發(fā)布時(shí)間：2018-06-05 19:44

  本文選題：型糖尿病 + 日內(nèi)平均血糖波動(dòng)幅度��； 參考：《山東醫(yī)藥》2017年46期

【摘要】：目的探討2型糖尿病(T2DM)患者慢性血糖波動(dòng)指標(biāo)與冠狀動(dòng)脈狹窄程度的關(guān)系,為T(mén)2DM患者冠心病的防治提供依據(jù)。方法選擇因胸痛行冠狀動(dòng)脈造影的T2DM患者153例,根據(jù)冠狀動(dòng)脈造影結(jié)果分為觀察組(合并冠狀動(dòng)脈狹窄)92例及對(duì)照組(不合并冠狀動(dòng)脈狹窄)61例。抽取兩組空腹靜脈血4 m L,檢測(cè)空腹血糖(FBG)、糖化血紅蛋白(Hb A1c)水平。應(yīng)用動(dòng)態(tài)血糖監(jiān)測(cè)系統(tǒng)(CGMS)實(shí)施連續(xù)72 h的血糖跟蹤監(jiān)測(cè),記錄血糖波動(dòng)指標(biāo)包括日內(nèi)平均血糖波動(dòng)幅度(MAGE)、日間血糖的平均絕對(duì)差(MODD)、餐后血糖的波動(dòng)幅度(PPGE)。對(duì)兩組患者均行冠狀動(dòng)脈造影檢查,采用Gensini積分法評(píng)價(jià)冠狀動(dòng)脈狹窄程度。采用Spearman法分析Gensini積分與觀察組患者臨床資料的相關(guān)性,采用Logistic回歸法分析觀察組患者Gensini積分的影響因素。結(jié)果觀察組Hb A1c、MAGE、PPGE水平均高于對(duì)照組(P均0.05)。觀察組Gensini積分高于對(duì)照組(P0.01)。觀察組Gensini積分與年齡、Hb A1c、MAGE及PPGE均呈正相關(guān)(P均0.05)。Logistic回歸分析示,年齡、Hb A1c及MAGE是觀察組Gensini積分的影響因素(P均0.05),且MAGE為獨(dú)立危險(xiǎn)因素(OR=3.129,95%CI為1.007~7.216)。結(jié)論發(fā)生冠狀動(dòng)脈狹窄的T2DM患者血糖波動(dòng)幅度更高,MAGE是T2DM患者發(fā)生冠狀動(dòng)脈狹窄的獨(dú)立危險(xiǎn)因素。
[Abstract]:Objective to investigate the relationship between chronic blood glucose fluctuation and coronary artery stenosis in patients with type 2 diabetes mellitus (T2DM) and to provide evidence for the prevention and treatment of coronary heart disease in patients with T2DM. Methods 153 patients with T2DM underwent coronary angiography due to chest pain were divided into observation group (92 cases with coronary artery stenosis) and control group (61 cases without coronary artery stenosis) according to the results of coronary angiography. Fasting venous blood (4 mL) was taken from the two groups, and fasting blood glucose (FBGG) and HbA1c were measured. The dynamic blood glucose monitoring system (CGMS) was used to track and monitor blood glucose for 72 hours. The fluctuation indexes of blood glucose were recorded, including the fluctuation range of intraday mean blood glucose, the average absolute difference between day and day, and the fluctuation range of postprandial blood glucose. Coronary angiography was performed in both groups, and Gensini integration was used to evaluate the degree of coronary artery stenosis. Spearman method was used to analyze the correlation between Gensini integral and clinical data in observation group, and Logistic regression method was used to analyze the influencing factors of Gensini score in observation group. Results the PPGE levels of HbA1cCMAGEG in the observation group were higher than those in the control group (P < 0.05). The Gensini score in the observation group was higher than that in the control group (P 0.01). Gensini scores were positively correlated with age HbA1CMAGE and PPGE in the observation group by 0.05).Logistic regression analysis. The results showed that age, HB A1c and MAGE were the influential factors of Gensini score in the observation group (P < 0.05), and MAGE was an independent risk factor, the CI was 1.007 and 7.2166.In the observation group, HbA1c and MAGE were the independent risk factors. Conclusion the range of blood glucose fluctuation in T2DM patients with coronary artery stenosis is higher. Mage is an independent risk factor for coronary artery stenosis in T2DM patients.
【作者單位】： 天津市津南區(qū)咸水沽醫(yī)院;天津市寧河區(qū)醫(yī)院;
【基金】：天津市衛(wèi)生局醫(yī)藥衛(wèi)生科技項(xiàng)目(2016KZ78)
【分類(lèi)號(hào)】：R541.4;R587.2

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