糖化血红蛋白首次达标时间切点的研究

Study on the cut-off point of the first standard time of glycosylated hem-oglobin

目的总结初次强化控制血糖的糖尿病患者的糖化血红蛋白首次控制达标所需的强化治疗时间。方法收集2017年9月~2019年12月在嵊州市人民医院(以下简称“本院”)内分泌科首次住院强化控制血糖且自开始强化控制血糖之日算起120 d内在本院复诊的患者,根据糖尿病诊治指南,糖化血红蛋白<7%定义为血糖控制达标。结果自开始强化控制血糖之日算起120 d内复诊的患者共119例,男80例,女39例;年龄19~85岁,平均(50.7±14.3)岁;首次复诊间隔时间为(70.8±25.7)d。首次血糖控制达标时间出现在开始强化控制血糖的第45天;糖化血红蛋白控制在正常范围的时间切点发生在首次强化控制血糖的第59天。结论糖化血红蛋白控制达标的最早复诊时间切点为自强化控制血糖之日算起的第45天;糖化血红蛋白完全控制在正常范围的最早复诊时间切点为强化控制血糖之日算起的第60天,自强化控制血糖之日算起的45天之内复查糖化血红蛋白并无临床意义。

Objective To explore the intensive treatment time for control of glycosylated hemoglobin in diabetic patients with intensive blood glucose control for the first time.Methods Patients were collected who were hospitalized for the first time in the Department of Endocrinology of Shengzhou People's Hospital(hereinafter referred to as"our hospital")for intensive blood glucose control from September 2017 to December 2019,and returned to our hospital within 120 days from the date of intensive blood glucose control.According to the diabetes diagnosis and treatment guidelines,glycosylated hemoglobin<7%was considered as blood glucose control meeting the standard.Results A total of 119 patients revisited within 120 days from the date of intensive blood glucose control,including 80 males and 39 females.The age ranged from 19 to 85 years old,with an average age of(50.7±14.3)years old.The interval time of first follow-up visit was(70.8±25.7)days.The first time to reach the blood glucose standard occurred on the forty-fifth day after the initiation of intensive control of blood glucose.The cut-off point for the control of glycosylated hemoglobin within the normal range occurred on the fifty-ninth day of the first intensive blood glucose control.Conclusion The cut-off point of the earliest revisit for glycosylated hemoglobin control meeting the standard is the forty-fifth day from the initiation of intensive blood glucose control.The earliest cut-off point for revisit when the glycosylated hemoglobin is fully controlled within the normal range is the sixtieth day from the initiation of intensive control of blood glucose.There is no clinical significance when rechecking glycosylated hemoglobin within 45 days from the initiation of intensive blood glucose control.