不同病程2型糖尿病患者甲襞微循环状态比较

目的:观察不同病程2型糖尿病(T2DM)患者甲襞微循环障碍程度。方法:600例住院T2DM患者,依病程分为新诊断组、3月～5年组、6年～10年组和>10年组。选取30例健康体检者为对照组。用徐州产HD-WX-10型微循环显微仪,在22～24℃室温下,检测所有对象的左手无名指,观察甲襞微循环形态、流态和袢周状态,并对各组加权积分值、不同程度异常率和部分指标异常进行统计学分析比较。结果:(1)不同病程各组T2DM患者甲襞微循环形态、流态和袢周状态积分均高于对照组,以管袢减少、白微栓、渗出和出血等改变较明显(P<0.01),中度异常患者比例较高。(2)病程10年以内各组患者积分值、部分指标异常率及异常程度无统计学差异(P>0.05)。(3)>10年组患者甲襞微循环流态及袢周形态积分和总积分较其它组增加(P<0.05),中度异常患者比例较高(P<0.01),管袢明显减少,白微栓和渗出显著增多(P<0.01)。结论:T2DM患者存在微循环障碍,病程>10年者较重。

The Comparison of the Nailfold Microcirculation Status in Patients of Type 2 Diabetes Mellitus with Different Clinical Course

Objective: To observe the nailfold microcirculation disorder degree of different clinical course in patients with type 2 diabetes(T2DM). Method: 600 cases of hospitalized patients of T2DM were divided into new diagnostic group, 3 months-5 years group, 5-10 years group, and more than 10 years group according to the clinical course. The other 30 cases of healthy people as control group. All people's left ring finger were detected by DH-WX-10 microcirculation microscope made in Xuzhou at room temperature of 22 to 24℃, induding the form, flow pattern and week of loops of the nailfold microcirculation. Results: (1)The nailfold microcirculation integral of T2DM patients with different clinical course were higher than the control group, and the change of vascular loops reducing, white micro thrombus, exudation and hemorrhage were obvious (P<0.01). The proportion of moderately abnormal patients was higher. (2)Each integral value, some abnormal rate and abnormal degree of the patients with a clinical course within 10 years had no significant statistical difference (P>0.05). (3)The flow pattern, loops week integral and the total integral of the T2DM patients were increased in more than 10 years group (P<0.05). The proportion of moderately abnormal patients was higher (P<0.01), with week of loops obviously decreased, white micro thrombus and exudation increased significantly (P<0.01). Conclusion: There is microcirculation disorder in the patients with T2DM, and is more severe with a clinical course more than 10 years.