血糖波动在2型糖尿病合并颈动脉病变患者中的意义

目的探讨血糖波动在2型糖尿病（T2DM）合并颈动脉病变患者中的意义。方法选择T2DM65例，应用彩色多普勒超声检测颈动脉粥样硬化斑块发生情况及内中膜厚度（IMT），根据病变程度分为无病变组（A组）30例、有病变组（B组）35例。同时对所有患者进行72h动态血糖监测，记录日内平均血糖波动幅度（MAGE）、最大血糖波动幅度（LAGE）、平均餐后血糖波动幅度（MPPGE）、血糖标准差（SDBG），并测定IMT，检测胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL）、c反应蛋白（CRP）、血管性血友病因子（vwF）、糖化血红蛋白（HbA1C）。结果①B组年龄、病程、收缩压（SBP）、胆固醇（Tc）、低密度脂蛋白（LDL）均高于A组，差异有统计学意义（P〈0．05）。②B组HbAIc、SDBG、MAGE、LAGE、MPPGE均高于A组，差异有统计学意义（P〈0．05）。③B组C反应蛋白（CRP）、血管性假血友病因子（vwF）及IMT均高于A组，差异有统计学意义（P〈0．01）。结论T2DM合并颈动脉病变患者血糖波动明显增强，血糖波动与T2DM血管病变密切相关。

Significance of Glucose Fluctuation in Patients with Type 2 Diabetes Mellitus Combined with Carotid Lesions

Objective To explore the significance of glucose fluctuation in patients with type 2 diabetes mellitus （T2DM） complicated with carotid lesions. Methods The status of carotid atherosclerotic plaque and intima-media thickness （IMT） in 65 patients with T2DM were detected by color ultrasonic Doppler. The patients were divided into pa- tients without lesions group （group A, n = 30） and patients with lesions （group B, n = 35 ） by the lesion degrees. Blood glucose of each patient was monitored for 72 hours by a continuous glucose monitoring system （CGMS） , and values of mean amplitude of glycemic excursions （MAGE） , largest amplitude of glycemie excursions （LAGE） , mean postprandial glucose excursion （MPPGE） and standard deviation of Mood glucose （SDBG） were also recorded. The IMT, total cho- lesterol （TC）, triglyceride （TG）, low density lipoprotein cholesterol （LDL-CH）, C-reactive protein （CRP） , von wille- brand factor （vwF） and glycated hemoglobin （HbAlc） were detected. Results The values of age, course of disease, systolic blood pressure （SBP） , TC and LDL in group B were significantly higher than those in group A （P 〈 0.05 ）. The values of HbAlc, SDBG, MAGE, LAGE and MPPGG in group B were significantly higher than those in group A, and the differences were statistically significant （ P 〈0. 05 ）. The values of CRP, vwF and IMT in group B were significantly high- er than those in group A （ P 〈 0.01 ）. Conclusion T2DM complicated with carotid lesions can significantly enhance pa- tients＇glucose fluctuation, and glucose fluctuation is closely related with diabetic angiopathies.