文章摘要
奚 珏,李 伟,郭海燕,甘 甜,李培培,范静静.2型糖尿病患者血糖波动与心律失常和下肢血管病变的关系及其影响因素分析[J].,2021,(5):996-1000
2型糖尿病患者血糖波动与心律失常和下肢血管病变的关系及其影响因素分析
Relationship between Blood Glucose Fluctuation and Arrhythmia and Lower Extremity Vascular Lesions in Patients with Type 2 Diabetes Mellitus and Its Influencing Factors
投稿时间:2020-09-14  修订日期:2020-09-28
DOI:10.13241/j.cnki.pmb.2021.05.042
中文关键词: 2型糖尿病  血糖波动  心律失常  下肢血管病变  影响因素
英文关键词: Type 2 diabetes  Glucose fluctuation  Arrhythmology  Lower extremity vascular lesions  Influencing factors
基金项目:江苏省卫计委科研项目(H201667)
作者单位E-mail
奚 珏 徐州医科大学附属医院内分泌科 江苏 徐州 221006 lfflfyi@163.com 
李 伟 徐州医科大学附属医院内分泌科 江苏 徐州 221006  
郭海燕 江苏省中医院内分泌科 江苏 南京 210029  
甘 甜 徐州医科大学附属医院内分泌科 江苏 徐州 221006  
李培培 徐州医科大学附属医院内分泌科 江苏 徐州 221006  
范静静 徐州医科大学附属医院内分泌科 江苏 徐州 221006  
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中文摘要:
      摘要 目的:探讨2型糖尿病(T2DM)患者血糖波动与心律失常和下肢血管病变的关系,分析影响T2DM心律失常和下肢血管病变的因素。方法:选择2019年7月到2020年6月我院收治的82例T2DM患者,根据是否合并心律失常分为心律失常组28例和无心律失常组54例,根据是否合并下肢血管病变分为下肢血管病变组31例和无下肢血管病变组51例。所有患者均通过72 h监测血糖获得日内平均血糖波动幅度(MAGE)、日间血糖平均绝对差(MODD)、全天血糖标准差(SDBG)、全天血糖波动次数(NGE)。比较组间差异,分析影响T2DM患者心律失常和下肢血管病变的因素。结果:心律失常组MAGE、MODD、SDBG、NGE、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、T2DM病程、同型半胱氨酸(Hcy)、丙二醛(MDA)高于无心律失常组(P<0.05)。下肢血管病变组T2DM病程、Hcy、MDA、HOMA-IR、MAGE、MODD、SDBG、NGE均高于无下肢血管病变组(P<0.05)。Logistic回归分析结果显示MDA、HOMA-IR、MAGE、MODD 是T2DM患者心律失常的危险因素(P<0.001),MAGE、MODD、SDBG是T2DM患者下肢血管病变的危险因素(P<0.001)。结论:T2DM患者血糖波动与心律失常和下肢血管病变均有关,血糖波动增加是T2DM心律失常和下肢血管病变的危险因素。
英文摘要:
      ABSTRACT Objective: To investigate the relationship between blood glucose fluctuation and arrhythmia and lower extremity vascular lesions in patients with type 2 diabetes mellitus (T2DM), and to analyze the influencing factors the arrhythmia and lower extremity vascular lesions in T2DM. Methods: A total of 82 patients with T2DM who were admitted to our hospital from July 2019 to June 2020 were selected. According to the presence or absence of arrhythmia, the patients were divided into arrhythmia group(28 cases) and non arrhythmia group(54 cases). According to the presence or absence of lower extremity vascular disease, they were divided into lower extremity vascular lesions group (31 cases) and non lower extremity vascular lesions group (51 cases). The average amplitude of intra-day blood glucose fluctuation (MAGE), the average absolute difference of daytime blood glucose (MODD), the standard deviation of all-day blood glucose (SDBG), and the number of all-day blood glucose fluctuation (NGE) were obtained by monitoring blood glucose for 72h. The differences between groups were compared, and the factors affecting arrhythmia and lower extremity vascular lesions in patients with T2DM were analyzed. Results: MAGE, MODD, SDBG, NGE, glycosylated hemoglobin (HbA1c), insulin resistance index (HOMA-IR), T2DM course, homocysteine (Hcy), malondialdehyde (MDA) in the arrhythmia group were higher than those in the non arrhythmia group (P<0.05). The T2DM course, Hcy, MDA, HOMA-IR, MAGE, MODD, SDBG and NGE in the lower extremity vascular lesions group were all higher than those in the non lower extremity vascular lesions group (P<0.05). Logistic regression analysis showed that MDA, HOMA-IR, MAGE and MODD were risk factors for arrhythmia in patients with T2DM (P<0.001), MAGE, MODD and SDBG were risk factors for lower extremity vascular lesions in patients with T2DM (P<0.001). Conclusion: Blood glucose fluctuation in patients with T2DM is related to arrhythmia and lower extremity vascular lesions, and increased blood glucose fluctuation is a risk factor for arrhythmia of T2DM and lower extremity vascular lesions.
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