血糖波动对2型糖尿病合并冠心病患者冠状动脉病变的影响  

Influence of Blood Sugar Fluctuation on Coronary Artery Lesion in Patients with Type 2 Diabetes Mellitus Complicated with Coronary Atherosclerotic Heart Disease

作　　者：陈少敏[1] 吕肖锋[1] 宫倩倩[1] 武晋晓[1] 焦秀敏[1] 王亚双[1] 马艳霞[1] 彭永[1] 

机构地区：[1]北京军区总医院内分泌科,北京100700

出　　处：《解放军医药杂志》2014年第8期17-20,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：国家科技重大专项子课题(2011ZX09307-001-08)

摘　　要：目的探讨血糖波动对2型糖尿病合并冠心病患者冠状动脉病变的影响。方法选择2013年2—9月在北京军区总医院内分泌科住院且经冠状动脉造影(CAG)确诊冠心病的2型糖尿病(T2DM)患者43例,行72 h动态血糖监测,根据全天血糖标准差(SDBG)分为血糖异常波动组(SDBG≥1.4 mmol/L,n=24)及血糖正常波动组(SDBG<1.4 mmol/L,n=19)。比较两组血糖波动参数,检测并比较C反应蛋白(CRP),且对CAG结果行Gensini评分,对Gensini评分与各观察指标进行相关性分析。结果 1血糖异常波动组CRP、Gensini评分、日内平均血糖波动幅度(MAGE)、平均餐后血糖波动幅度(MPPGE)、日间血糖平均绝对差(MODD)比血糖正常波动组均明显升高(P<0.05);2MAGE、MPPGE、MODD、CRP、收缩压与Gensini评分呈显著正相关(r=0.511、0.442、0.323、0.495、0.582,P<0.05);多元逐步回归分析结果:MAGE、CRP、收缩压与Gensini评分独立相关(Y=0.443MAGE+0.397收缩压+0.365CRP-5.316)。结论血糖波动与2型糖尿病合并冠心病患者冠状动脉病变关系密切,是2型糖尿病合并冠心病患者冠状动脉病变进展的独立危险因素。Objective To explore the influence of blood sugar fluctuation on coronary artery lesion in patients with type 2 diabetes mellitus （T2DM） and coronary atherosclerotic heart disease. Methods A total of 43 inpatients with T2DM complicated with coronary artery disease diagnosed by coronary angiography （CAG）, from February to September 2013 in Department of Endocrinology underwent 72 h continuous blood sugar monitoring. According to the level of stand-ard deviation of blood glucose （SDBG）, the patients were divided into abnormal group （SDBG≥1. 4 mmol/L, n=24） and normal group （SDBG〈1. 4 mmol/L, n=19）. Indexes of blood sugar fluctuation in the two groups were compared, and the levels of C-reactive protein （ CRP） were also detected and compared, and then CAG results underwent Gensini scoring. The correlation between Gensini score and related indexes was analyzed. Results ①Values of CRP, Gensini score, mean amplitude of glycemic excursions （MAGE）, mean postprandial glucose excursion （MPPGE） and absolute means of daily difference （MODD） in abnormal group were significantly higher than those in normal group （P〈0. 05）;②Values of MAGE, MPPGE, MODD, CRP and systolic blood pressure （ SBP） were significantly positive correlation with Gensini score （r=0. 511, 0. 442, 0. 323, 0. 495, 0. 582, P〈0. 05）; multielement stepwise regression analysis showed that values of MAGE, CRP and SBP were independently correlated with Gensini score （ Y =0. 443MAGE ＋0. 397SBP＋0. 365CRP-5. 316）. Conclusion Blood glucose fluctuations is closely related to coronary artery lesions in T2DM patients with coronary atherosclerotic heart disease, and it is an independent risk factor of coronary artery disease in T2DM patients.

关 键 词：糖尿病  2型 冠心病 血糖波动 冠状动脉疾病 C反应蛋白 

分 类 号：R587.1[医药卫生—内分泌]