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目的探讨糖尿病微血管病变与糖尿病病程及糖化血红蛋白(HbA1c)控制水平之间的关系。方法根据糖尿病病程将340例2型糖尿病患者分为4组:初发组(90例,<1年)、1~9年组(94例)、10~19年组(86例)及≥20年组(70例);以HbA1c是否达标(HbA1c<7%为血糖控制达标,HbA1c≥7%为血糖未达标)分为2组,即达标组(112例)和未达标组(215例)。记录各组患者的基本资料(性别、年龄、BMI、SBP、DBP),肾功能[尿酸(UA)、肌酐(Cr)、尿素氮(BUN)],血脂[胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]及HbAlc水平变化,观察不同病程及不同HbAlc水平的2型糖尿病患者糖尿病周围神经病变(DNP)及糖尿病视网膜病变(DR)的发生情况,分析糖尿病微血管病变与糖尿病病程、HbAlc之间的关系。结果 4组DBP、HbA1c、UA、TG、TC、HDL-C、LDL-C等指标比较差异无统计学意义(P>0.05);BMI、SBP、Cr、BUN等比较差异有统计学意义(均P<0.05)。初发组、1~9年组、10~19年组及≥20年组的DNP发生率分别为34.4%、45.7%、51.2%及70.0%(χ2=20.539,P<0.01),DR发生率分别为5.6%、7.8%、27.9%及38.6%(χ2=41.319,P<0.01)。达标组DR发生率明显低于未达标组(χ2=8.655,P<0.05),DNP发生率比较差异无统计学意义(χ2=1.172,P>0.05)。结论 2型糖尿病患者随着病程延长,DNP及DR的发生率呈显著上升趋势;良好的血糖控制可预防DR的进展,而DNP的发生率无明显下降。
Objective To investigate the relationship between diabetic microangiopathy and the course of diabetes and the control of glycosylated hemoglobin (HbA1c). Methods According to the duration of diabetes, 340 patients with type 2 diabetes were divided into 4 groups: initial treatment group (90 cases, <1 year), 1-9 years group (94 cases), 10-19 years group (86 cases) (HbA1c <7%, HbA1c≥7%, HbA1c≥7%, HbA1c≥7%, respectively) were divided into two groups: the standard group (112 cases) and the non-standard group (215 cases) . The basic data (sex, age, BMI, SBP, DBP), renal function (UA, creatinine, BUN), blood lipid [cholesterol, triglyceride TG, HDL-C, LDL-C) and HbAlc levels in diabetic patients with type 2 diabetes mellitus (T2DM) and diabetic nephropathy The incidence of diabetic retinopathy (DR), analysis of diabetic microangiopathy and diabetes duration, the relationship between HbAlc. Results There was no significant difference in DBP, HbA1c, UA, TG, TC, HDL-C and LDL-C among the four groups (P> 0.05) P <0.05). The incidence of DNP in the primary group, 1-9 years group, 10-19 years group and ≥20 years group were 34.4%, 45.7%, 51.2% and 70.0% respectively (χ2 = 20.539, P <0.01) 5.6%, 7.8%, 27.9% and 38.6% respectively (χ2 = 41.319, P <0.01). The incidence of DR in the standard group was significantly lower than that in the non-standard group (χ2 = 8.655, P <0.05). The incidence of DNP was not significantly different (χ2 = 1.172, P> 0.05). Conclusions The incidence of DNP and DR in patients with type 2 diabetes mellitus (T2DM) increases significantly with the prolongation of duration. Good glycemic control can prevent the progression of DR, while the incidence of DNP does not decrease significantly.