糖皮质激素治疗患者动态血糖特征及意义  

Characteristics and Clinical Significance of Daily Blood Glucose Profiles of Patients with Glucocorticoid Therapy Detected by Continuous Glucose Monitoring System

作　　者：付建芳[1] 涂艳阳[2] 高彬[1] 史皆然[3] 王琼[1] 赖敬波[1] 姬秋和[1] 

机构地区：[1]第四军医大学西京医院内分泌代谢科,陕西西安710032 [2]第四军医大学唐都医院急诊科 [3]第四军医大学西京医院呼吸科

出　　处：《实用预防医学》2011年第1期113-115,共3页Practical Preventive Medicine

摘　　要：目的观察糖皮质激素治疗患者动态血糖特点,为描述此类患者血糖变化特点并早期对其高血糖进行监测、干预提供依据。方法采用CGMS software3.0软件对14例患者口服醋酸泼尼松片治疗前后动态血糖监测系统(CGMS)的监测结果进行统计分析。结果应用醋酸泼尼松片后患者24 h平均血糖水平(MBG),血糖>7.8 mmol/L,>11.1mmol/L的曲线下面积(area under the curve,AUC)均高于未用之前(P<0.05)。血糖变化的特点以中餐至晚餐后血糖增高为主,具体表现为中、晚餐后3h血糖水平、餐后血糖峰值及AUC增值均显著高于早餐(P<0.05),尤以中餐后血糖波动幅度最大,而空腹血糖与未用激素之前相比表现为正常和仅轻微升高。1例患者在CGMS监测期间共发生1次低血糖事件,发生在午夜,持续时间为14min。结论糖皮质激素治疗患者的血糖变化具有自身特点,其中大部分患者表现午后至睡前严重高血糖,部分患者可出现夜间低血糖。Objective To investigate the characteristics of the daily blood glucose profiles of patients with glucocorticoid therapy by continuous glucose monitoring system（CGMS） so as to guide the clinical treatment. Methods The characteristics of the daily blood glucose of 14 patients with glucocorticoid therapy were analyzed by CGMS software. Results MBG and AUC（7.8 mmol/L,11.1mmol/L） of patients with glucocorticoid therapy were significantly increased than those of before glucocorticoid therapy（P0.05）.It was revealed by CGMS that the climax of glucose level tended to appear during the period from post-lunch to bedtime in most people with glucocorticoid therapy.The level of FPG was not significantly changed before and after glucocorticoid therapy.The peak of the daily blood glucose profile was mostly occurred at post-lunch（12.47±2.07 mmol/L）.One patient with glucocortocoid therapy experienced asymptomatic hypoglycemia（blood glucose ≤ 2.8 mmol /L） which lasted 14 min. Conclusions The daily blood glucose profile of patients with glucocorticoid therapy may exhibit distinct characteristics from type 2 diabetes mellitus.The feature of post-lunch and post-dinner hyperglycemia and hypoglycemia at bedtime in some patients shall be occurred.

关 键 词：动态血糖监测 糖皮质激素 醋酸泼尼松 

分 类 号：R587.1[医药卫生—内分泌]