糖尿病性眼肌瘫痪患者血糖、糖化血红蛋白、血脂水平和血液流变学的变化及其关系

Changes and their relationships of blood glucose,glycosylated hemoglobin 1c,plasma lipid level and haemorheology in patient with diabetic ocular muscles palsy

目的探讨糖尿病性眼肌瘫痪患者血糖、糖化血红蛋白(HbA1c)和血液流变学、血脂水平的变化及其关系。方法对36例糖尿病性眼肌瘫痪患者(糖尿病组)与36名健康对照者(正常对照组)进行血HbA1c、空腹血糖(FBG)和餐后2 h血糖(2h-PG)、血液流变学、血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)检测;并进行相关性分析。结果糖尿病组红细胞变形指数与血HDL水平显著低于正常对照组(均P<0.01),HbA1c、FBG、2h-PG水平及其他血液流变学指标和血脂显著高于正常对照组(均P<0.01)。糖尿病组血糖、HbA1c水平与全血黏度(低切、中切、高切)、血浆黏度呈正相关(r=0.42～0.86;均P<0.05),与红细胞变形指数呈负相关(r=-0.53、-0.79;均P<0.01)。结论糖尿病性眼肌瘫痪患者血糖、HbA1c、血脂水平增高,血液流变学异常;高血糖是其血脂和血液流变学异常的重要因素。

Objective To inv.estigate the changes and their relationships of blood＇ glucose, glycosylated hemoglobin lc （HbAlc）, plasma lipid level and haemorheology in patient with diabetic ocular muscles palsy. Methods HbA1 c, fasting blood glucose（FBG） and postprandial 2 h blood glucose （2h-PG） , haemorheology, total cholesterol （TC） , triglycerides （TG） , high-density lipoprotein （HDL） , and low-density lipoprotein （LDL） were detected in 36 patients with diabetic ocular muscles palsy （ diabetic group ） and 36 healthy controls normal control group, and the correlation of those indexes were analyzed. Results The levels of plasma RBC deformation index and HDL in diabetic group were significantly lower than normal control group （ all P 〈0. 01 ）. The levels of HbAlc ,FBG and 2 h-PG, the other haemorheology indexes and plasma lipid level in diabetic group were significantly higher than normal control group （all P 〈 0.01 ）. The levels of blood glucose and HbAlc in diabetic,group were positively correlated with whole blood viscosity （ high shear, middle shear, low shear） and plasma viscosity （ r = 0. 42 - 0.86 ; all P 〈0. 05 ）, and negatively correlated with the levels of plasma RBC deformation index（ r = - 0. 53, - 0.79, all P 〈0. 01 ）. Conclusions The levels of blood glucose, HbAlc and plasma lipid in patients with diabetic ocular muscles palsy are significant higher, and haemorheology is abnormal. Hyperglycosemia is the important factor of abnormal plasma lipid level arid haemorheology.