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
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| 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: |
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| 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. |
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