2型糖尿病低血糖患者的实验室检查指标分析

摘要

目的：分析2型糖尿病（T2DM ）低血糖患者的实验室检查指标，研究低血糖是否会加重机体损伤，加快并发症的进展。方法选取2014年1～6月住院发生低血糖的T2DM 患者27例作为低血糖组，另选取未发生过低血糖的糖尿病住院患者80例作为非低血糖组，比较两组各项指标的差异及低血糖发生前后各指标的变化。同时研究低血糖发生率与糖化血红蛋白（HbA1c）控制程度的关系。结果低血糖组患者年龄、病程、丙氨酸氨基转移酶（ALT）、肌酐（SCr）和尿蛋白排出量（Upro）均高于非低血糖组，差异均有统计学意义（P＜0．05）；而两组间空腹血糖（FPG）、性别、体质量指数（BMI）和HbA1c比较差异无统计学意义（P＞0．05）。T2DM患者低血糖发生后肌酸激酶（CK）、超敏C反应蛋白（hs‐CRP）和纤维蛋白原（FIB）水平均高于发生前，超氧化物歧化酶（SOD）水平低于发生前，差异均有统计学意义（P＜0．05）。T2DM 患者低血糖发生率与 HbA1c呈不完全逆相关关系（P＞0．05），趋势图显示 HbA1c控制接近正常时较控制不良者发生率增高更明显。结论 T2DM 患者年龄较大和病程较长及HbA1c水平接近正常时较易发生低血糖，低血糖的发生会加重T2DM 患者的机体损伤，加快并发症的进展。%Objective To analyze the laboratory indexes related to type 2 diabetes mellitus(T2DM ) and to explore whether hy‐poglycemia would aggravate the injury of body and development of complication .Methods 27 cases of patients with T2DM from Jan .to Jun .2014 were enrolled in hypoglycemia group ,and 80 patients of diabetes mellitus without hypoglycemia were enrolled in non‐hypoglycemia group .The laboratory indexes were compared between the two groups ,and the relationship between incidence rate of hypoglycemia and levels of glycosylated hemoglobin (HbAc1) were also analyzed ..Results The age ,course of the disease , levels of alanine aminotransferase (ALT ) and serum creatinine (SCr) and urinary protein excretion (Upro ) in the hypoglycemia group were higher than those in the non‐hypoglycemia group ,there were statistical significant differences (P<0 .05);while there was no significant differences in levels of fasting plasma glucose(FPG) and HbA1c ,gender and body mass index(BMI) between the two groups(P>0 .05) .The levels of creatine kinase(CK) ,high sensitivity C‐reactive protein(hs‐CRP) and fibrinogen(FIB) in pa‐tients with T2DM after developing hypoglycemia were higher than those in patients before developing hypoglycemia ,while superox‐ide dismutase(SOD) was lower ,there were statistical significant differences (P<0 .05) .It showed an incomplete inverse correlation between risk of hypoglycemia in patients with T 2DM and levels of HbA1c(P>0 .05) ,at the same time the risk of hypoglycemia tended to be higher in patients with near‐normal level of HbA1c than patients with poor HbA1c control .Conclusion The older , long course of disease and near‐normal levels of HbA1c controled in patients with T2DM may be prone to develop hypoglycemia . Hypoglycemia could aggravate the body injury and speed up the development of complications of T 2DM .