2型糖尿病患者糖化血红蛋白与血液流变学相关性分析

发布时间：2018-05-06 02:19

本文选题：2型糖尿病 + 糖化血红蛋白　；参考：《青海大学》2017年硕士论文

【摘要】：目的:本研究通过对2型糖尿病患者不同Hb A1c水平与血液流变学指标之间的研究探讨,旨在对2型糖尿病并发症的预防及早期诊断和治疗提供参考价值。方法:本研究随机抽取2015年1月至2016年11月期间在青海大学附属医院住院的2型糖尿病患者200例,其中男性患者151例,女性患者49例。所有研究对象均符合1999年WHO糖尿病诊断分型标准。排除标准符合入选前1个月有服用抗血小板聚集、抗凝药物应用史、入选前有服用皮质类固醇药物史、高原红细胞增多症、血液系统疾病、严重肝、肾功能不全、结缔组织病、免疫系统疾病、肿瘤患者、感染性疾病。所抽取的研究对象按糖化血红蛋白水平分A、B、C三组,A组31例:Hb A1c7%,血糖控制良好;B组71例:Hb A1c为7%-9%,血糖控制一般;C组98例:Hb A1c9%,血糖控制较差。统计学处理:所有数据均采用SPSS21.0统计软件处理,计量资料符合正态分布的以均数±标准差((?)±s)表示,多组均数之间比较采用单因素方差分析,两两比较采用LSD检验法,全血粘度的影响因素采用多元线性回归分析。计数资料采用x2检验。检验水准α=0.05。结果:1.本研究结果显示2型糖尿病患者不同Hb A1c组的一般临床资料比较,对于年龄、性别、BMI、RBC、HCT、Hb、TCH、TG、FIB、ESR水平,三组比较均无统计学差异(P0.05);对于AIB、TP、FBG、PBG水平,三组比较均有显著差异(P0.05);2.2型糖尿病患者不同Hb A1c组血液流变学指标比较显示:全血低切、中切、高切粘度水平均随Hb A1c水平的升高而升高。3.2型糖尿病患者不同Hb A1c组在血浆粘度水平比较,B组与C组的患者有统计学差异(P0.05),而A组与B组、C组均无统计学差异(P0.05),即随着Hb A1c的升高,血浆粘度值呈下降趋势。4.2型糖尿病患者全血低切、高切还原粘度及全血低切、高切相对粘度均随Hb A1c的升高而升高。5.患者2型糖尿病的男性与女性在血液流变学水平比较显示:两者在全血低切粘度5(1/s)、中切粘度、血浆粘度及血沉方程K值存在统计学差异。6.2型糖尿病患者全血低切粘度的影响因素是Hb A1c和RBC;全血高切粘度的影响因素是Hb A1c、RBC和TP;全血低切还原粘度的影响因素是Hb A1c、HCT、RBC变形指数;全血高切还原粘度的影响因素是Hb A1c、HCT、BUN、RBC变形指数;全血低切及高切相对粘度的影响因素是Hb A1c、RBC、RBC刚性指数。结论:1.随着Hb A1c的升高,2型糖尿病患者的血液流变学发生了明显的改变:在低、中、高切变率下的全血粘度均随着Hb A1c的升高而升高,其全血相对粘度及还原粘度也相应升高;而血浆粘度随着Hb A1c的升高呈下降趋势。2.2型糖尿病患者的全血低切粘度主要受Hb A1c和RBC的影响;而全血高切粘度主要受Hb A1c、RBC和TP的影响;全血低切及高切相对粘度均受Hb A1c、RBC、RBC刚性指数的影响。全血低切还原粘度主要受Hb A1c、HCT、RBC变形指数的影响;而全血高切还原粘度除此之外还受BUN值的影响。3.患有2型糖尿病的男性与女性在血低切粘度5(1/s)、中切粘度、血浆粘度及血沉方程K值均存在差异。4.随着Hb A1c的升高,2型糖尿病患者的RBC物理特性未发生改变。
[Abstract]:Objective: the purpose of this study was to provide reference value for the prevention and early diagnosis and treatment of type 2 diabetes complications through the study of different Hb A1c levels and hemorheological indexes in type 2 diabetes. Methods: This study randomly selected type 2 diabetes in Affiliated Hospital of Qinghai University from January 2015 to November 2016. There were 200 cases of disease, including 151 male and 49 female patients. All the subjects were in accordance with the standard of WHO diabetes diagnosis in 1999. The exclusion criteria were in accordance with the antiplatelet aggregation, the history of anticoagulant drug use in the first 1 months of admission, the history of corticosteroids, high altitude polycythemia, hematological diseases, and severe disease before admission. Heavy liver, renal insufficiency, connective tissue disease, immune system disease, tumor patients, infectious diseases. The subjects were divided into A, B, C three groups, 31 cases in group A, Hb A1c7%, good control of blood sugar, 71 cases in group B, Hb A1c 7%-9%, blood glucose control general, C group 98 cases, poor blood glucose control. Statistical treatment: statistics processing: statistics processing: statistics processing: statistics processing: statistics processing: statistics processing: statistics processing: statistics processing: statistics processing: all numbers: all numbers According to all the SPSS21.0 statistical software, the measurement data accords with the normal distribution of normal distribution with mean mean deviation ((?) + s). The comparison of the multiple groups is compared with the single factor analysis of variance. The 22 comparison adopts the LSD test and the factors of the whole blood viscosity are analyzed by multiple linear regression analysis. The count data are tested by x2 test. The level of alpha =0.05. junction is tested. Results: 1. the results of the 1. study showed that there were no significant differences in age, sex, BMI, RBC, HCT, Hb, TCH, TG, FIB, ESR levels between the three groups, and there were no significant differences between the three groups (P0.05), and there were significant differences between the three groups in the three groups. Compared with the Hb A1c level, the blood viscosity level of the different Hb A1c groups in the patients with.3.2 type diabetes was higher than that in the B group and the C group (P0.05), but there was no statistical difference between the A group and the B group and the C group (P0.05). The patients with type.4.2 diabetes had low total blood cut, high shear viscosity and low blood cut, and high shear relative viscosity increased with the increase of Hb A1c. The blood rheology level of the men and women of type 2 diabetes in.5. patients showed that there were 5 (1/s), medium shear viscosity, plasma viscosity and K value of erythrocyte sedimentation equation in the whole blood. The factors affecting low viscosity of whole blood in patients with type.6.2 diabetes are Hb A1c and RBC; the factors affecting the high shear viscosity of whole blood are Hb A1c, RBC and TP, and the factors affecting low reduction viscosity of whole blood are Hb A1c, HCT, and RBC deformable index. The influence factors of viscosity are Hb A1c, RBC, and RBC rigidity index. Conclusion: 1. with the increase of Hb A1c, the blood rheology of type 2 diabetic patients changed obviously: the whole blood viscosity at low, middle and high shear rates increased with the increase of Hb A1c, and the relative viscosity and reducing viscosity of the whole blood increased correspondingly, while the plasma viscosity was with Hb A1c. The low shear viscosity of whole blood was mainly influenced by Hb A1c and RBC, while the whole blood viscosity was mainly influenced by Hb A1c, RBC and TP, and the low shear and high shear viscosity of whole blood were affected by Hb A1c, RBC, and RBC rigid index. In addition, the high reduced viscosity of whole blood was also affected by the BUN value. The difference in blood viscosity 5 (1/s), medium tangent viscosity, plasma viscosity and erythrocyte sedimentation rate equation of.3. in men and women with type 2 diabetes was different.4. with the increase of Hb A1c, and the physical specificity of RBC in type 2 diabetics did not change.

【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.1

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