经皮氧分压与糖脂代谢及2型糖尿病并发症的关系分析

Analysis of relationships between transcutaneous pressure of oxygen and blood glucose control,diabetic complications

目的：探讨经皮氧分压与2型糖尿病患者血糖、血脂以及并发症的关系。方法：回顾性分析262例2型糖尿病患者临床资料,以经皮氧分压≥40 mm Hg、20~40 mm Hg及≤20 mm Hg水平将患者分为3组,分析比较3组间Hb A1c、低密度脂蛋白、肌酐等指标,χ~2检验分析比较经皮氧分压与糖尿病并发症的关系,并进一步行Pearson相关性分析比较经皮氧分压与各指标间关系。结果：经皮氧分压≥40 mm Hg组Hb A1 c水平显著低于其他两组,差异有统计学意义（P〈0.001）,≤20 mm Hg组低密度脂蛋白显著高于其他两组（P〈0.05）;χ~2检验发现3组间糖尿病并发症发生率差异无统计学意义;相关性分析发现经皮氧分压与Hb A1c及病程呈负相关关系（r=-0.206,P〈0.001;r=-0.131,P〈0.05）;经皮氧分压与B超对照分析发现经皮氧分压≥40 mm Hg组有6例患者存在血管狭窄,但经皮氧分压〈40 mm Hg者仅7例存在血管狭窄。结论：（1）经皮氧分压与血糖关系更为密切;（2）经皮氧分压和大血管狭窄之间并不平行,提示经皮氧分压作为微循环功能检查可能是血管、神经综合水平的反应。

Objective： To explore the relationships between transcutaneous pressure of oxygen（ Tc PO_2） and blood glucose,lipid,diabetic complications. Methods： It was a retrospective study which analyzed clinical data of 262 patients with type 2 diabetes. Three groups were set on the basis of the level of Tc PO_2 with ≥ 40 mm Hg,20-40 mm Hg or ≤20 mm Hg. Hb A1 c,low density lipoprotein and serum creatinine of three groups were compared. The relationships between Tc PO_2 and diabetic complications were analyzed through χ~2test. The correlations between Tc PO_2 and diabetic indexes were analyzed through the Pearson correlation analysis. Results： Hb A1 c of Tc PO_2≥40 mm Hg group was significantly lower than that of the other two groups（ P 0. 01）. Low density lipoprotein of Tc PO_2≤20 mm Hg group was higher than that of other groups（ P 0. 05）,however,no statistically significant difference was found between Tc PO_2 and diabetic complications via χ~2test. Negative correlation was found between Tc PO_2 and Hb A1 c,duration via the Pearson correlation analysis（ r =- 0. 206,P 0. 001; r =- 0. 131,P 0. 05）. Six patients in Tc PO_2≥40 mm Hg group existed vascular stenosis and only seven patients in Tc PO_2 40 mm Hg groups had stenosis of vessel. Conclusion：（ 1） Tc PO_2 has more closer relationship with blood glucose;（ 2） Tc PO_2 is not parallel with vascular stenosis,which suggests the Tc PO_2 may be response of mixed levels of vessel and nerve.