CAJ | 학술논문

目的：探讨血糖波动对2型糖尿病合并冠心病患者冠状动脉病变的影响。方法选择2013年2-9月在北京军区总医院内分泌科住院且经冠状动脉造影(CAG)确诊冠心病的2型糖尿病(T2DM)患者43例,行72 h动态血糖监测,根据全天血糖标准差(SDBG)分为血糖异常波动组(SDBG≥1.4 mmol/L,n=24)及血糖正常波动组(SDBG<1.4 mmol/L,n=19)。比较两组血糖波动参数,检测并比较C反应蛋白(CRP),且对CAG结果行Gensini评分,对Gensini评分与各观察指标进行相关性分析。结果①血糖异常波动组CRP、Gensini评分、日内平均血糖波动幅度(MAGE)、平均餐后血糖波动幅度(MPPGE)、日间血糖平均绝对差(MODD)比血糖正常波动组均明显升高(P <0.05)；②MAGE、MPPGE、MODD、CRP、收缩压与Gensini评分呈显著正相关(r=0.511、0.442、0.323、0.495、0.582,P<0.05)；多元逐步回归分析结果：MAGE、CRP、收缩压与 Gensini 评分独立相关( Y =0.443MAGE +0.397收缩压+0.365CRP-5.316)。结论血糖波动与2型糖尿病合并冠心病患者冠状动脉病变关系密切,是2型糖尿病合并冠心病患者冠状动脉病变进展的独立危险因素。
목적：탐토혈당파동대2형당뇨병합병관심병환자관상동맥병변적영향。방법선택2013년2-9월재북경군구총의원내분비과주원차경관상동맥조영(CAG)학진관심병적2형당뇨병(T2DM)환자43례,행72 h동태혈당감측,근거전천혈당표준차(SDBG)분위혈당이상파동조(SDBG≥1.4 mmol/L,n=24)급혈당정상파동조(SDBG<1.4 mmol/L,n=19)。비교량조혈당파동삼수,검측병비교C반응단백(CRP),차대CAG결과행Gensini평분,대Gensini평분여각관찰지표진행상관성분석。결과①혈당이상파동조CRP、Gensini평분、일내평균혈당파동폭도(MAGE)、평균찬후혈당파동폭도(MPPGE)、일간혈당평균절대차(MODD)비혈당정상파동조균명현승고(P <0.05)；②MAGE、MPPGE、MODD、CRP、수축압여Gensini평분정현저정상관(r=0.511、0.442、0.323、0.495、0.582,P<0.05)；다원축보회귀분석결과：MAGE、CRP、수축압여 Gensini 평분독립상관( Y =0.443MAGE +0.397수축압+0.365CRP-5.316)。결론혈당파동여2형당뇨병합병관심병환자관상동맥병변관계밀절,시2형당뇨병합병관심병환자관상동맥병변진전적독립위험인소。
Objective To explore the influence of blood sugar fluctuation on coronary artery lesion in patients with type 2 diabetes mellitus (T2DM) and coronary atherosclerotic heart disease. Methods A total of 43 inpatients with T2DM complicated with coronary artery disease diagnosed by coronary angiography (CAG), from February to September 2013 in Department of Endocrinology underwent 72 h continuous blood sugar monitoring. According to the level of stand-ard deviation of blood glucose (SDBG), the patients were divided into abnormal group (SDBG≥1. 4 mmol/L, n=24) and normal group (SDBG<1. 4 mmol/L, n=19). Indexes of blood sugar fluctuation in the two groups were compared, and the levels of C-reactive protein ( CRP) were also detected and compared, and then CAG results underwent Gensini scoring. The correlation between Gensini score and related indexes was analyzed. Results ①Values of CRP, Gensini score, mean amplitude of glycemic excursions (MAGE), mean postprandial glucose excursion (MPPGE) and absolute means of daily difference (MODD) in abnormal group were significantly higher than those in normal group (P<0. 05);②Values of MAGE, MPPGE, MODD, CRP and systolic blood pressure ( SBP) were significantly positive correlation with Gensini score (r=0. 511, 0. 442, 0. 323, 0. 495, 0. 582, P<0. 05); multielement stepwise regression analysis showed that values of MAGE, CRP and SBP were independently correlated with Gensini score ( Y =0. 443MAGE +0. 397SBP+0. 365CRP-5. 316). Conclusion Blood glucose fluctuations is closely related to coronary artery lesions in T2DM patients with coronary atherosclerotic heart disease, and it is an independent risk factor of coronary artery disease in T2DM patients.