不同浓度糖化血红蛋白及空腹血糖的2型糖尿病患者β-羟丁酸水平变化分析

目的:观察2型糖尿病(T2DM)患者不同糖化血红蛋白(HbA1c)及空腹血糖(FBG)水平时β-羟丁酸(β-HBA)血清水平的变化。方法:随机选择T2DM患者100例,男65例,女35例,年龄25～83岁,平均57±13岁。测定各患者血清β-HBA浓度,根据HbA1c水平将T2DM患者分为轻度组(HbA1c<7%)、中度组(7%≤HbA1c≤9%)、重度组(HbA1c>9%)。又根据FBG水平将T2DM患者分为轻度组(FBG<7mmol/L)、中度组(7mmol/L≤FBG≤mmol/L)、重度组(FBG>9mmol/L)。分析比较不同水平HbA1c和FBG组间β-HBA水平差异。结果:随着HbA1c水平的逐渐升高,β-HBA水平亦有逐渐升高的趋势,HbA1c重度组与轻度组和中度组比较差异有统计学意义(P<0.05)。不同FBG水平组间β-HBA没有统计学差异(P>0.05)。结论:在血浆HbA1c>9%的T2DM患者中,β-HBA显著升高,提示临床加强血糖控制,降低HbA1c,防止糖尿病酮症及酮症酸中毒。

Relationships between Fasting Blood Glucose Level,Glycosylated Hemoglobin and Beta-Hydroxybutyrate Concentration in Type 2 Diabetes Patients

Objective:This study focus on discussing the relationships between fasting blood glucose level,glycosylated hemoglobin(HbA1c) and ketones concentration in type 2 diabetes patients.Method:100 patients with type 2 diabetes were selected randomly,65 cases of male,35 cases of female,ages from 25 to 83.According to the level of glycated hemoglobin,the patients were divided into three groups:light group(HbA1c <7%),medium group(7% ≤ HbA1c≤ 9%),severe group(HbA1c> 9%).Based on fasting blood glucose levels,the patients were divided into three groups:light group(FBG <7mmol/L),medium group(7mmol/L ≤ FBG ≤ 9mmol/L),severe group(FBG> 9mmol/L).Fasting blood glucose and blood beta-hydroxybutyrate(β-HBA) level were tested in all subjects.The relationships between FPG,HbA1c level and β-HBA were studied in T2DM subjects.Results:The β-HBA level of T2DM subjects was obviously positive related with HbA1c.There was significant difference in HbA1c severe group compare with the other groups(P<0.05).The β-HBA level of T2DM subjects was not relevant with FBG level.Conclusion:β-HBA level was significantly incresed in the HbA1c>9% T2DM subjects.Blood glucose level should be strictly controlled to prevent diabetic ketoacidosis.