血糖波动在评估2型糖尿病微血管并发症中的临床价值

Clinical value of glucose fluctuation in evaluating microvascular complications of type 2 diabetes

目的探究血糖变化在评估2型糖尿病微血管并发症中的临床价值。方法选取2018年9月-2019年9月郑州市某医院诊治的96例2型糖尿病患者为研究对象,根据患者平均血糖波动幅度(MAGE)是否异常将其分为异常组(n=43)和正常组(n=53)。分析MAGE与微血管并发症发生之间的关系。结果异常组患者冠心病、糖尿病足、糖尿病肾病、糖尿病视网膜病变以及高血压的发生率均显著高于正常组,差异均有统计学意义(P<0.05)。2组患者的肾小球滤过率(eGFR)分布构成比较,差异有统计学意义(P<0.05)。2组患者颞侧上动、静脉直径比较,差异均无统计学意义(P>0.05);但异常组患者视网膜动静脉比值(AVR)显著低于正常组,差异有统计学意义(P<0.05)。Logistic多元回归分析表明,尿微量蛋白、高血压、eGFR、AVR是糖尿病患者MAGE异常的独立危险因素(P<0.05)。结论MAGE与2型糖尿病患者微血管并发症的发生密切相关,可在一定程度上作为评估2型糖尿病患者发生视网膜病变和肾病的重要指标。

Objective To investigate the clinical value of glucose fluctuation in the evaluation of microvascular complications of type 2 diabetes.Methods Ninety-six patients with type 2 diabetes treated in a hospital in Zhengzhou from September 2018 to September 2019 were divided into abnormal group(n=43)and normal group(n=53)according to the abnormal range of mean amplitude of glycemic excursions(MAGE).The relationship between MAGE and microvascular complications was analyzed.Results The incidences of coronary heart disease,diabetic foot,diabetic nephropathy,diabetic retinopathy and hypertension in the abnormal group were significantly higher than those in the normal group(P<0.05).There were significant differences in the distribution of eGFR within and between the two groups(P<0.05).There was no significant difference in the diameter of superior temporal artery and superior temporal vein between the two groups(P>0.05),but the AVR in the abnormal group was significantly lower than that in the normal group(P<0.05).Logistic multiple regression analysis showed that microalbuminuria,hypertension,EGFR and AVR were independent risk factors for abnormal fluctuation of MAGE in patients with diabetes mellitus(P<0.05).Conclusion MAGE is closely related to the occurrence of microvascular complications in patients with type 2 diabetes.To some extent,MAGE can be used as an important index to evaluate the incidence of retinopathy and nephropathy in patients with type 2 diabetes.