【摘要】 目的 對比分析胰島素類似物賴脯胰島素75/25和人胰島素優泌林70/30治療2型糖尿病對血糖的控制作用和安全性。 方法 選取2007年6月-2008年7月107例2型糖尿病患者，隨機分為兩組:賴脯胰島素75/25組54例，每日早、晚餐前10 min皮下注射賴脯胰島素75/25，劑量0.5～0.7 U/（kg?d）；優泌林70/30組53例，每日早、晚餐前30 min注射優泌林70/30，劑量0.7～1.0 U /（kg?d），治療2周后觀察患者日胰島素總量、血糖控制情況、體質量及低血糖發生率。 結果 治療2周后，賴脯胰島素75/25組FBG由（15.4±3.1） mmol/L降為（6.5±1.4） mmol/L（Plt;0.05）、PBG-2h由（22.2±6.5） mmol/L降至（9.23±2.51） mmol/L（Plt;0.05）；優泌林70/30組FBG由（14.9±3.0） mmol/L降為（6.7±1.7） mmol/L（Plt;0.05），PBG-2h由（21.7±7.3） mmol/L降至（11.10±2.73） mmol/L（Plt;0.05）。治療3個月后賴脯胰島素75/25組HbA1c水平明顯下降，與優泌林70/30組比較差異有統計學意義（Plt;0.05）；日胰島素用量賴脯胰島素75/25組較優泌林70/30組低（Plt;0.05），體質量變化及低血糖發生率兩組比較無統計差異性（Pgt;0.05）。 結論 賴脯胰島素75/25治療2型糖尿病，HbA1c水平更低，達標患者的比例更高，具有良好的安全性及依從性。【Abstract】 Objective To compare the clinical safety and effect of insulin analogues insulin lispro 75/25 and human insulin humulin 70/30 on type 2 diabetes mellitus. Methods A total of 107 patients with type 2 diabetes mellitus from June 2007 to July 2008 were randomly divided into two groups: 54 patients in group A were injected with insulin lispro 75/25 [0.5-0.7 U/(kg?d)], twice per day, 10 minutes before each breakfast and dinner, and another 53 patients in group B were injected with human insulin humulin 70/30 [0.7-1.0 U/(kg?d)], twice per day, 30 minutes before each breakfast and dinner. The daily insulin dosage, level of blood glucose, body mass and the incidence of low blood sugar in the two groups were observed. Results Two weeks after the treatment, the level of FBG decreased from (15.4±3.1) mmol/L to (6.5±1.4) mmol/L (Plt;0.05), and the level of PBG-2h decreased from (22.2±6.5) mmol/L to (9.23±2.51) mmol/L (Plt;0.05) in group A; the level of FBG decreased from (14.9±3.0) mmol/L to (6.7±1.7) mmol/L (Plt;0.05), and the level of PBG-2h decreased from (21.7±7.3) mmol/L to (11.10±2.73) mmol/L (Plt;0.05) in group B. Three months after the treatment, the level of HbA1c in group A decreased apparently, which differed much from that in group B (Plt;0.05). The daily dosage of insulin in group A was lower than that in group B (Plt;0.05); the differences in changes of body mass and the incidence of hypoglycemia between the two groups were not significant (Pgt;0.05). Conclusion The treatment with insulin lispro 75/25 for type 2 diabetes mellitus shows a good effect on HbA1c level control with safety and compliance.
ObjectiveTo compare the differences in patient satisfaction and health-related quality of life after total mastectomy and breast-conserving surgery for breast cancer. MethodsBreast cancer patients who underwent surgical treatment in the First Hospital of Shanxi Medical University and The People’s Hospital of Shanxi Province from March to June 2021 were selected as the research objects by convenient sampling method. Self-designed questionnaires were used to evaluate the general situation of the patients. Patients’ satisfaction and quality of life were investigated by using the postoperative scale of the BREAST-Q module of total mastectomy (to investigate patients after total mastectomy) and the postoperative scale of the breast-conserving plastic surgery module (to investigate patients after breast-conserving surgery), and the patient-reported outcomes of total mastectomy and breast-conserving surgery were compared, including breast satisfaction, psychosocial health, chest and upper limb physical health, sexual health, medical team satisfaction, and information satisfaction. ResultsIn this study, there were 100 patients in the total mastectomy group and 50 patients in the breast conserving group. There were no significant differences between the two groups in marital status, monthly family income, education, body mass index, whether combined with other physical diseases, chemotherapy, targeted therapy, axillary lymph node dissection, tumor stage, and molecular typing (P>0.05). The rates of radiotherapy and endocrine therapy in the breast conserving group were higher than those in total mastectomy group ( χ2=48.701, P<0.001; χ2=15.891, P<0.001). The scores of quality of life and patient satisfaction scores of the breast conserving group including breast satisfaction, satisfactions of breast doctors, nurses and other doctors, social and mental health, sexual health score were higher than those of the total mastectomy group (P<0.001), but there was no significant difference in the physical health of chest and upper limbs score between the two groups (P>0.05). In addition, the satisfaction score of radiotherapy information in the breast conserving group was 69.40±20.44 and that of medical information given by breast surgeons was 87.04±19.46. ConclusionScores of breast satisfaction, psychosocial health, sexual health, and health-related quality of life in breast-conserving patients are higher than those in total mastectomy patients.
