利用动态血糖监测早期发现无症状低血糖症对脑卒中合并糖尿病患者康复治疗的意义  

The significance of early detection of hypoglycemia unawareness in patients with stroke complicated with diabetes mellitus during rehabilitation by continuous glucose monitoring

作　　者：黄美玲[1] 王玉龙[1] 方锐[1] 王坤[1] 欧晓慧 骆伟[1] 山林林[1] HUANG Meiling WANG Yulong FANG Rui et al(The Second People＇s Hospital of Shenzhen, 518035)

机构地区：[1]深圳市第二人民医院(深圳大学第一附属医院)康复医学科,深圳518035

出　　处：《中国康复医学杂志》2017年第7期788-792,共5页Chinese Journal of Rehabilitation Medicine

基　　金：深圳市卫生和计划生育委员会课题(201506024)

摘　　要：目的:评价动态血糖监测系统(continuous glucose monitoring system,CGMS)对脑卒中合并糖尿病患者在康复治疗中发生无症状低血糖症的意义。方法:35例康复医学科脑卒中合并糖尿病患者入院后在康复治疗介入时均安装CGMS,连续佩戴72h,同时使用便携式末梢血糖仪和试纸进行每日末梢血糖监测(三餐前、三餐后2h、睡前及凌晨3∶00),比较两种方法对低血糖及无症状低血糖检出情况。结果:CGMS监测出无症状低血糖例数比末梢血糖监测高,差异有显著性意义(P<0.01)。35例患者无症状低血糖多发生在3∶00—8∶00,占22.86%,血糖值平均为(3.25±1.07)mmol/L,最低值为2.3mmol/L。结论:CGMS能及时监测无症状低血糖现象,避免风险发生。Objective： To evaluate the significance of continuous glucose monitoring system（CGMS） in hypoglycemia unawareness of stroke patients with diabetes mellitus during rehabilitation therapy. Method：The CGMS was installed in 35 stroke patients with diabetes mellitus for 72 hours during rehabilitation exercise intervention after admission. At the same time, blood glucose level was monitored by using porta- ble peripheral blood glucose meters and test trips for 8 times a day, including before meals, after meals, at bedtime, in the middle of the night. The detection rates of hypoglycemia and hypoglycemia unawareness were analyzed and compared. Result： The detection rate of hypoglycemia unawareness by using CGMS was significantly higher than that of portable peripheral blood glucose meters（P〈 0.01）.22.86% of the 35 patients showed hypoglycemia unawareness from 3：00 to 8： 00. The average blood glucose level was （3.25±1.07）mmol/L and the lowest value was 2.3 mmol/L. Conclusion： Hypoglycemia unawareness can be timely detected by CGMS. Risk can be avoided by using CGMS.

关 键 词：脑卒中 糖尿病 动态血糖监测 无症状低血糖 

分 类 号：R587.1[医药卫生—内分泌] R743.3[医药卫生—内科学]