动态血糖监测在2型糖尿病并发心绞痛患者中的应用

Application of dynamic monitoring of blood glucose in type 2 diabetes patients with angina pectoris

目的:探讨动态血糖监测系统(CGMS)在老年2型糖尿病并发心绞痛患者中的应用效果。方法:采用CGMS对30例空腹血糖≤8.0 mmo/L,餐后2 h血糖≤11.1 mmol/L,糖化血红蛋白≤7.5%的老年2型糖尿病因心绞痛发作入院的患者进行连续3 d的动态血糖监测,分析血糖动态变化结果。结果:30例患者中,发生无症状性低血糖18例(60%),血糖值1.7~3.8 mmol/L;发生有症状性低血糖6例(20%),血糖值1.7~3.8 mmol/L。在24例无症状和有症状性低血糖患者中,有20例(66.7%)患者低血糖发生于凌晨0:00-4:30。患者低血糖发生于中餐前10:00-11:30 7例(23.3%)。餐后2 h血糖>11.1 mmol/L 28例(93.3%),其中发生早餐后高血糖22例,血糖值(11.2~22.6)mmol/L;发生午餐后高血糖16例,血糖值(11.5~16.6)mmol/L;发生晚餐后高血糖11例,血糖值(11.4~17.5)mmol/L。结论:对于应用空腹血糖、餐后2 h血糖、糖化血红蛋白来判定血糖控制良好的老年2型糖尿病患者,反复发生心绞痛,需要通过全天多点血糖监测,了解任意时间的血糖情况,作为临床治疗方案调整的基础,达到精细化降糖目的,以避免低血糖诱发心绞痛。

Objective:To investigate the application effect of dynamic glucose monitoring system(CGMS) in elderly patients with type 2 diabetes mellitus complicated with angina pectoris.Methods:30 elderly patients of type 2 diabetes mellitus admitted to hos-pital due to the attack of angina pectoris,whom with fasting blood glucose≤8.0 mmo/L,postprandial 2 h blood glucose≤11.1 mmol/L,and glycosylated hemoglobin≤7.5%,and they were given dynamic blood sugar monitoring for 3 days by using CGMS,then we analyzed the results of changes dynamic of blood glucose.Results:Among those 30 patients,there were 18 cases(60%) occur-rence of asymptomatic hypoglycemia,with lood glucose value ranged 1.7~3.8 mmol/L;6 cases(20%) occurrence of symptomatic hypoglycemia with blood glucose value of 1.7~3.8 mmol/L.In those 24 patients with asymptomatic or symptomatic hypoglycemia, there were 20 cases(66.7% ) occurred hypoglycemia at 0:00-4:30 am.7 cases(23.3% ) occurred hypoglycemia at 10:00-11:30 am.28 cases(93.3%) with postprandial 2 h blood glucose＞11.1 mmol/L,in which there were 22 cases of high blood sugar occurred after breakfast,and their blood glucose level ranged(11.2~22.6) mmol/L;16 cases with hyperglycemia occurred after lunch,their blood glucose level ranged(11.5~16.6) mmol/L;11 cases of hyperglycemia occurred after dinner,the blood sugar value ranged(11.4~17.5) mmol/L.Conclusion:The elderly patients with type 2 diabetic who application of fasting blood glucose,post-prandial 2 h blood glucose and glycated hemoglobin to determine good glycemic control,needed monitoring of blood glucose with multi-points in a day if they recurrent angina pectoris,in order to acquaintance their blood glucose at any time,as the basis for ad-justment of clinical treatment plan,to achieve fine hypoglycemic objective,and avoid vital hypoglycemia induced angina pectoris.