54例不同治疗方式后2型糖尿病患者的动态血糖监测分析  

Continuous glucose monitoring of 54 diabetic patients after different treatments

作　　者：谷成英[1] 王朝迅[1] 刘继红[1] 徐冬香[1] 龚敏[1] 曾艺鹏[1] 王爱华[1] 

机构地区：[1]上海复旦大学附属华山医院南汇分院内分泌科,上海201300

出　　处：《中国现代医学杂志》2011年第1期100-103,108,共5页China Journal of Modern Medicine

摘　　要：目的探讨不同治疗方式后血糖波动的特点。方法根据糖化血红蛋白(HbA1c)及病程,将抽样对象分为格列美脲(A)组、胰岛素皮下注射(B)组及胰岛素泵(C)组,3组患者血糖控制至目标值即开始进行72h动态血糖监测,根据监测结果调整治疗及饮食。结果 A组的病程、HbA1c及空腹C肽水平明显高于其他两组,其余各项基线资料3组均具有较好的可比性。各组平均血糖值几乎相等;A组的血糖波动系数、血糖时间百分比(TPG)(>7.8 mmol/L或>11.1 mmol/L)及出院血糖日均值较C组明显增加;3组三餐后2 h血糖无显著差异;B组的波动系数、TPG(>7.8mmol/L)、TPG(>11.1mmol/L)及空腹血糖平均值显著高于C组。A组低血糖的发生率最低,接近零;B组低血糖的发生率明显高于C组,回归分析显示,B组血糖的波动与晚餐后2h血糖成线性回归关系。结论根据动态血糖监测及双"C"治疗方案调整降糖药物及饮食规律,可更高效率、更安全地强化血糖控制。[ Objective ] To investigate the fluctuation of blood glucose after different therapy. [ Methods ] The sample drawing objects were divided into glimeplride therapy group（A）, insulin therapy group （B） and insulin pump therapy group （C） through HbAle and course of disease. Therapy or diet was adjusted according to 72 h continuous glucose monitoring result. [ Results] The course of disease, HbAle and fast level of C peptide were higher in A group, other baseline data had good comparability. The average blood glucose was almost equal in different group; compared with the C group, the blood glucose fluctuate coefficient, time percentage of glucose and the mean blood glucose level in hospital discharge in A group were increase significantly; the P2hBG in three, group was no difference. Compared with the C group, the glucose fluctuating coefficient, TPG（〉7.8 mmol/L）, TPG（〉1 1.1 mmol/L） and fast glucose were all higher in the B group. The incidence of hypoglycemic in the oral drug group was the lowest in the different group; incidence of hypoglycemic the premix insulin group was higher than the insulin pump group, regression analysis showed that the glucose fluctuate was liner regression with 2 h blood glucose after dinner. [ Conclusion ] To adjust hypoglycemic drug and diet pattern according to the dynanfic glucose monitor or double ＂C＂ treatment plan can increase the efficiency and safety of intensity glucose control.

关 键 词：治疗 2型糖尿病 动态血糖监测 

分 类 号：R587.1[医药卫生—内分泌]