CAJ | 학술논문

【目的】探讨2型糖尿病（T2DM ）患者全天血糖漂移变化及波动趋势的临床意义，为合理治疗方案提供临床依据。【方法】采用雷兰动态血糖监测系统（CGMS）对325例T2DM 患者进行连续72 h动态血糖监测。根据血糖波动系数为≤2．0组和＞2．0组，了解两组患者的糖化血红蛋白（HBA1C ）、日内的平均血糖水平（24hMBG）、三餐前后平均血糖水平、日内最大血糖漂移幅度（LAGE）、日内平均血糖漂移幅度（MAGE）及漂移次数（NGE）、血糖波动系数、不同血糖水平所占日内时间百分比（PT ），对比评价两组患者全天血糖漂移变化的特点。【结果】血糖波动系数＞2．0者共275例，发生低血糖126例（45．8％），血糖波动系数≤2．0者共50例，发生低血糖18例（36．0％）。HBA1C不能反映血糖水平波动的幅度和频率。两组比较，血糖波动系数＞2．0组较≤2．0组发生高血糖及血糖漂移≥11．1 mmol/L 的时间及幅度明显增多（ P ＜0．05）。【结论】血糖波动系数＞2．0组患者较≤2．0组血糖漂移于较高水平，漂移幅度增大，两组均有低血糖发生。CGMS有助于详细地评估T2DM患者血糖漂移变化的趋势及特征。
【목적】탐토2형당뇨병（T2DM ）환자전천혈당표이변화급파동추세적림상의의，위합리치료방안제공림상의거。【방법】채용뢰란동태혈당감측계통（CGMS）대325례T2DM 환자진행련속72 h동태혈당감측。근거혈당파동계수위≤2．0조화＞2．0조，료해량조환자적당화혈홍단백（HBA1C ）、일내적평균혈당수평（24hMBG）、삼찬전후평균혈당수평、일내최대혈당표이폭도（LAGE）、일내평균혈당표이폭도（MAGE）급표이차수（NGE）、혈당파동계수、불동혈당수평소점일내시간백분비（PT ），대비평개량조환자전천혈당표이변화적특점。【결과】혈당파동계수＞2．0자공275례，발생저혈당126례（45．8％），혈당파동계수≤2．0자공50례，발생저혈당18례（36．0％）。HBA1C불능반영혈당수평파동적폭도화빈솔。량조비교，혈당파동계수＞2．0조교≤2．0조발생고혈당급혈당표이≥11．1 mmol/L 적시간급폭도명현증다（ P ＜0．05）。【결론】혈당파동계수＞2．0조환자교≤2．0조혈당표이우교고수평，표이폭도증대，량조균유저혈당발생。CGMS유조우상세지평고T2DM환자혈당표이변화적추세급특정。
Objective To explore clinical significance of 24h-blood glucose drift change and fluctuation trend in patients with type 2 diabetes mellitus (T2DM ) in order to provide clinical basis for the reasonable treatment scheme .[Methods]Reland dynamic glucose monitoring system(CGMS) was used for continuous 72h dynamic sugar monitoring in 325 T2DM patients .According to blood glucose fluctuation coefficient ,all pa-tients were divided into ≤2 .0 group and >2 .0 group .Glycosylated hemoglobin(HBA1C) ,24h-average blood glucose(24hMBG) ,mean blood glucose before and after 3 meals ,24h-maximum amplitude of glycemic excur-sion(LAGE) ,24h-mean amplitude of glycemic excursion(MAGE) and frequency (NGE) ,blood glucose fluc-tuation coefficient and the percentage of time of different blood glucose levels in 24h(PT ) of all patients were understood .The characteristics of 24h-blood glucose drift change were compared between two groups .[Re-sults]Among 275 patients with blood glucose fluctuation coefficient >2 .0 ,126 patients(45 .8% ) had hypogly-cemia .Among 50 patients with blood glucose fluctuation coefficient ≤2 .0 ,18 patients(36% ) had hypoglyce-mia .HBA1C did not reflect the amplitude and frequency of blood glucose fluctuation .The incidence of hyper-glycemia and the time and amplitude of blood glucose drift ≥11 .1mmol/L in the group with blood glucose fluc-tuation coefficient>2 .0 were obviously higher than those in the group with blood glucose fluctuation coefficient≤2 .0( P <0 .05) .[Conclusion] Compared with the group with blood glucose fluctuation coefficient ≤2 .0 , blood glucose drift in the group with blood glucose fluctuation coefficient >2 .0 is higher ,and drift amplitude is increased .Both groups have hypoglycemia .CGMS contributes to the detailed assessment of the trend and characteristics of blood glucose drift change in patients with T 2DM .