中华内分泌代谢杂志
中華內分泌代謝雜誌
중화내분비대사잡지
CHINESE JOURNAL OF ENDOCRINOLOGY AND METABOLISM
2014年
2期
96-100
,共5页
糖尿病,2型%血糖变异性%冠状动脉狭窄
糖尿病,2型%血糖變異性%冠狀動脈狹窄
당뇨병,2형%혈당변이성%관상동맥협착
Diabetes mellitus,type 2%Glucose variability%Coronary artery stenosis
目的 探讨2型糖尿病患者血糖变异性与冠状动脉狭窄程度的相关性.方法 连续选取2012年2月至2012年10月在郑州大学第一附属医院心内科住院的行冠脉造影术的2型糖尿病患者100例为研究对象,据冠脉造影结果分2组:(1)2型糖尿病合并冠心病者60例,男35例,女25例,年龄(63±12)岁,为冠心病组；(2)2型糖尿病不合并冠心病者40例,男20例,女20例,年龄(59±8)岁,为对照组.入院后均行72 h动态血糖监测(continuous glucose monitoring,CGM),计算动态血糖波动指标,并根据冠脉造影结果评价冠脉狭窄程度(以Gensini积分表示),比较2组间各项动态血糖指标、Gensini积分及各项临床生化指标,组间比较采用t检验,相关性分析采用Pearson相关和多元逐步回归分析,P＜0.05为差异有统计学意义.结果 与对照组的最大血糖波动幅度(LAGE)、24 h内血糖波动标准差(SDBG)、日内血糖平均波动幅度(MAGE)、餐后血糖波动幅度(MPPGE)、日间血糖波动平均绝对差(MODD)[(8.1±2.1)、(1.9±0.5)、(4.8±1.3)、(4.5±1.4)、(2.4±0.8)]相比,冠心病组分别为[(11.3±3.5)、(3.2±1.2)、(7.0±2.6)、(6.4±1.9)、(3.1±1.3)],均显著增加,差异均有统计学意义(t分别为5.132、6.644、4.887、5.321和2.856,均P＜0.05).MPPGE、MODD、LAGE、C反应蛋白与Gensini积分呈明显正相关(r分别为0.498、0.246和0.227,均P＜0.05).左室射血分数(LVEF)与Gensini积分呈负相关(r=-0.261,P＜0.05).多因素逐步回归分析显示:MPPGE、LVEF与Gensini积分独立相关(Y=59.727+ 11.779×MPPGE-1.437×LVEF).结论 2型糖尿病合并冠心病患者血糖变异性明显增大,血糖波动幅度与冠状动脉狭窄程度呈正相关,其中餐后血糖变异性为冠脉狭窄程度的独立预测因素.
目的 探討2型糖尿病患者血糖變異性與冠狀動脈狹窄程度的相關性.方法 連續選取2012年2月至2012年10月在鄭州大學第一附屬醫院心內科住院的行冠脈造影術的2型糖尿病患者100例為研究對象,據冠脈造影結果分2組:(1)2型糖尿病閤併冠心病者60例,男35例,女25例,年齡(63±12)歲,為冠心病組；(2)2型糖尿病不閤併冠心病者40例,男20例,女20例,年齡(59±8)歲,為對照組.入院後均行72 h動態血糖鑑測(continuous glucose monitoring,CGM),計算動態血糖波動指標,併根據冠脈造影結果評價冠脈狹窄程度(以Gensini積分錶示),比較2組間各項動態血糖指標、Gensini積分及各項臨床生化指標,組間比較採用t檢驗,相關性分析採用Pearson相關和多元逐步迴歸分析,P＜0.05為差異有統計學意義.結果 與對照組的最大血糖波動幅度(LAGE)、24 h內血糖波動標準差(SDBG)、日內血糖平均波動幅度(MAGE)、餐後血糖波動幅度(MPPGE)、日間血糖波動平均絕對差(MODD)[(8.1±2.1)、(1.9±0.5)、(4.8±1.3)、(4.5±1.4)、(2.4±0.8)]相比,冠心病組分彆為[(11.3±3.5)、(3.2±1.2)、(7.0±2.6)、(6.4±1.9)、(3.1±1.3)],均顯著增加,差異均有統計學意義(t分彆為5.132、6.644、4.887、5.321和2.856,均P＜0.05).MPPGE、MODD、LAGE、C反應蛋白與Gensini積分呈明顯正相關(r分彆為0.498、0.246和0.227,均P＜0.05).左室射血分數(LVEF)與Gensini積分呈負相關(r=-0.261,P＜0.05).多因素逐步迴歸分析顯示:MPPGE、LVEF與Gensini積分獨立相關(Y=59.727+ 11.779×MPPGE-1.437×LVEF).結論 2型糖尿病閤併冠心病患者血糖變異性明顯增大,血糖波動幅度與冠狀動脈狹窄程度呈正相關,其中餐後血糖變異性為冠脈狹窄程度的獨立預測因素.
목적 탐토2형당뇨병환자혈당변이성여관상동맥협착정도적상관성.방법 련속선취2012년2월지2012년10월재정주대학제일부속의원심내과주원적행관맥조영술적2형당뇨병환자100례위연구대상,거관맥조영결과분2조:(1)2형당뇨병합병관심병자60례,남35례,녀25례,년령(63±12)세,위관심병조；(2)2형당뇨병불합병관심병자40례,남20례,녀20례,년령(59±8)세,위대조조.입원후균행72 h동태혈당감측(continuous glucose monitoring,CGM),계산동태혈당파동지표,병근거관맥조영결과평개관맥협착정도(이Gensini적분표시),비교2조간각항동태혈당지표、Gensini적분급각항림상생화지표,조간비교채용t검험,상관성분석채용Pearson상관화다원축보회귀분석,P＜0.05위차이유통계학의의.결과 여대조조적최대혈당파동폭도(LAGE)、24 h내혈당파동표준차(SDBG)、일내혈당평균파동폭도(MAGE)、찬후혈당파동폭도(MPPGE)、일간혈당파동평균절대차(MODD)[(8.1±2.1)、(1.9±0.5)、(4.8±1.3)、(4.5±1.4)、(2.4±0.8)]상비,관심병조분별위[(11.3±3.5)、(3.2±1.2)、(7.0±2.6)、(6.4±1.9)、(3.1±1.3)],균현저증가,차이균유통계학의의(t분별위5.132、6.644、4.887、5.321화2.856,균P＜0.05).MPPGE、MODD、LAGE、C반응단백여Gensini적분정명현정상관(r분별위0.498、0.246화0.227,균P＜0.05).좌실사혈분수(LVEF)여Gensini적분정부상관(r=-0.261,P＜0.05).다인소축보회귀분석현시:MPPGE、LVEF여Gensini적분독립상관(Y=59.727+ 11.779×MPPGE-1.437×LVEF).결론 2형당뇨병합병관심병환자혈당변이성명현증대,혈당파동폭도여관상동맥협착정도정정상관,기중찬후혈당변이성위관맥협착정도적독립예측인소.
Objective To investigate the relationship between glucose variability and severity of coronary artery stenosis in patients with type 2 diabetes mellitus (T2DM).Methods One hundred hospitalized patients with T2DM(55 males and 45 females,39-81 years old) who had undergone angiography were included in the study from February 2012 to October 2012.They were divided into 2 groups:(1) 60 patients with coronary heart disease(CHD)as experimental group and (2) 40 patients without coronary heart disease as control group.All participants underwent selective coronary angiography to evaluate the severity of coronary artery stenosis (Gensini score) and continuous glucose monitoring(CGM) for 72 h.The correlation was analyzed between biochemical findings,and Gensini scores between the 2 groups.The comparison between 2 groups was performed with LSD test,correlation analysis with Pearson correlation and multiple stepwise regression analysis.Result Compared with the levels of largest amplitude of blood glucose excursion (LAGE),standard deviation of blood glucose (SDBG),mean amplitude of glycemic excursion (MAGE),postprandial glucose excursion (MPPGE),and absolute means of daily differences (MODD) in control group [(8.1 ± 2.1),(1.9 ± 0.5),(4.8 ± 1.3),(4.5 ± 1.4),and (2.4 ± 0.8) respectively],the levels in the experimental group[(11.3 ± 3.5),(3.2 ± 1.2),(7.0 ± 2.6),(6.4 ± 1.9),and (3.1 ± 1.3)] were higher respectively.MPPGE,MODD,LAGE,and C-reactive protein(CRP) were positively related to Gensini score(r were 0.498,0.246,and 0.227,all P＜0.05),while left ventricular ejection fraction (LVEF) was negatively related to Gensini score(r=-0.261,P＜0.05).Multiple stepwise regression analysis indicated that MPPGE and LVEF were independent risk factors of Gensini score (Y =59.727 + 11.779 × MPPGE-1.437 × LVEF).Conclusion Glucose variability in patients with T2DM and CHD was markedly enhanced.MPPGE was positively correlated with the severity of coronary artery stenosis in patients with T2DM and CHD.
