行血液透析治疗的糖尿病肾病患者血糖变异性与腹主动脉钙化的相关性  

Relationship between blood glucose variability and abdominal aortic calcification in hemodialysis patients with diabetic nephropathy

作　　者：余娜[1] 杨太星[1] 王百聆[1] Yu Na;Yang Taixing;Wang Bailing(Department of Nephrology,Jiaozuo People’s Hospital,Jiaozuo 454000,China)

机构地区：[1]河南省焦作市人民医院肾内科,454000

出　　处：《中国实用医刊》2021年第3期57-60,共4页Chinese Journal of Practical Medicine

摘　　要：目的观察行血液透析治疗的糖尿病肾病(DN)患者血糖变异性(GV)情况,并分析血糖变异性与患者腹主动脉钙化(ACC)的关系。方法抽取2018年3月至2020年3月焦作市人民医院收治的81例行血液透析治疗的DN 5期患者为研究对象,通过腹部侧位X线平片检测患者ACC情况并分组(ACC评分0分者为非钙化组,ACC评分>0分者为钙化组);检测行血液透析治疗的DN患者透析当日GV指标[平均血糖波动幅度(MAGE)、血糖值标准差(SDBG)],采集患者基线资料,分析MAGE、SDBG与DN患者ACC的关系。结果81例患者经评估结果显示,35例发生ACC,发生率为43.21%;钙化组血清游离三碘甲状腺原氨酸(FT3)水平低于非钙化组,MAGE、SDBG水平高于非钙化(P<0.05),组间其他基线资料比较差异未见统计学意义(P>0.05)。经二元Logistic回归分析后建立多元回归模型,结果显示,FT3低表达,MAGE、SDBG高表达均是血液透析的DN患者ACC发生的影响因素(OR>1,P<0.05)。结论行血液透析治疗的DN患者有较高的ACC发生风险,可能与患者GV异常表达有关。Objective To observe the blood glucose variability(GV)in hemodialysis patients with diabetic nephropathy(DN),and to analyze the relationship between GV and abdominal aortic calcification(ACC).Methods A total of 81 patients with DN 5 stage who underwent hemodialysis from March 2018 to March 2020 in Jiaozuo People’s Hospital were selected as the research subjects.The ACC condition of patients was detected by lateral abdominal X-ray film,and they were divided into two groups,patients with ACC score of 0 as non calcification group,patients with ACC score>0 as calcification group.The GV index on the day of hemodialysis,such as mean amplitude of glycemic excursions(MAGE),standard deviation of blood glucose(SDBG),were detected in hemodialysis patients with DN.And their baseline data were collected,and then the relationship between MAGE,SDBG and ACC in patients with DN was analyzed.Results Among 81 patients,the results of evaluation showed that 35 patients developed ACC,and the incidence was 43.21%.The serum free triiodothyronine(FT3)level in the calcification group was lower than that in the non calcification group(P<0.05),MAGE,SDBG levels were higher than those in the non calcification group(P<0.05).There was no significant difference in other baseline data between the two groups(P>0.05).Multiple regression model,based on binary logistic regression analysis,showed that low expression of FT3,high expression of MAGE and SDBG were the influencing factors of ACC in hemodialysis patients with DN(OR>1,P<0.05).Conclusions Hemodialysis patients with DN have a higher risk of ACC,which may be related to the abnormal expression of GV.

关 键 词：血液透析 糖尿病肾病 血糖变异性 腹主动脉钙化 相关性 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]