老年2型糖尿病患者血糖波动对颈动脉斑块形成的影响  

Influence of blood glucose instability on carotid plaque in aged patients with type 2 diabetes mellitus

作　　者：陈朝婷[1] 孙赟[1] 蔡文玮[1] 盛净[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院老年科,上海200011

出　　处：《新乡医学院学报》2010年第5期473-475,共3页Journal of Xinxiang Medical University

基　　金：第九人民医院优秀青年骨干资助项目(编号:20080516)

摘　　要：目的研究老年2型糖尿病患者血糖波动与颈动脉斑块形成的相关性。方法选取55例老年2型糖尿病患者,以动态血糖监测系统(CGMS)进行持续3d的血糖监测,并行颈动脉超声检测,按血糖波动系数分<1.5(n=15)、1.5～3.0(n=28)和>3.0(n=12)3组,评估24h平均血糖水平(MBG)、高血糖及低血糖时间比、平均餐后血糖波动幅度(M-PPGE)对血糖波动系数的影响,并分析血糖波动系数与颈动脉斑块分级和颈动脉斑块内中膜厚度(IMT)的相关性。结果血糖波动系数与MBG(R=0.848,P<0.01)、高血糖(>7.8mmol·L-1)时间比(R=0.871,P<0.01)、高血糖(>11.1mmol·L-1)时间比(R=0.688,P<0.01)和M-PPGE(R=0.833,P<0.01)均显著相关;血糖波动系数对颈动脉斑块内中膜厚度(R=0.701,校正R=0.492,P<0.01)尤其斑块严重程度分级CPS(R=0.798,校正R=0.637,P<0.01)有显著影响。结论老年2型糖尿病患者血糖波动增加动脉粥样硬化风险,需重视动态血糖监测。Objective To investigate the relationship between blood glucose fluctuation and carotid artery plaques in aged type 2 diabetes mellitus（ T2DM） patients. Methods Fifty-five aged patients with T2DM were chosed and underwent continuous glucose monitoring for three days and color Doppler ultrasound detection in carotid artery,then were divided into 〈1. 5 group （ n = 15） ,1. 5 - 3. 0 group（ n = 28） and 〉3. 0 group （ n = 12） according to the blood glucose wavy coefficient. The mean levels of 24 hours blood glucose values（ MBG） ,percentage of high blood glucose time or low blood glucose time and influence of mean levels of postprandial glycemic excursions（ M-PPGE） on blood glucose wavy coefficient were evaluated. The relationships between blood glucose fluctuation and carotid artery plaque score（ CPS） or intima-media thickness（ IMT） were also analysed. Results MBG（ R =0.848,P〈 0. 01） ,percentage of time above 7. 8 mmol·L^ -1 （ R = 0. 871,P 〈0. 01） ,percentage of time above 11. 1 mmol·L^ -1 （ R = 0. 688,P 〈0. 01） and M-PPGE（ R = 0. 833,P 〈0. 01） were significantly correlated with blood glucose wavy coefficient including. Blood glucose wavy coefficient was largely attributed to carotid artery plaque IMT especially to CPS（ P 〈0. 01） . Conclusion The fluctuation of blood glucose in aged T2DM patients would increase the risk of artery atherosclerosis,so continuous glucose monitoring must be paid attention in aged T2DM patients.

关 键 词：2型糖尿病 动态血糖监测 血糖波动系数 斑块 

分 类 号：R587.1[医药卫生—内分泌]