2型糖尿病患者慢性血糖波动指标与冠状动脉狭窄程度的相关性分析

发布时间：2018-06-05 19:44

本文选题：型糖尿病 + 日内平均血糖波动幅度　；参考：《山东医药》2017年46期

【摘要】：目的探讨2型糖尿病(T2DM)患者慢性血糖波动指标与冠状动脉狭窄程度的关系,为T2DM患者冠心病的防治提供依据。方法选择因胸痛行冠状动脉造影的T2DM患者153例,根据冠状动脉造影结果分为观察组(合并冠状动脉狭窄)92例及对照组(不合并冠状动脉狭窄)61例。抽取两组空腹静脉血4 m L,检测空腹血糖(FBG)、糖化血红蛋白(Hb A1c)水平。应用动态血糖监测系统(CGMS)实施连续72 h的血糖跟踪监测,记录血糖波动指标包括日内平均血糖波动幅度(MAGE)、日间血糖的平均绝对差(MODD)、餐后血糖的波动幅度(PPGE)。对两组患者均行冠状动脉造影检查,采用Gensini积分法评价冠状动脉狭窄程度。采用Spearman法分析Gensini积分与观察组患者临床资料的相关性,采用Logistic回归法分析观察组患者Gensini积分的影响因素。结果观察组Hb A1c、MAGE、PPGE水平均高于对照组(P均0.05)。观察组Gensini积分高于对照组(P0.01)。观察组Gensini积分与年龄、Hb A1c、MAGE及PPGE均呈正相关(P均0.05)。Logistic回归分析示,年龄、Hb A1c及MAGE是观察组Gensini积分的影响因素(P均0.05),且MAGE为独立危险因素(OR=3.129,95%CI为1.007~7.216)。结论发生冠状动脉狭窄的T2DM患者血糖波动幅度更高,MAGE是T2DM患者发生冠状动脉狭窄的独立危险因素。
[Abstract]:Objective to investigate the relationship between chronic blood glucose fluctuation and coronary artery stenosis in patients with type 2 diabetes mellitus (T2DM) and to provide evidence for the prevention and treatment of coronary heart disease in patients with T2DM. Methods 153 patients with T2DM underwent coronary angiography due to chest pain were divided into observation group (92 cases with coronary artery stenosis) and control group (61 cases without coronary artery stenosis) according to the results of coronary angiography. Fasting venous blood (4 mL) was taken from the two groups, and fasting blood glucose (FBGG) and HbA1c were measured. The dynamic blood glucose monitoring system (CGMS) was used to track and monitor blood glucose for 72 hours. The fluctuation indexes of blood glucose were recorded, including the fluctuation range of intraday mean blood glucose, the average absolute difference between day and day, and the fluctuation range of postprandial blood glucose. Coronary angiography was performed in both groups, and Gensini integration was used to evaluate the degree of coronary artery stenosis. Spearman method was used to analyze the correlation between Gensini integral and clinical data in observation group, and Logistic regression method was used to analyze the influencing factors of Gensini score in observation group. Results the PPGE levels of HbA1cCMAGEG in the observation group were higher than those in the control group (P < 0.05). The Gensini score in the observation group was higher than that in the control group (P 0.01). Gensini scores were positively correlated with age HbA1CMAGE and PPGE in the observation group by 0.05).Logistic regression analysis. The results showed that age, HB A1c and MAGE were the influential factors of Gensini score in the observation group (P < 0.05), and MAGE was an independent risk factor, the CI was 1.007 and 7.2166.In the observation group, HbA1c and MAGE were the independent risk factors. Conclusion the range of blood glucose fluctuation in T2DM patients with coronary artery stenosis is higher. Mage is an independent risk factor for coronary artery stenosis in T2DM patients.
【作者单位】：天津市津南区咸水沽医院;天津市宁河区医院;
【基金】：天津市卫生局医药卫生科技项目(2016KZ78)
【分类号】：R541.4;R587.2

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