强化降糖对2型糖尿病血管并发症的影响

Effects of intensive glucose control on angiopathy complication of patients with type 2 diabetes

目的:观察强化降糖治疗对2型糖尿病患者大血管和微血管并发症的影响。方法:选择具备大血管或微血管危险因素的55岁以上2型糖尿病患者61例,分为强化降糖组(n=33)和标准降糖组(n=28),相应给予降糖治疗,比较治疗后空腹血糖(FBG)、糖化血红蛋白(HbA1c)、晨尿白蛋白/肌酐比值(A/C)、血压和肌酐(Scr)的变化,对大血管并发症复合终点及微血管并发症复合终点进行评估。结果:治疗前后2组间差值相比,HbA1c、FBG、A/C、pSB、pDB和Scr差异有统计学意义(t分别为6.165、7.775、20.383、9.236、3.802和5.971,P均<0.001)。大血管终点事件:标准组4例,强化组0例,2组间相比差异有统计学意义(P=0.039);标准组死亡3例,强化组0例,差异无统计学意义(P=0.091)。2组均无严重低血糖发生。结论:强化降糖可降低微血管事件的发生。

Aim ： To observe the effects of intensive glucose control on macrovascular and microvascular complications of patients with type 2 diabetes. Methods：A total of 61 cases of patients with type 2 diabetes were chosen and divided into two groups randomly： group one received standard glucose control （ n = 28） and group two received intensive glucose con- trol （n = 33 ）. The observation indicators included HbAlc, BP, FBG, Scr, and A/C. The composite end points of macrovas- cular and mierovascular complications were recorded. Results：At the end of trial, there was significant difference on HbA1 c, FBG, A/C ,PsB ,PoB, and Scr changes between two groups （ t was 6. 165,7. 775,20. 383,9. 236,3. 802, and 5.971, P 〈 0. 001 ）. There was no significant difference in mortality between two groups （ 3 vs. 0,P = 0. 091 ） , and there was signifi- cant difference in myocardial infarction between two groups （ 4 vs. 0, P = 0. 039 ）. Conclusion ： Intensive glucose control could decrease microvascular complication of patients with type 2 diabetes.