长期血液透析和腹膜透析糖尿病患者糖代谢状况的临床分析

Clinical analysis on the glucose metabolism status of patients with diabetes for Long-term hemodialysis and peritoneal dialysis

目的分析长期血液透析和腹膜透析糖尿病患者的糖代谢状况。方法选取长期血液透析和腹膜透析的糖尿病患者104例,其中血液透析32例,腹膜透析72例。按透析时间分为≤3年和>3年组,比较血透组和腹透组患者在首次透析前血糖、胰岛素用量、年龄和糖尿病时间,及≤3年组和>3年组血透和腹透患者目前的血糖、胰岛素用量、血浆白蛋白、胆固醇和甘油三酯含量的差异。结果血透组和腹透组进入透析前患者的年龄、糖尿病病程、血糖和胰岛素用量差异无统计学意义(P>0.05)。≤3年组,血透组和腹透组血糖差异无统计学意义(P>0.05),而腹透组使用胰岛素量明显高于血透组(P<0.05),胆固醇和甘油三酯含量也高于血透组(P<0.05),血浆白蛋白差异无统计学意义(P>0.05)。>3年组,腹透组血糖和胰岛素用量明显高于血透组(P<0.05),胆固醇和甘油三酯含量也高于血透组(P<0.05),而血浆白蛋白明显低于血透组(P<0.05)。结论长期腹膜透析的糖尿病患者血糖水平高于血液透析,为控制血糖需增加胰岛素用量;长期血液透析的糖尿病患者血糖水平偏低,需逐渐减少或停用胰岛素。腹膜透析患者胆固醇和甘油三酯高于血液透析患者,白蛋白水平则低于血液透析患者。

Objective To analyze the sugar metabolism of patients with diabetes of long - term hemodialysis （HD） and perito- neal dialysis （PD）. Methods 104 cases patients with diabetes of hemodialysis and peritoneal dialysis were selected in this study. He- modialysis was in 32 cases and peritoneal dialysis was in72 cases, and the patients were divided into less than 3 years group and more than 3 years group. The blood glucose,insulin dosage, age, and time of diabetes before the first time in HD and PD ; the differences of the blood glucose,insulin, plasma albumin, cholesterol and triglyceride in HD and in PD of less than 3 years group;the differences of the blood glucose,insulin, plasma albumin, cholesterol and triglyceride in HD and in PD of more than 3 years group. Results The blood glu- cose,insulin dosage, age, and time of diabetes before the first time of HD and PD had no significant difference （ P 〉 0.05 ）. In less than 3 years group,the blood glucose had no significant difference （P 〉 0.05 ）, and insulin dosage of PD was higher than that of HD （P 〈 0.05 ）, cholesterol and triglyceride levels of PD were higher than that of HD （ P 〈 0.05 ）, plasma albumin had no significant difference （ P 〉 0.05 ）. In more than 3 years group, the blood sugar and insulin dosage of PD was higher than that of HD （ P 〈 0.05 ）, cholesterol and triglyeeride levels of HD were higher than that of HD （ P 〈 0.05 ） , while plasma albumin of PD was lower than that of HD （ P 〈 0.05 ）, Conclusion The blood sugar levels of PD of patients with diabetes is higher for a long time, need to increase the dosage of insu- lin to keep blood sugar under control, and the blood lipid level is higher than that of HD, albumin levels is lower than that of HD. The blood sugar of HD of patients with diabetes is low and the cholesterol and triglyceride is low.