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监控糖尿病视网膜病变餐后血糖临床意义 被引量:2

The clinical significance of monitoring postprandial blood glucose for diabetic retinopathy
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摘要 目的探讨糖尿病视网膜病(diabetic retimopathy,DR)变在空腹血糖有效控制下,餐后血糖失控对视网膜病变进程的影响。方法临床病例分析研究。对2008年1月至2012年1月在河南省立眼科医院选择Ⅱ型糖尿病实施过胰岛素强化治疗的糖尿病视网膜病变患者172例,连续监测空腹及餐后血糖,以其差值分级确认日间血糖波动度并统计分析与糖尿病视网膜病变程度的相关性。同时对高波动度实施干预治疗的随访结果进行比较性研究。结果(1)总体晨空腹血糖4.6-7.8mmol/L,餐后2h血糖8-21.5mmol/L,其中90%以上餐后血糖峰值〉11mmol/L。(2)日间血糖波动度,49.4%的病例波动度〉7mmol/L,其中21.5%〉10mmol/L。(3)增生性DR中60%的患者日间血糖波动度〉7mmol/L,较非增生性DR明显增多。(4)长期随诊显示严格调控餐后血糖组患者糖化血红蛋白达标率为67.39%,而未调控组达标率仅为7.69%。结论餐后血糖失控易引发日间血糖高波动,昼间持续性高血糖状态是糖尿病视网膜病变加剧恶化的重要因素。 Objective To investigate the influence for the progress of diabetic retinopathy in which postprandial blood glucose (PBS) out of control, while fasting blood glucose (FBS) under the effective control. Methods Selected 172 cases of diabetes II patients with diabetic retinopathy who implementation of intensive insulin therapy, continuous monitoring of fasting and postprandial glu- cose. Based on the difference between fasting and postprandial glucose in a day determined the day- time blood glucose fluctuations levels. Analyzed it's relation with the severity degree of diabetic reti- nopathy. At the same time intervention treatment were taken in the high daytime blood glucose fluc- tuations levels group. The follow-up results were compared studied. Resttlts (1) Overall the fasting glucose were 4.6-7.8 retool/L, 2 hours postprandial blood glucose were 8 to 21.5 mmol/L. More than 90% of the postprandial blood glucose was 〉11 mmol/L. The highest data appeared after lunch. (2) Postprandial hyperglycemia led to high daytime blood sugar volatility degrees, 49.4% of the cases daytime blood glucose fluctuated 〉7 mmol/L, 21.5% of which 〉10 mmol/L. (3) In prolifer- ative DR patients, the daytime blood glucose fluctuations degrees 〉7 mmol/L occupied 60%, signifi- cantly increased compared with non-proliferative DR. (4) During the long-term follow-up study showed that in the strict regulation of postprandial hyperglycemia group, 67.39% of patients with gly- cosylated hemoglobin decreased to ideal level, while in un-control group, that was only 7.69%. Condosions Out of control of postprandial glucose may lead to daytime high blood sugar fluctua- tions, and persistent hyperglycemia states in daytime are the important factors for aggravated diabetic retinopathy.
出处 《中国实用眼科杂志》 CSCD 北大核心 2013年第11期1413-1415,共3页 Chinese Journal of Practical Ophthalmology
关键词 糖尿病视网膜病变 餐后血糖 糖化血红蛋白 Diabetic retinopathy Postprandial blood glucose Glycosylated hemoglobin
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