血糖云端监测平台在控制维持性血液透析患者血糖中的作用  

Application of Blood Glucose Monitoring Cloud Platform in Patients on Hemodialysis

作　　者：胡婕[1] 刘玉梅[1] 盛晓华[1] 陈林艳[1] 滕雯怡 曹兰支[1] 秦海峰[1] 汪年松[1] 

机构地区：[1]上海交通大学附属第六人民医院肾脏风湿科,上海200233

出　　处：《中国中西医结合肾病杂志》2016年第6期495-498,I0002,共5页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：国家自然基金面上项目(No.81270824);国家自然基金青年基金资助项目(No.81400735);上海交通大学医学院转化医学基金资助项目(No.152H2011)

摘　　要：目的：探索血糖云端监测平台在帮助维持性血液透析的糖尿病患者控制血糖的作用。方法：建立糖尿病防治云平台,血糖仪测量血糖并通过蓝牙方式将数据传输至装有血糖监测软件的手机,手机通过3G网络将数据传输至后台云端平台,进行血糖数值记录、图表绘制等,随访1年。结果：15例维持性血液透析的终末期糖尿病肾病患者自愿参与使用该系统,其中13人完成度高,参与满12个月,2例因完成度差,退出试验。13例平均透析龄（34.2±37.1）月,中位透析时间16月,每周透析均达到12 h。最长连续监测时间为284 d,高血糖的发生比例为6.2%~45.9%,最常见于早餐后,低血糖的发生比例5.6%~24.1%,最常见于早餐前空腹。参与项目后,空腹血糖由基线（11.5±4.4）mmol/L下降至（8.0±3.3）mmol/L（P=0.030）,达标率由18.2%上升至61.5%（P=0.016）;糖化血红蛋白由基线（7.9%±1.0%）下降至（6.7%±0.8%）（P=0.003）。结论：糖尿病防治云平台能够很好地帮助患者进行血糖的自我监测及医护沟通,但部分技术尚需持续改进。Objective： To explore a glucose monitoring cloud platform for patients on hemodialysis to control blood glucose.Methods： A glucose monitoring cloud platform was set up. Blood glucose was collected by glucometer,and data was transmitted to mobile phone via blue tooth. Data then was transmitted to background cloud platform by mobile phone through 3G net. Volunteers were followed up for one year. Results： Fifteen people attended for more than 12 months. Among them,thirteen people attended for more than one year,and two people were dropped out. Their average dialysis month was（ 34. 2 ± 37. 1） months and median dialysis month was 16 months,for 12 hours a week. They were all DN patients,and all had other chronic diabetic complications. The longest continuous monitoring time was 284 days. Percentage of high blood glucose was（ 6. 2 ~ 45. 9） %,mostly found after breakfast. Percentage of low blood glucose was（ 5. 6 ~ 24. 1） %,mostly found before breakfast. Fast blood glucose could be controlled from（ 11. 5 ±4. 4） mmol / L to（ 8. 0 ± 3. 3） mmol / L（ P = 0. 030）,and its standard rate could be controlled from 18. 2% to 61. 5%（ P = 0. 016）.Glycated hemoglobin could be controlled from（ 7. 9 ± 1. 0） % to（ 6. 7 ± 0. 8） %（ P = 0. 003）. Conclusion： Blood glucose monitoring platform can be a good help for patients for self blood glucose monitoring and medical communication,while some technology could be sustainably improved.

关 键 词：血糖 糖尿病肾病 血液透析 云端平台 移动技术 

分 类 号：R692.5[医药卫生—泌尿科学] R587.1[医药卫生—外科学]