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1.
Inflamm Bowel Dis ; 2023 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-36640130

RESUMO

BACKGROUND: In women with inflammatory bowel disease, at least 3 months of preconception corticosteroid-free remission (CFREM) is recommended by experts in current consensus statements. However, data are lacking on the appropriate preconception remission period. We investigated the appropriate preconception CFREM period in women with ulcerative colitis to reduce maternal disease activity and adverse pregnancy outcomes (ie, preterm birth, low birth weight, and small for gestational age). METHODS: We retrospectively examined 141 pregnancies in women with ulcerative colitis at 2 institutions. We categorized the patients into 3 subgroups by their preconception CFREM period (≥3 months, >0 to <3 months, and non-CFREM). We also investigated disease activity during pregnancy and postpartum and adverse pregnancy outcomes in each group. RESULTS: During pregnancy, the rate of active disease was significantly lower in the ≥3 months and >0 to <3 months CFREM groups compared with that in the non-CFREM group (P < .001 and P = .0257, respectively). Postpartum, the rate of active disease was significantly lower in the ≥3 months CFREM group compared with that in the non-CFREM group (P = .0087). The preconception CFREM period of ≥3 months was an independent inhibitory factor for active disease during pregnancy and postpartum (adjusted odds ratio, 0.15; P = .0035; and adjusted odds ratio, 0.33; P = .027, respectively). Adverse pregnancy outcomes were less common in the >3 months CFREM group compared with those in the other groups, but this difference was not significant. CONCLUSIONS: A preconception CFREM period of more than 3 months may be appropriate for better maternal and adverse pregnancy outcomes, as recommended in consensus statements.


In women with ulcerative colitis, a preconception corticosteroid-free remission period for at least 3 months may be appropriate. This period could reduce disease activity during pregnancy and postpartum and reduce the incidence of adverse pregnancy outcomes.

2.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-991716

RESUMO

Objective:To investigate the efficacy of work-amusement activities combined with daytime rehabilitation technology for schizophrenia in remission.Methods:A total of 218 patients with schizophrenia in remission who received treatment in Shaoxing 7 th People's Hospital from September 2018 to April 2020 were prospectively included in this study. They were randomly divided into an observation group ( n = 109) and a control group ( n = 109). Both groups were treated with routine drugs. Based on this, the control group was treated with daytime rehabilitation technology, and the observation group was treated with daytime rehabilitation technology combined with work-amusement activities. After 12 weeks of treatment, curative effect, Positive and Negative Symptom Scale (PANSS) and Montreal Cognitive Assessment (MoCA) scores were compared between the two groups. Results:After 12 weeks of treatment, total response rate in the observation group was significantly higher than that in the control group (91.74% vs. 77.06%, χ2 = 8.92, P < 0.05). After treatment, PANSS score in the observation group was significantly decreased compared with that before treatment [(33.12 ± 4.19) points vs. (40.54 ± 5.32) points, t = 11.44, P < 0.05). After treatment, PANSS score in the control group was significantly decreased compared with that before treatment [(35.02 ± 4.33) points vs. (40.54 ± 5.32) points, t = 8.55, P < 0.05). After treatment, PANSS score in the observation group was significantly lower than that in the control group ( t = 3.29, P < 0.05). After treatment, MoCA score in the observation group was significantly increased compared with that before treatment [(27.14 ± 2.89) points vs. (23.39 ± 2.48) points, t = 10.28, P < 0.05]. After treatment, MoCA score in the control group was significantly increased compared with that before treatment [(26.02 ± 2.73) points vs. (23.41 ± 2.56) points, t = 7.28, P < 0.05]. After treatment, MoCA score in the observation group was significantly higher than that in the control group ( t = 2.94, P < 0.05). Conclusion:The efficacy of work-amusement activities combined with daytime rehabilitation technology is marked on schizophrenia in remission, which can markedly improve mental symptoms and cognitive function.

3.
Artigo em Inglês | MEDLINE | ID: mdl-36231246

RESUMO

Skin autofluorescence (SAF) is a noninvasive method reflecting tissue accumulation of advanced glycation end products (AGEs). We investigated whether, in newly diagnosed children and adolescents with type 1 diabetes (T1D), this surrogate marker of long-term glycemia is associated with markers of the early manifestation phase, residual secretion capacity of the ß-cells, and the occurrence of remission. SAF was measured in 114 children and adolescents (age: 8.0 ± 4.5 years, 44% girls) at the time of T1D diagnosis, and related to HbA1c, C-peptide, diabetic ketoacidosis, and remission. 56 patients were followed up for 1 year. Seventy-four sex- and age-matched healthy individuals served as controls. SAF was higher in the T1D group compared with controls (1.0 ± 0.2 vs. 0.9 ± 0.2, p < 0.001). At the time of diagnosis, SAF correlated with HbA1c (r = 0.285, p = 0.002), was similar in patients with and without ketoacidosis, and was lower in the remitters compared with non-remitters (0.95 ± 0.18 vs. 1.04 ± 0.26, p = 0.027). Unlike HbA1c, SAF was an independent predictor of remission (∆R2 = 0.051, p = 0.004). Former studies consider SAF in diabetic patients as a tool to identify individuals at an increased risk of chronic complications. Here we show that determination of SAF at the time of T1D diagnosis might potentially predict remission, at least in children.


Assuntos
Diabetes Mellitus Tipo 1 , Adolescente , Biomarcadores , Peptídeo C , Criança , Pré-Escolar , Diabetes Mellitus Tipo 1/complicações , Feminino , Hemoglobinas Glicadas/análise , Produtos Finais de Glicação Avançada , Humanos , Masculino , Pele/química
4.
Front Psychiatry ; 12: 677082, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34504442

RESUMO

Background: Far from being a clinical disease, the COVID-19 pandemic has become a threatening social event worldwide exerting long-term impacts on human beings. Objective: This study was designed to determine if and to what extent psychiatric inpatients during the remission phase of the pandemic suffered from vicarious traumatization. Method: Totally 266 eligible participants from psychiatric and psychological wards in a hospital were recruited during October 26th, 2020 to February 4th, 2021 to finish a self-made online questionnaire consisting of Impact of Event Scale-Revised (IES-R), Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), Obsessive-Compulsive Inventory-Revised (OCI-R), Pittsburgh Sleep Quality Index-Revised (PSQI-R), Social Support Rating Scale (SSRS), Beck Suicide Ideation Scale (SSI), 12-Item Short-Form Health Survey (SF-12). Meanwhile, some socio-demographics and information related to the pandemic were also recorded. Results: The detection rate of vicarious traumatic symptoms (VTS) was 80.83%, including 40.98% for mild ones, 25.56% for moderate ones, and 14.29% for severe ones, among whom 98.14% possessed all three phenotypes. 27.07% of the sample were considered possible vicarious traumatization (pVT). Having acquaintances infected with or died from COVID-19, worries on re-outbreak of COVID-19, a higher score of OCI-R or lower score of SF-12, and long latency of VTS were independent risk factors of pVT. Conclusion: Our study showed that COVID-19 could have profound mental influences on psychiatric inpatients. It is high time we did some screening in the wards to seek for patients at risk.

5.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-906243

RESUMO

Objective:This study aims to evaluate the clinical effect of Changyanqing mixture combined with mesalazine enteric-coated tablets in the maintenance treatment of ulcerative colitis(UC) in remission period. Method:The 140 patients with UC in remission period were randomly divided into control group (70 cases) and observation group (70 cases). The 61 patients in control group completed the therapy (6 cases lost or lost to follow-up and 3 were eliminated), 63 patients in observation group completed the therapy (5 cases lost or lost to follow-up and 2 were eliminated). Both groups′ patients got treatment of lifestyle adjustment, and they also took mesalazine enteric-coated tablets orally, 0.5 g/time, 3 times/day. Patients in observation group took Changyanqing mixture orally for a month in the morning and evening every day, 150 mL/time, and then changed to 150 mL/time, 1 time/day, for 3 consecutive months, finally changed to once every other day for 8 months. Patients in control group took simulated medicine of Changyanqing mixture orally in the same way as observation group. The treatment was continued for 12 months. When UC recurred during the treatment, patients took mesalazine enteric-coated tablets orally at 1 g/time, 3 times/day until remission, when the above intervention plan was continued to be adopted. The recurrence rate, first recurrence time within 12 months (duration from remission to Mayo≥3) and the degree of disease activity at recurrence were recorded. Scores of traditional Chinese medicine(TCM)syndrome and inflammatory bowel disease questionnaire (IBDQ) were evaluated once every 2 months. Before treatment, and at the 6<sup>th</sup> and 12<sup>th</sup> month after treatment, colonoscopy and mucosal histology were performed once, enteroscopic mucosal scores, Geboes index of mucosal histology were evaluated, and fecal calprotectin(FC) levels were detected. Also, safety evaluation was conducted. Result:During 12 months, the recurrence rate in observation group was 20.63% (13/63), lower than 39.34% (24/61) in control group(<italic>P</italic><0.05), the frequency of recurrence and the first recurrence duration in observation group were all less than those in control group(<italic>P</italic><0.01). All these meant the disease activity of patients in observation group was lighter than that in control group (<inline-formula><alternatives><mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:msup><mml:mrow><mml:mi>χ</mml:mi></mml:mrow><mml:mrow><mml:mn mathvariant="normal">2</mml:mn></mml:mrow></mml:msup></mml:math><graphic specific-use="big" xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="alternativeImage/444CE72A-DE9D-4013-BB0B-F487F60C8DC8-M003.jpg"><?fx-imagestate width="3.30200005" height="3.64066648"?></graphic><graphic specific-use="small" xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="alternativeImage/444CE72A-DE9D-4013-BB0B-F487F60C8DC8-M003c.jpg"><?fx-imagestate width="3.30200005" height="3.64066648"?></graphic></alternatives></inline-formula>=5.947, <italic>P</italic><0.05). After repeated measurements of variance analysis, scores of TCM syndrome, enteroscopic mucosal scores, Geboes index and FC levels in two groups gradually increased(<italic>P</italic><0.05), and scores of IBDQ gradually decreased (<italic>P</italic><0.05) during the 12-month period. At the second, fourth, sixth, eighth, tenth and twelfth month, scores of TCM syndromes in observation group were lower than those in control group (<italic>P</italic><0.01), and scores of IBDQ were higher than those in control group (<italic>P</italic><0.01). At the sixth and twelfth month after treatment, intestinal endoscopic mucosal scores, Geboes index and FC levels in observation group were all lower than those in control group (<italic>P</italic><0.01). And there were no adverse reactions related to Changyanqing mixture. Conclusion:Changyanqing mixture combined with mesalazine enteric-coated tablets in the maintenance treatment of patients with UC in remission can control the FC level, further reduce the recurrence rate, delay the recrudescence-time, reduce the frequency of UC and the disease activity, maintain the good remission state of UC, stabilize the quality of life of patients, and ensure the safety of clinical use.

6.
Dermatol Ther ; 33(3): e13351, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32232885

RESUMO

This study aimed to evaluate whether the supplementary balneotherapy with Chinese herbal medicine (CHM) could facilitate the treatment of psoriasis vulgaris and thus be beneficial for long-term remission from the symptoms. Two hundred psoriasis vulgaris patients with moderate-to-severe plaque psoriasis from January 2013 to June 2014 were evenly divided into two groups: the consolidated therapy group (CTG) and unconsolidated therapy group (UTG); the remission period of the two groups was compared. There was no significant difference in Psoriasis Area Severity Index (PASI) score between the two groups at the beginning and the end of the treatment. However, the average remission time in CTG was 10.99 months, which was significantly longer than that of 7.94 months in UTG (P = .001). After a correction of age, course of disease, skin type as well as PASI baseline value using a COX model, we found that the risk of recurrence of psoriasis vulgaris in UTG was higher than that in the CTG (P < .001). No adverse reactions were discovered when combing the two treatments together. The combined treatment of CHM balneotherapy and narrowband ultraviolet B could significantly prolong the remission time in patients with psoriasis vulgaris.


Assuntos
Balneologia , Medicamentos de Ervas Chinesas , Psoríase , Terapia Ultravioleta , Terapia Combinada , Humanos , Psoríase/diagnóstico , Psoríase/tratamento farmacológico , Resultado do Tratamento
7.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-873165

RESUMO

Objective:To discuss the effect of modified Yangxintang on chronic pulmonary heart disease (CPHD) with syndrome of deficiency of heart and lung Qi and progress of disease. Method:One hundred and twenty-eight patients were randomly divided into control group 64 cases and observation group 64 cases by random number table. Patients in control group got comprehensive rehabilitation measures of western medicine. Those who had respiratory distress got Salmeterol ticasone powder inhaler, 1-2 times/day, 1 inhale/time.And those who had cough and phlegm got Ambroxol hydrochloride tablets for 1-2 week, 1-2 tablet/time, 3 times/day. In addition to the therapy of control group, patients in observation group was also added with modified Yangxintang, 1 dose/day, 5 days/week. Record the and times of acute aggravate and cold, pulmonary artery systolic pressure (PASP), mean pulmonary artery pressure (MPAP), left ventricular ejection fraction (LVEF), stroke volume (SV) and cardiac output (CO) were recorded during 48 weeks. Before and after treatment, scores of modified British medical research council respiratory questionnaire (mMRC questionnaire), Minnesota Heart Failure Quality of life scale (MLHFQ), syndrome of deficiency of heart and lung Qi and 6-minute walking test (6 MWT) were scored. And levels of N-terminal B-type natriuretic peptide (NT-proBNP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), nitric oxide (NO), endothelin (ET-1), CD3+, CD4+, CD8+ and CD4+/CD8+ were detected. Result:The clinical efficacy in observation group was better than that in control group (Z=2.108, P<0.05). During 48 weeks of observation period, times of acute aggravate and cold in observation group were less than those in control group (P<0.01). Levels of PASP, MPAP and NT-proBNP were lower than those in control group (P<0.01). And levels of LVEF, SV, CO, 6 MWT and NO were higher than those in control group (P<0.01), levels of CD3+, CD4+ and CD4+/CD8+ were higher than those in control group (P<0.05). And levels of mMRC, MLHFQ, score of syndrome of deficiency of heart and lung Qi, TNF-α , IL-6, ET-1, CD8+ and were all lower than those in control group (P<0.01, P<0.05). Conclusion:In addition to anti-inflammatory, anti-asthmatic and anti-tussive therapies, modified Yangxintang can improve the immune function, relieve the symptoms of heart and lung, improve the function of heart and lung and the quality of life, inhibit the inflammatory reaction, improve the function of vascular endothelium, reduce the pulmonary hypertension, control the progress of disease.

8.
Nutrients ; 11(9)2019 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-31505819

RESUMO

Vitamin D and omega 3 fatty acid (ω-3) co-supplementation potentially improves type 1 diabetes (T1D) by attenuating autoimmunity and counteracting inflammation. This cohort study, preliminary to a randomized control trial (RCT), is aimed at evaluating, in a series of T1D children assuming Mediterranean diet and an intake of cholecalciferol of 1000U/day from T1D onset, if ω-3 co-supplementation preserves the residual endogen insulin secretion (REIS). Therefore, the cohort of 22 "new onsets" of 2017 received ω-3 (eicosapentenoic acid (EPA) plus docosahexaenoic acid (DHA), 60 mg/kg/day), and were compared retrospectively vs. the 37 "previous onsets" without ω-3 supplementation. Glicosilated hemoglobin (HbA1c%), the daily insulin demand (IU/Kg/day) and IDAA1c, a composite index (calculated as IU/Kg/day × 4 + HbA1c%), as surrogates of REIS, were evaluated at recruitment (T0) and 12 months later (T12). In the ω-3 supplemented group, dietary intakes were evaluated at T0 and T12. As an outcome, a decreased insulin demand (p < 0.01), particularly as pre-meal boluses (p < 0.01), and IDAA1c (p < 0.05), were found in the ω-3 supplemented group, while HbA1c% was not significantly different. Diet analysis in the ω-3 supplemented group, at T12 vs. T0, highlighted that the intake of arachidonic acid (AA) decreased (p < 0.01). At T0, the AA intake was inversely correlated with HbA1c% (p < 0.05; r;. 0.411). In conclusion, the results suggest that vitamin D plus ω-3 co-supplementation as well as AA reduction in the Mediterranean diet display benefits for T1D children at onset and deserve further investigation.


Assuntos
Diabetes Mellitus Tipo 1/terapia , Dieta Mediterrânea , Suplementos Nutricionais , Ácidos Graxos Ômega-3/administração & dosagem , Vitamina D/administração & dosagem , Ácido Araquidônico/administração & dosagem , Criança , Colecalciferol/administração & dosagem , Diabetes Mellitus Tipo 1/sangue , Feminino , Hemoglobinas Glicadas/análise , Humanos , Insulina/uso terapêutico , Secreção de Insulina/efeitos dos fármacos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Retrospectivos
9.
Chinese Journal of Dermatology ; (12): 537-541, 2019.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-755796

RESUMO

Objective To evaluate the effect of an emollient containing Prinsepia utilis Royle oil extracts and other extracts on clinical symptoms and disease recurrence in children aged 2-12 years with atopic dermatitis (AD) in the remission period.Methods A multicenter,randomized,parallel-group,controlled clinical trial was conducted from December 2017 to September 2018.A total of 297 children aged 2-12 years with moderate AD were enrolled from 5 hospitals in China,and randomly divided into the test group (148 cases) and control group (149 cases).In the acute stage,the two groups were both topically treated with mometasone furoate cream once a day on the skin lesions,and with an emollient containing Prinsepia utilis Royle oil extracts and other extracts twice a day throughout the whole body for 2-4 weeks.The children would be enrolled into the remission stage if their Investigator's Global Assessment (IGA) score was ≤ 1 at following visits.In the remission stage,the test group was only topically treated with the emollient twice a day throughout the whole body,while mometasone furoate cream and the emollient were both withdrawn in the control group.At weeks 4,8 and 12 in the remission stage,the recurrence of AD,eczema area and severity index (EASI),children's dermatology life quality index (CDQOL) and adverse events were evaluated.Statistical analysis was carried out with SAS 9.4 software by using t test for comparison of normally distributed continuous data between two groups,chi-square test for comparison of unordered categorical data,Kaplan-Meier method for analysis of survival rates,Cox regression analysis for evaluating the effect of different therapies on AD recurrence in children in the remission stage,and Logistic regression analysis for analysis of odds ratio (OR) of EASI or CDQOL at week 4 in the remission stage between the test group and control group.Results Of the 297 children with AD,31 breached the clinical trial protocol,and 266 were included in the per protocol set (PPS),including 132 in the test group and 134 in the control group.In the PPS,114 and 106 patients completed the follow-up in the test group and control group respectively,and the recurrence rate was significantly lower in the test group (47,41.23%) than in the control group (84,79.25%;x2 =32.96,P < 0.001).The time to recurrence was significantly longer in the test group(61.99 d ± 2.80 d)than in the control group(39.17 d ± 2.54 d,t =6.03,P < 0.001),and the recurrence risk was significantly lower in the test group than in the control group (Log rank test,x2 =32.02,P < 0.001).After adjustment for age and gender,Cox regression analysis showed that the recurrence risk in the test group was 0.35 times that in the control group (HR =0.35,95% CI:0.24-0.51,P < 0.01).At week 4 in the remission stage,the EASI score at P50-P75 and P75-P100 in the test group were 0.42,0.25 times that in the control group respectively (95% CI:0.20-0.86,0.12-0.54 respectively;P =0.02,< 0.01respectively).Moreover,the CDQOL score at P75-P100 in the test group was 0.33 times that in the control group (95% CI:0.17-0.65,P < 0.01).No significant difference in the incidence of adverse events was observed between the two groups (P > 0.05).Conclusion Maintenance treatment with the emollient containing Prinsepia utilis Royle oil extracts and other extracts can markedly reduce the recurrence risk in AD children,improve clinical symptoms,and enhance the quality of life.

10.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-802166

RESUMO

Objective:To observe the regulatory effect of Guben Fangxiao decoction on Toll-like receptor (TLR)4, TLR7, nuclear factor-kappa B p65 (NF-κB p65) and NF-κB inhibitor protein alpha (IκBα) in mice with asthma remission, in order to explore the mechanism of Guben Fangxiao decoction in treating asthma remission. Method:Respiratory syncytial virus (RSV) combined with chicken ovalbumin (OVA) was used to build asthma remission model in 3-week-old BALB/c mice. Sixty mice were divided into blank group, model group, dexamethasone group (0.001 g·kg-1), low,medium and high-dose Guben Fangxiao decoction group (6.5,13,26 g·kg-1), respectively. Intervention was given once a day for 28 days. After administration, the mice were put to death. Hematoxylin-eosin (HE) staining was used to observe the pathological changes of lung tissue and score the pulmonary inflammation. Western blot was used to detect the expressions of TLR4, TLR7, IκBα and nuclear NF-κB p65 in lung tissue of mice. Immunofluorescence was used to observe the expression of NF-κB p65 in cellnucleuses. Result:Compared with blank group, the lung tissue of model group showed obvious inflammatory cell infiltration (PκB p65 increased significantly (PκBα proteins increased significantly (PPκB p65 (PκB p65 (PκBα proteins (PConclusion:Guben Fangxiao decoction can alleviate airway inflammation, and its therapeutic effect may be achieved by regulating TLR4, TLR7, NF-κB p65 and IκBα.

11.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-615812

RESUMO

Objective To evaluate the effect of Liujunzi soup on the total course of disease and inflammatory mediators in patients with remission of allergic cough. Methods Eighty six patients with allergic cough were enrolled in our hospital from April 2011 to April 2012. The patients were randomly divided into observation group (n = 43) and control group (n = 43). The control group was given basic western medicine treatment, the observation group in the control group on the basis of another treatment of six gentleman soup. The levels of inflammatory cytokines, pulmonary function and adverse reactions were compared between the two groups in clinical efficacy, hospitalization time, total course of disease, IL-2, TNF-α and IL-6. Results The total effective rate was 90.70% in the observation group was significantly higher than that in the control group (72.09%)( P<0.05). The duration of hospitalization (13.35 ± 3.24) d and the total course of disease (17.68 ± 4.53) d were significantly shorter than those in the control group (16.23 ±3.10) d, (20.35 ± 4.67) d (P<0.05). The levels of inflammatory factors and pulmonary function in the observation group were statistically significant compared with the control group (P<0.05). No adverse reactions occurred in both groups. Conclusion Liujunzi Decoction combined with western medicine can improve the level of inflammatory cytokines and lung function, shorten the length of hospital stay, the total course of disease and high safety, and have good clinical value.

12.
J Dermatol ; 41(7): 622-7, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24942986

RESUMO

The aim of this study was to investigate the duration of remission periods in psoriasis after narrowband ultraviolet B (NB-UVB) phototherapy, especially during multiple cycles of treatment. We analyzed 63 patients (101 cases) demonstrating marked improvement after NB-UVB phototherapy. The remission period was defined as the duration of time from the end of phototherapy until treatment using either phototherapy or systemic treatments was required again. It was found that an age of 60 years or older, history of systemic therapy within 6 months and three or more phototherapy cycles were significantly associated with shorter remission periods. Furthermore, multivariate analysis confirmed that three or more phototherapy cycles (odds ratio [OR], 4.0; 95% confidence interval [CI], 1.73-9.33; P = 0.001) and a history of systemic therapy (OR, 2.2; 95% CI, 1.27-3.95; P = 0.005) were independently associated with the shorter remission period. In conclusion, when planning NB-UVB phototherapy for psoriatic patients who have undergone multiple phototherapy cycles, clinicians should consider the possibility of shorter remission periods.


Assuntos
Psoríase/radioterapia , Terapia Ultravioleta/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Indução de Remissão , Estudos Retrospectivos , Fatores de Tempo , Adulto Jovem
13.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-424707

RESUMO

ObjectiveTo observe β cell function in newly diagnosed diabetic patients with ketosis before and in remission period and evaluate its classification and predictive value.MethodsA total of 206 patients newly diagnosed as diabetic ketosis who had been treated with intensive insulin therapy in our hospital and entered in the honeymoon after the withdraw of insulin therapy were followed for 36 months from onset of diabetes.They were divided into two groups of type 1 and type2 diabetes ( group A and B),according to the dependence or independence on insulin treatment. The β cell function of the two groups before and in remission period was compared by oral glucose tolerance test (OGTF).β cell function was measured with the AUC of insulin and C-peptide and homeostatic model assessment β-cell function (HOMA-β),while homeostatic model assessment insulin resistant (HOMA-IR) for insulin resistant.The duration of the honeymoon and the change of insulin and C-peptide curve before and in honeymoon were also observed.ResultsThe AUC of insulin and C-peptide,the HOMA-β and the HOMA-IR before and after the intensive insulin treatment were lower in group A than that in group B [ before the insulin treatment:(10.18 ±2.36)mIU · h · L-1 vs (20.28 ±6.89)mIU · h · L-1,(1.56 ±0.53) μg · h · L-1 vs (3.75 ±0.67) μg · h · L-1,3.68 ± 1.08 vs 18.20 ±6.59,1.22 ±0.49 vs 3.06 ± 1.54,respectively;after the insulin treatment:(29.86 ± 8.65 ) mIU · h · L-1 vs (93.35 ± 19.42 ) mIU · h · L-1,( 3.99 ± 0.79 )μg · h · L-1 vs ( 12.54 ±3.83) μg · h · L-1,8.50 ±2.46 vs 56.17 ± 19.42,0.63 ±0.56 vs 1.42 ±0.78,respectively ].The duration of the honeymoon in group A was significantly shorter than in group B [ (7.9 ±5.2) months vs (20.9 ± 9.9 ) months ].In oral glucose insulin and C-peptide release test,the peak of insulin and C-peptide releasing curve in group A was brought forward by a half to 1 hour after intensive treatment while delayed in group B by 1 or 2 hours.The releasing peak of insulin and C-peptide in group A was less than two folds of the basic value,while four to ten fold of the basic value in group B.The positive ratio of glutamic acid decarboxylase antibody,insulin autoantibody and insular cellular antibody in group A and group B were 21.2% vs 4.8%,18.1% vs 3.3%,9.2% vs 10.6%,respectively.ConclusionsOf all the patients newly diagnosed as diabetes ketosis who had entered into the honeymoon after intensive insulin therapy,91% were type 2 diabetes.Inferior β cell function before insulin therapy,weaker remission after insulin therapy and shorter duration of remission period suggest the classification of type 1 diabetes.

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