• 血糖及血压波动增加2型糖尿病患者发生微血管并发症风险
  • 肖康丽.血糖及血压波动增加2型糖尿病患者发生微血管并发症风险[J].内科急危重症杂志,2022,28(6):487-491
    扫码阅读全文 本文二维码信息
    DOI:10.11768/nkjwzzzz20220612
    中文关键词:  血糖波动  血压波动  2型糖尿病  糖尿病肾病
    英文关键词:
    基金项目:
    作者单位E-mail
    肖康丽 华中科技大学同济医学院附属协和医院 lhqing5@126.com 
    摘要点击次数: 754
    全文下载次数: 1093
    中文摘要:
          摘要 目的:观察血糖及血压波动对 2型糖尿病(T2DM)患者微血管并发症-糖尿病肾病(DN)的影响,并探讨DN患者血糖及血压波动的相关性。方法:收集T2DM合并高血压患者160例。根据尿白蛋白/尿肌酐比值(UACR)将患者分为正常蛋白尿组84例(UACR<30mg/g)和微量蛋白尿组76例(近半年2次以上30mg/g≤UACR≤300mg/g)。采用动态血压监测仪监测24h血压,分析血压波动情况;采用多点血糖监测评估血糖波动 [血糖标准差(SDBG)、餐后血糖波动幅度(PPGE),最大血糖波动幅度(LAGE)];并分析DN与血糖及血压波动指标的相关性。结果:微量蛋白尿组空腹血糖(FBG)、糖化血红蛋白(HbA1c)、SDBG、LAGE及全天血压、24h收缩压标准差(24hSBP-SD)、24h舒张压标准差(24hDBP-SD)、日间收缩压标准差(dSBP-SD)和舒张压标准差(dDBP-SD)高于正常蛋白尿组(P均<0.05)。微量蛋白尿组SDBG与24hDBP-SD呈正相关,微量蛋白尿组尿白蛋白/UACR与FBG、HbA1c、SDBG、LAGE、24hSBP、24hSBP-SD呈正相关(P均<0.05)。结论:血糖及血压波动可能增加T2DM合并高血压患者微血管并发症的发生。
    英文摘要:
          Abstract Objective: To observe the effect of glycemic variability and blood pressure fluctuation on diabetic nephropathy and to explore the correlation between glycemic variability and blood pressure fluctuation in diabetic nephropathy patients. Methods: A total of 160 patients with type 2 diabetes mellitus complicated with hypertension were collected. According to the urinary albumin creatinine ratio (UACR), the patients were divided into normoalbuminuria group (84 cases) (UACR <30mg/g) and microalbuminuria group (76 cases) (30mg/g≤ UACR ≤300mg/g, more than twice in recent six months). The 24h blood pressure was monitored by ambulatory blood pressure monitor and blood pressure fluctuation was analyzed. Multi-point blood glucose monitoring was used to evaluate glycemic variability [blood glucose standard deviation (SDBG), postprandial blood glucose fluctuation (PPGE), largest blood glucose fluctuation (LAGE)]. The correlation between glycemic variability and blood pressure fluctuation in diabetic nephropathy patients was analyzed. Results: Fasting blood glucose (FBG), glycated hemoglobin (HbA1c), SDBG, LAGE and whole day blood pressure, standard deviation of 24h systolic blood pressure (24hSBP-SD), standard deviation of 24h diastolic blood pressure (24hDBP-SD), standard deviation of day systolic blood pressure (dSBP-SD) and standard deviation of day diastolic blood pressure (dDBP-SD) in microalbuminuria group were higher than those in the normoalbuminuria group (P< 0.05). SDBG in microalbuminuria group was positively correlated with 24hDBP-SD, and UACR was positively correlated with FBG, HbA1c, SDBG, LAGE, 24hSBP and 24h SBP-SD (P< 0.05). Conclusion: The fluctuation of blood glucose and blood pressure may increases the incidence of microvascular complications in type 2 diabetes mellitus complicated with hypertension.