血糖波动的意义及临床评估方法  

The clinical significance and assessment methods of glucose fluctuation

作　　者：李强[1] 李鹏杰[1] 

机构地区：[1]哈尔滨医科大学附属第二医院内分泌代谢病科,哈尔滨150086

出　　处：《中国实用内科杂志》2009年第9期876-878,共3页Chinese Journal of Practical Internal Medicine

摘　　要：越来越多的证据显示,血糖波动独立于糖化血红蛋白(HbA1c),可能与糖尿病并发症显著相关。本文从日内血糖波动、日间血糖波动、进餐相关性血糖波动、严重低血糖危险等4个方面介绍评估血糖波动的方法。日内血糖波动的评估指标包括血糖水平的标准差(SDBG)、血糖波动于某一范围的时间百分比、曲线下面积或频数分布、最大血糖波动幅度(LAGE)、M-值、平均血糖波动幅度(MAGE);日间血糖波动的评估指标包括空腹血糖变异系数(FPG-CV)和日间血糖平均绝对差(MODD);餐后血糖波动的评估指标包括平均进餐波动指数(MIME)和餐后血糖的时间与曲线下面积增值(IAUC);严重低血糖危险的评估指标为低血糖指数(LBGI)。临床上应根据各参数特点和评估目的进行合理选择。More and more evidence shows that glucose fluctuation, independent of HbA1 c, may play a significant role in the risk for diabetes complications. The purpose of this article is to introduce the assessment of glycemic fluctuation in four aspects, such as within-day blood glucose excursions, day-to-day blood glucose excursions, postprandial blood glucose excursions, and the risk of serious hypoglycemia. The indexes for assessment of within-day blood glucose excursions contain standard deviation of blood glucose （SDBG） ,time percentage of blood glucose excursions in a certain range, area under the curve or frequency distribution, the largest amplitude of glycemic excursions （ LAGE ） , M-value, and mean amplitude of glycemic excursions （MAGE） ;the indexes for assessment of day-to-day blood glucose excursions contain fasting plasma glucose-coefficient variation（FPG-CV） ,and absolute means of daily differences（MODD） ;the indexes for assessment of postprandial blood glucose excursions contain mean indices of meal excursions （MIME） and increase area under the curve （IAUC） ;the indexes for assessment of the risk of serious hypoglycemia contain low blood glucose index （LBGI）. Rational choices should be made according to the feature of every index and the aim of assessment in Clinicians.

关 键 词：血糖波动 日内血糖波动 日间血糖波动 进餐相关性血糖波动 

分 类 号：R5[医药卫生—内科学]