2型糖尿病患者血糖波动与下肢血管病变的相关性

目的探讨血糖波动与2型糖尿病（T：DM）下肢血管病变（PVD）严重程度的相关性。方法2型糖尿病合并下肢血管病变患者98例，根据踝肱指数（ABI），以0．7〈ABI〈0．9、0．5〈ABI〈0．7、ABI≤0．5分为轻、中、重度组。所有患者均采用动态血糖检测系统（CGMS）连续监测患者血糖72h，计算各血糖波动参数，包括平均血糖水平（MBG）、全天血糖水平标准差（SDBG）、日内平均血糖波动幅度（MAGE）和血糖波动最大幅度（LAGE），并记录患者年龄、性别、病程、体重指数（BMI）、血压、糖化血红蛋白（HbAlc）及一般生化指标。结果各组间MBG．SDBG、MAGE的差异比较有统计学意义，随着下肢血管病变严重程度的增加而增加（P〈0．05），下肢血管病变严重程度分别与MBG、MAGE呈正相关（B=0．238、0．187，P〈0．05）。结论血糖波动与糖尿病下肢血管病变程度关系密切，应重视平稳降糖。

Objective To investigate the relationship between blood glucose fluctuation and peripheral vascular disease in type 2 diabetic patients. Methods 98 hospitalized patients with T2DM having peripheral vascular disease were divided into mild, moderate and severe groups according to ankle brachial index （ 0.7〈ABI〈0.9, 0.5〈ABI≤0.7, ABI≤0.5 ） . The fluctuating feature of 72 hours blood glucose of all the patients were recorded by continuous glucose monitoring system （ CGMS ） , then CGMS parameters including mean blood glucose （ GBG ） , standard deviation of blood glucose （ SDBG ） , mean amplitude of glycemic excursions （ MAGE ） and maximal amlpitude of glycemic excursions （ LAGE ） were calculated and the age, gender, disease duration, BMI, blood pressure, HbA1 c and biochemical indicators were also recorded. Results There were significant difference in MBG, SDBG, MAGE among groups and MBG, SDBG, MAGE increases with growing severity of the vascular disease （ P〈0.05 ） . The severity of the vascular disease was positively correlated with MBG and MAGE （ I~ =0.238, 0.187, P〈0.05 ） . Conclusion Blood glucose fluctuation is closely associated with the severity of peripheral vascular disease, so clinical protocols should be aimed at steadily reducing glucose level.