应用动态血糖监测系统观察消化性溃疡对血糖的影响

摘要

Objective To observe the effect of peptic ulcer on blood glucose by a continuous glucose monitoring sys⁃tem( CGMS ) in the elderly diabetic patients with peptic ulcer. Methods A total of 56 elderly diabetic patients undergoing CGMS over 72 h were selected and divided into observation group ( 26 cases suffering from peptic ulcer) and control group (30 cases without peptic ulcer). The mean plasma glucose(MPG), standard deviation of plasma glucose(SD⁃PG),large amplitude of glycemic excursions(LAGE),the numbers of glycemic excursions and unrecognized hypoglycemia were recorded. And fasting blood glucose(FBG) and postprandial 2 h blood glucose (PBG) were detected in the two groups.Meanwhile,HbA1c levels,hemoglobin were measured before the monitoring period and 3 months later. Results The CGMS showed that blood glucose fluctuation in observation group was more obvious than that in control group. There were significant differences in MPG,SDPG and the numbers of glycemic excursions between the two groups( P<0�05) ,but there were no significant differences in FBG or PBG. HbA1c concentrations decreased( P<0�05) and hemoglobin increased ( P<0�05) in observation group after 3 months, treatment for peptic ulcer. Conclusions The outcomes indicate that pep⁃tic ulcer has influence on glucose fluctuation, but the risks are underestimated. CGMS is superiority to capillary glucose measurements especially for elderly diabetic patients complicated with peptic ulcer.%目的应用动态血糖监测系统（ CGMS）观察老年糖尿病合并消化性溃疡患者的血糖波动情况，观察消化性溃疡对血糖的影响。方法把56例伴或不伴消化性溃疡的老年2型糖尿病患者分为观察组和对照组，佩带CGMS监测血糖72 h后分析数据，包括平均血糖值、血糖水平标准差、血糖漂移次数／d及低血糖次数，并测定空腹及餐后2h血糖、糖化血红蛋白、血红蛋白等指标，同时观察消化性溃疡治疗前后的血糖变化。结果2组监测空腹和餐后2 h血糖的指端毛细血管血糖值无差异，但CGMS结果显示观察组血糖波动比对照组大，2组的平均血糖值[（10�15±1�06） mmol／L 比（8�6±0�99） mmol／L）]、血糖漂移次数／d（3�44±1�67比2�0±1�06）均有统计学差异（P＜0�05或P＜0�01）。观察组溃疡治疗前后的血红蛋白[（101�31±27�44） g／L比（140�85±17�87） g／L]及糖化血红蛋白[（8�82±3�62）％比（6�85±1�30）％]，差异亦有统计学意义（P＜0�05）。结论消化性溃疡增加老年糖尿病人的临床风险，增大其血糖波动，在此特殊时期应用CGMS比监测指端毛细血管血糖优越。