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目的:探讨2型糖尿病(T2DM)患者血糖波动与糖尿病视网膜病变(DR)的关系。方法:T2DM患者进行眼底照相或眼底荧光造影,根据DR程度分为糖尿病背景期视网膜病变(BDR)组、糖尿病增殖期视网膜病变(PDR)组、无视网膜病变(NDR)组,记录年龄、性别、体重指数、病程、测量血压、糖化血红蛋白、空腹胰岛素、餐后2 h胰岛素、空腹C-肽、餐后2 h C-肽、血脂指标。选取三组中上述基线指标具有可比性的病例共106例(BDR组38例,PDR组35例,NDR组33例)纳入观察。采用动态血糖监测系统(CGMS)连续监测患者血糖72 h。结果:各组间平均血糖水平(MBG)、血糖标准差(SDBG)、平均血糖波动幅度(MAGE)及血糖波动最大幅度(LAGE)相比较有统计学差异(P<0.05)。Spearman相关分析显示,糖尿病视网膜病变(DR)与MBG、SDBG、MAGE及LAGE呈正相关(P<0.05)。校正MBG后,糖尿病视网膜病变(DR)与SDBG、MAGE及LAGE的相关系数分别为0.297、0.396、0.284(P<0.01)。结论:血糖波动与糖尿病视网膜病变(DR)的发生发展有关,应尽早干预。
Objective: To investigate the relationship between blood glucose fluctuation and diabetic retinopathy (DR) in type 2 diabetes mellitus (T2DM). Methods: Fundus or fundus fluorescein angiography was performed in patients with T2DM. According to the degree of DR, they were divided into two groups: diabetic retinopathy (BDR) group, diabetic proliferative diabetic retinopathy (PDR) group and no retinopathy (NDR) group. The age, sex, Body mass index, course of disease, blood pressure measurement, glycosylated hemoglobin, fasting insulin, 2 h postprandial insulin, fasting C-peptide, postprandial 2 h C-peptide, A total of 106 cases (38 cases in the BDR group, 35 cases in the PDR group and 33 cases in the NDR group) were selected for comparison among the above three groups. Continuous glucose monitoring (CGMS) was used to monitor blood glucose for 72 hours. Results: The average blood glucose level (MBG), standard deviation of blood glucose (SDBG), mean blood glucose level (MAGE) and maximum blood glucose level (LAGE) were significantly different among all groups (P <0.05). Spearman correlation analysis showed that diabetic retinopathy (DR) was positively correlated with MBG, SDBG, MAGE and LAGE (P <0.05). Correlation MBD, diabetic retinopathy (DR) and SDBG, MAGE and LAGE correlation coefficient were 0.297,0.396,0.284 (P <0.01). Conclusion: The fluctuation of blood glucose is related to the occurrence and development of diabetic retinopathy (DR), and should be interfered as soon as possible.