不同血糖控制水平对T2DM患者血管病变的影响

Effects of different blood glucose levels on vascular lesions in T2DM Patients

目的探讨不同血糖控制水平与2型糖尿病患者大血管及微血管病变之间的关系。方法选取2015年6月至2016年8月于武汉市新洲区人民医院内分泌科住院并符合入组标准的126例2型糖尿病患者,平均年龄(57.20±8.66)岁,根据糖化血红蛋白(Hb A1c)水平将研究对象分为三组,Hb A1c≤8.0%为A组,共40例,平均年龄(59.58±8.56)岁;8%<Hb A1c<10%为B组,共42例,平均年龄(56.02±9.15)岁;Hb A1c≥10%为C组,共44例,平均年龄为(56.16±7.99)岁。测量所有患者身高、体重、BMI等基础资料,并检测溶血磷脂酸(LPa)、超敏C反应蛋白(hsCRP)等生化指标。比较各组患者的LPa、hs-CRP水平,并将Hb A1c与有关指标进行相关性分析。结果 LPa、hsCRP水平在A、B、C三组中逐渐升高[78.10(37.55,158.93)mg/L,119.90(64.73,268.03)mg/L,222.65(125.25,337.08)mg/L;0.87(0.26,2.25)mg/L,1.56(0.51,5.14)mg/L,4.41(1.85,7.65)mg/L]。三组患者的LPa、hs-CRP水平比较,差异均有统计学意义(P<0.01)。经Pearson相关性分析,Hb A1c与LPa、hs-CRP呈正相关(r=0.334,0.395,P<0.01)。结论糖化血红蛋白含量与2型糖尿病合并血管并发症的病情发展有密切关系,严格控制Hb A1c水平,能延缓T2DM合并血管并发症的发生、发展。

Objective To explore the relationship between the different grades of blood glucose and cardiovascular disease in patients with type 2 diabetes mellitus（T2 DM）. Methods A total of 126 patients with T2 DM who were treated in Wuhan Xinzhou District People＇s Hospital from June 2015 to August 2016,（57.20±8.66） years old in average,were divided into group A（HbA1c≤8.0%, 40 cases）, group B（8.0% HbA1c10%, 42 cases） and group C（HbA1c≥10%, 44 cases）. The basic indexes（height, weight, BMI）, and Lipoprotein a（LPa）, hypersensitive C-reactive protein（hsCRP） levels were detected and compared among the three groups. Pearson analysis was used to analyze the relationship between related parameters and HbA1c. Results The LPa, hs-CRP levels gradually increased in group A, B, C： 78.10（37.55, 158.93） mg/L, 119.90（64.73, 268.03） mg/L, 222.65（125.25, 337.08） mg/L for LPa; 0.87（0.26, 2.25） mg/L, 1.56（0.51, 5.14） mg/L, 4.41（1.85, 7.65） mg/L for hs-CRP. There were significant differences between the three groups（all P0.01）. There were significantly positive correlation between HbA1c and LPa（r=0.334, P0.001）, hs-CRP（r=0.395, P0.01）. Conclusion The development of T2 DM with cardiovascular complications is correlated with the levels of HbA1c, so the levels of HbA1c should be strictly controlled in order to delay the development of cardiovascular diseases.