目的 探讨动态血糖监测糖尿病患者糖化血红蛋白与今天各时间段血糖的关系;并结合动态血糖监测观察胰岛素治疗的疗效.方法 随机选取80例住院老年Ⅱ型糖尿病患者,检测身高、体重、血压、心率、空腹血糖、糖化血红蛋白、血脂、肝功等指标,并监测72小时血糖.结果 糖化血红蛋白与全天平均血糖、早餐后、午餐后、晚餐后2h平均血糖、22.00～24.00时间段、03.00～06.00时间段平均血糖显著相关,与三餐后血糖波动幅度无关;结合动态血糖监测胰岛素治疗达标时间缩短,低血糖发生少.结论 Ⅱ型糖尿病患者HbAlc与动态血糖水平显著相关;动态血糖监测血糖谱可以反应患者总体血糖控制情况,提供的信息有助于更全面了解血糖波动的细节,从而制定相应的治疗措施,使胰岛素治疗更安全有效.%Objective To explore the relationship between glycosylated hemoglobin and blood glucose level of different time points by using dynamic monitoring of blood glucose and to observe the efficacy of insulin treatment combined with dynamic monitoring of blood glucose. Methods We randomly selected 80 elderly patients with type 2 diabetes from inpatients of our hospital. Then we detected their height, weight, blood pressure, heart rate, fasting glucose, glycosylated hemoglobin, lipids, liver function and other indicators, and carried out 72 hour glucose monitoring. Results The patients' glycosylated hemoglobin was significantly related to the whole-day average glucose, the average glucose two hours after the three meals, and the average glucose at 22:00~24:00 and 3:00~06:00. It had no correlation with postprandial fluctuations of blood glucose. Combination of postprandial glucose monitoring with insulin use led to more effective treatment of diabetes and less occurrence of hypoglycemia. Conclusion HbAlc of type 2 diabetes patients is significantly correlated with the dynamic blood glucose level. Dynamic monitoring of blood glucose spectrum can reflect the general status of patients' blood glucose control, which may help better understand details of blood glucose fluctuations so as to work out corresponding therapeutic measures and make insulin treatment safer and more effective
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