CI 0.44–0.95]; P = 0.03). 结果 平均基线24hUNa为184 ± 73 mmol/24小时,在后继随访过程中保持一致(个体内变异系数[CV] 23 ± 11%)。经过中位随访时间9.9年后,有175例患者死亡,75例(43%)继发于心血管事件。在校正其他基线危险因素后,全因死亡率与24hUNa呈负相关(P < 0.001)。24hUNa每升高100 mmol,全因死亡率降低28%(95%CI为6-45%,P = 0.02)。在校正非心血管死亡危险因素和其他预测因素后,24hUNa仍与心血管疾病死亡率显著相关(亚危险比为0.65 [95%CI 0.44-0.95],P = 0.03)。CONCLUSIONS In patients with type 2 diabetes, lower 24-h urinary sodium excretion was paradoxically associated with increased all-cause and cardiovascular mortality. Interventional studies are necessary to determine if dietary salt has a causative role in determining adverse outcomes in patients with type 2 diabetes and the appropriateness of guidelines advocating salt restriction in this setting. 结论 2型糖尿病患者24 h尿钠低排泄量与全因死亡率和心血管死亡率增加相关。需要进行干预研究,以确定是否食盐在确定2型糖尿病不良结局中具有致病性作用,糖尿病患者是否指南建议限制食盐是合适的。Diabetes Care March 2011 34:703-709;
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