糖化血红蛋白达标的2型糖尿病患者血糖波动与尿白蛋白／肌酐的关系探讨

摘要

目的：探讨糖化血红蛋白（HbA1c）达标的2型糖尿病患者血糖波动与尿白蛋白／尿肌酐（UACR）的关系。方法选择合肥市第二人民医院2010年8月至2016年3月收治的2型糖尿病患者（HbA1c＜7.0％）107例，根据UACR结果分为正常组21例（ NUA组）和升高组86例（ MUA组）。动态血糖监测系统（ CGMS ）对受试者进行连续72 h的血糖监测，计算出平均血糖（MBG）和平均血糖波动幅度（MAGE），同时检测血肌酐（Scr）、谷丙转氨酶（ALT），测量血压和计算体质指数（BMI）。结果 MUA组MAGE显著高于NUA组，差异有统计学意义（P＜0.05）。 MAGE与年龄、病程、Scr、UACR呈中度相关（P＜0.05），与收缩压、舒张压、BMI、ALT呈低度相关（P＜0.05）。结论血糖控制达标的2型糖尿病患者尿白蛋白排泄增加与血糖波动有关。%Objective To explore the relationship between blood glucose fluctuation and urinary albumin excretion rate(UACR)in type 2 diabetic patients attaining glycosylated hemoglobin(HbA1c)standard.Methods A total of 107 patients with type 2 diabetes,HbA1c<7.0%were divided into NUA group(n=21) and MUA group(n=86) according to UACR.The fluctuating feature of 72 hours blood glucose of all the patients were recorded by continuous glucose monitoring system(CGMS),then CGMS parameters including mean blood glucose ( MBG) and mean amplitude of glycemic excursions( MAGE) were calcalated and the age,disease duration,BMI,blood pressure and biochemi-cal indicators were also recorded.Results MUA group MAGE was significantly higher than that of NUA group,the difference was statistical-ly significant (P<0.05).MAGE with age,duration,Scr,UACR was moderately correlated,and systolic pressure,diastolic blood pressure, BMI,ALT are low.Conclusion Urinary albumin excretion increase is related to the blood sugar fluctuation in type 2 diabetics with targeted HbA1c.