摘要
目的探讨糖尿病微血管病变与糖尿病病程及糖化血红蛋白（HbA1c）控制水平之间的关系。方法根据糖尿病病程将340例2型糖尿病患者分为4组：初发组（90例,〈1年）、1~9年组（94例）、10~19年组（86例）及≥20年组（70例）;以HbA1c是否达标（HbA1c〈7%为血糖控制达标,HbA1c≥7%为血糖未达标）分为2组,即达标组（112例）和未达标组（215例）。记录各组患者的基本资料（性别、年龄、BMI、SBP、DBP）,肾功能[尿酸（UA）、肌酐（Cr）、尿素氮（BUN）],血脂[胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）]及HbAlc水平变化,观察不同病程及不同HbAlc水平的2型糖尿病患者糖尿病周围神经病变（DNP）及糖尿病视网膜病变（DR）的发生情况,分析糖尿病微血管病变与糖尿病病程、HbAlc之间的关系。结果 4组DBP、HbA1c、UA、TG、TC、HDL-C、LDL-C等指标比较差异无统计学意义（P〉0.05）;BMI、SBP、Cr、BUN等比较差异有统计学意义（均P〈0.05）。初发组、1~9年组、10~19年组及≥20年组的DNP发生率分别为34.4%、45.7%、51.2%及70.0%（χ2=20.539,P〈0.01）,DR发生率分别为5.6%、7.8%、27.9%及38.6%（χ2=41.319,P〈0.01）。达标组DR发生率明显低于未达标组（χ2=8.655,P〈0.05）,DNP发生率比较差异无统计学意义（χ2=1.172,P〉0.05）。结论 2型糖尿病患者随着病程延长,DNP及DR的发生率呈显著上升趋势;良好的血糖控制可预防DR的进展,而DNP的发生率无明显下降。
Objective To investigate the relationships of diabetic microangiopathy to the duration of type 2 diabetes mellitus（T2DM）and the control level of glycosylated hemoglobin（HbA1c）.Methods According to the duration of T2 DM,340patients were divided into four groups：initial onset group（〈1year,90patients）,1-9year group（94patients）,≥20year group（86patients）and≥20year group（70patients）.According to HbA1 clevels,these patients were divided into two groups：standard group（HbA1c〈7%,112patients）and non-standard group（HbA1c≥7%,215patients）.The gender,age,body mass index（BMI）,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,uric acid（UA）,creatinine（Cr）,blood urea nitrogen（BUN）,total cholesterol（TC）,triacylglycerol（TG）,high density lipoprotein cholesterol（HDLC）,low density lipoprotein cholesterol（LDL-C）and HbAlc were recorded in all patients.The occurrence of diabetic peripheral neuropathy（DPN）and diabetic retinopathy（DR）was observed in patients with different disease courses,as well as in patients with different HbAlc levels.In addition,the relationships of diabetic microangiopathy to disease courses and HbAlc levels were analyzed.Results There were significant differences among the four disease course groups in BMI,SBP,Cr and BUN（P〈0.05）,but not in DBP,HbA1 c,UA,TG,TC,HDL-C and LDL-C.The incidences of DNP were 34.4%,45.7%,51.2%and 70.0%in initial onset group,1-9year group,≥20year group and ≥20year group,respectively（χ2=20.539,P〈0.01）.The incidences of DR were 5.6%,7.8%,27.9% and 38.6%in initial onset group,1-9year group,≥20year group and10-19 year group,respectively（χ2=41.319,P〈0.01）.The incidence of DR in standard group was significantly lower than that in non-standard group（χ2=8.655,P〈0.05）.No significant difference in the incidence of DNP was found between the two groups（χ2=1.172,P〉0.05）.Conclusion The incidences of DNP and DR tend to increase with diabetes duration.The intensive blood-glucose control can prevent the progress of DR,but has no obvious effect on the incidence of DNP.
出处
《实用临床医学（江西）》
CAS
2016年第1期10-13,共4页
Practical Clinical Medicine
