<strong>Background:</strong> Diabetes mellitus is a chronic disease where there is an increased blood sugar level in the body which is either caused due to inability of the pancreas to secrete insulin or t...<strong>Background:</strong> Diabetes mellitus is a chronic disease where there is an increased blood sugar level in the body which is either caused due to inability of the pancreas to secrete insulin or the body’s inability to utilize it. The prevalence of diabetes mellitus is growing rapidly worldwide. Statistics show that in the year 2014, there were a total of 422 million cases of DM. Diabetes mellitus is a major cause of heart attacks, kidney failure, blindness and leg amputations. Diabetic foot ulcers are quite common and are estimated to affect nearly 15% of all diabetic patients during their lifetime. In long standing diabetic patients with chronic non-healing ulcers, bony changes or deformities are not uncommon. These bony changes can be identified using CT scans. <strong>Materials and Methods:</strong> An observational study was conducted on a total of 40 patients with chronic non-healing ulcer attending the surgery outpatient department of Saveetha Medical College, Chennai, Tamilnadu. The CT-scans of their foot were observed for deformities or bony changes. <strong>Results:</strong> Out of 40 patients, 67.5% were males and 32.5% were females. A maximum number of subjects fell under the age group of 51 - 60 years. The most common site of the ulcer was found to be in the plantar surface of big toe (53%). Among the 40 patients, 33 of them were found to have bony abnormalities on the CT scan of foot and no apparent changes were seen in the rest. Bone erosions (35%), osteopenic changes (22.5%), Charcot’s joint (2.5%), osteophyte formation (12.5) and reduced joint space (10%) were the predominant changes observed on the CT scans of the study population.展开更多
文摘<strong>Background:</strong> Diabetes mellitus is a chronic disease where there is an increased blood sugar level in the body which is either caused due to inability of the pancreas to secrete insulin or the body’s inability to utilize it. The prevalence of diabetes mellitus is growing rapidly worldwide. Statistics show that in the year 2014, there were a total of 422 million cases of DM. Diabetes mellitus is a major cause of heart attacks, kidney failure, blindness and leg amputations. Diabetic foot ulcers are quite common and are estimated to affect nearly 15% of all diabetic patients during their lifetime. In long standing diabetic patients with chronic non-healing ulcers, bony changes or deformities are not uncommon. These bony changes can be identified using CT scans. <strong>Materials and Methods:</strong> An observational study was conducted on a total of 40 patients with chronic non-healing ulcer attending the surgery outpatient department of Saveetha Medical College, Chennai, Tamilnadu. The CT-scans of their foot were observed for deformities or bony changes. <strong>Results:</strong> Out of 40 patients, 67.5% were males and 32.5% were females. A maximum number of subjects fell under the age group of 51 - 60 years. The most common site of the ulcer was found to be in the plantar surface of big toe (53%). Among the 40 patients, 33 of them were found to have bony abnormalities on the CT scan of foot and no apparent changes were seen in the rest. Bone erosions (35%), osteopenic changes (22.5%), Charcot’s joint (2.5%), osteophyte formation (12.5) and reduced joint space (10%) were the predominant changes observed on the CT scans of the study population.
文摘目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者骨钙素(bone glaprotein,BGP)水平和矿物质与骨代谢紊乱指标的相关性。方法选择2015年2月至2015年5月在济南军区总医院血液净化中心并发慢性肾脏病-矿物质与骨代谢紊乱(chronic kidney disease mineral and bone disorder,CKD-MBD)的MHD患者36例,抽取透析前空腹血进行常规实验室检查,同时检测血钙、血磷、总碱性磷酸酶。用化学发光法检测全段甲状旁腺素(immunoreactive parathyroid hormone,iPTH),酶联免疫法检测成纤维细胞生长因子23(fibroblast growth factor23,FGF23)、BGP。用Pearson相关及Logistic回归分析相关研究数据。结果36例MHD患者BGP平均水平为(193.59±87.38)μg/L,与血磷(r=0.529)、FGF23(r=0.492)、iPTH(r=0.601)正相关;与年龄(r=-0.346)负相关;与血钙(r=0.003)、总碱性磷酸酶(r=0.170)、患者透析时间(r=0.097)不相关。根据iPTH水平将患者分为低iPTH组、iPTH达标组和高iPTH组,统计分析发现组间BGP(F=21.365,P=0.0001)、FGF23(F=5.824,P=0.007)、血磷(F=7.739,P=0.002)存在差异,而血清钙、总碱性磷酸酶、年龄和透析时间之间无显著性差异。根据BGP水平将患者分为高于均值组和低于均值组,进行多因素Logistics回归分析,发现高iPTH(OR=3.49,P=0.042)、高FGF23(OR=3.221,P=0.043)、高血磷(OR=3.103,P=0.038)是BGP高于均值的独立危险因素。结论 BGP在MHD患者中明显升高,且与iPTH、血磷和FGF23正相关。
文摘目的:探讨益肾健脾方对慢性肾脏病脾肾气虚证3,4期(CKD 3,4期)肾功能和骨代谢的影响。方法:将80例CKD 3,4期患者随机按数字表法分为对照组和益肾健脾组各40例。对照组给予西医常规治疗,口服骨化三醇胶丸,0.25μg/次,1次/d;维D2乳酸钙片,0.16 g/次,1次/d。益肾健脾组在对照组治疗的基础上采用益肾健脾方内服,1剂/d,两组疗程均为3个月。检测治疗前后尿素氮(BUN)、血肌酐(SCr)和24 h尿蛋白定量(24 h Upr),并计算肾小球滤过率(eGFR);每月对脾肾气虚证进行评分;检测治疗前后全段甲状旁腺激素(iPTH)、血清Ca、血清磷(P)、骨钙素(BGP)、骨碱性磷酸酶(bAP)和瘦素(LP)水平。结果:益肾健脾组临床疗效总有效率为52.5%,优于对照组30%(P<0.05);益肾健脾组BUN,SCr和24 h Upr比治疗前下降(P<0.05),治疗后益肾健脾组Scr低于对照组(P<0.05);治疗后2,3个月益肾健脾组脾肾气虚证积分均低于对照组(P<0.05或P<0.01);治疗后益肾健脾组血清Ca高于对照组,iPTH、血清磷P和BGP低于对照组(P<0.05);治疗后两组bAP和LP水平均比治疗前下降(P<0.01),益肾健脾组低于对照组(P<0.01)。结论:益肾健脾方能改善CKD 3,4期患者肾功能,并对骨代谢紊乱有一定的调节作用。
