糖化血红蛋白达标的2型糖尿病患者血糖波动对糖尿病肾病尿微量白蛋白的影响

Influence of Blood Glucose Fluctuations on Urinary Microalbumin in Type 2 Diabetic Patients with Well-c Controlled Glycosylated Hemoglobin

目的探讨糖化血红蛋白控制较理想的2型糖尿病患者血糖波动对微量白蛋白尿的影响。方法对75例糖化血红蛋白<7,且血压≤140/90mm Hg的2型糖尿病患者进行连续72 h动态血糖监测,血糖波动系数反应血糖波动,测定24 h尿白蛋白定量,同时观察血压、空腹血糖、血脂、糖尿病病程、体重指数等。结果 (1)2型糖尿病尿蛋白正常组、尿微量白蛋白组、大量白蛋白尿组的患者血糖波动系数分别为(1.3±0.7)、(2.7±1.5)、(3.5±2.1)。(2)比较糖尿病病程,2型糖尿病尿蛋白正常组、尿微量白蛋白组、大量白蛋白尿组分别为(4.7±1.6)年、(5.1±2.1)年、(7.6±1.8)年。结论糖化血红蛋白控制较理想的2型糖尿病患者,在血压正常的情况下,血糖波动及糖尿病病程是糖尿病肾病的重要危险因素,可促进糖尿病肾病的发生发展。

Objective To disscuss the influence of blood glucose fluctuations on urinary microalbumin in type 2 diabetic patients with well-controlled glycosylated hemoglobin.Methods Choosing 75 cases of patients whose glycosylated hemoglobin 7,blood pleasure≤140/90 mm Hg and monitored blood sugar in 72 hours,and tested the mount of urinary microalbumin in 24 hours,at the mean time,measured blood pressure,fasting blood glucose,blood lipids,diabetes duration,body mass index and so on.Results（1） The coefficient of fluctuation of blood sugar of patients of normal group,Microalbumin group,loads of Microalbumin group are（1.3±0.7）,（2.7±1.5）,（3.5±2.1）.（2） Comparing diabetes duration,normal group,Microalbumin group,loads of Microalbumin group are（4.7±1.6）,（5.1±2.1）,（7.6±1.8） years.Conclusion Type 2 diabetic patients with well-controlled glycosylated hemoglobin,in the situation of normal blood pressure,blood glucose fluctuations and diabetes duration are important dangerous factors of diabetic nephropathy,it can promote the development of diabetic nephropathy.