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《广州医药》编辑部

广州医药杂志服务号
论著

实时动态血糖监测系统对2型糖尿病患者胰岛素泵强化治疗中血糖波动监测的价值研究

The value of real-time continuous glucose monitoring system in monitoring blood glucose fluctuation in type 2 diabetes mellitus patients during intensive insulin pump therapy

:893-898
 
       目的 深入分析实时动态血糖监测系统(CGMS)在2型糖尿病患者接受胰岛素泵强化治疗过程中的实际应用意义。方法 本研究采用前瞻性随机对照试验设计,收集2025年1月至2026年3月间收治的80名2型糖尿病患者,运用随机数字表法将其随机分配为两组,每组40名患者。对照组患者接受常规指尖血糖检测与胰岛素泵治疗,研究组采用深圳硅基传感公司生产的GS1型动态血糖监测系统辅助胰岛素泵治疗,两组患者的治疗周期均延长至14天。主要观测指标:目标血糖范围内时间占比(TIR,3.9~10.0 mmol/L);次要观测指标:糖化血红蛋白(HbAlc)、空腹血糖(FBG)、餐后2 h血糖(2hPBG)等代谢指标,低血糖发生频率、日内血糖波动幅度(MAGE)、日间血糖平均绝对差(MODD)、血糖高于目标范围时间占比(TAR,>10.0 mmol/L)、血糖低于目标范围时间占比(TBR,<3.9 mmol/L)。结果 治疗14天后,两组患者的血糖指标均较治疗前改善,研究组主要指标TIR(78.65%±8.23%)高于对照组(62.34%±9.56%)(P<0.001);次要指标中,研究组HbAlc、FBG和2hPBG的改善幅度及MAGE、MODD的降低幅度均优于对照组(P<0.05);研究组低血糖发生率(2.5%)、TBR(1.82%±0.95%)低于对照组(20%、5.68%±1.32%),TAR(19.53%±7.81%)低于对照组(31.98%±8.64%)(P<0.05)。研究组动态血糖图谱(AGP)显示血糖波动更平稳,峰值与谷值差异缩小,TIR分布更集中。结论 实时动态血糖监测技术通过提供连续、完整的血糖数据,精准捕捉血糖波动规律,为胰岛素泵参数调整提供科学依据,显著提升目标血糖达标时间占比,优化整体血糖控制效果,同时有效降低低血糖事件及血糖偏离目标范围的风险,是2型糖尿病患者胰岛素泵强化治疗的重要辅助手段。

      Objective To analyze the practical significance of real-time continuous glucose monitoring system(CGMS) in patients with type 2 diabetes mellitus(T2DM) receiving intensive insulin pump therapy.Methods A prospective randomized controlled trial design was used to collect 80 patients with T2DM from January 2025 to March 2026.The patients were randomly divided into two groups by random number table method,with 40 patients in each group.The patients in the control group received routine fingertip blood glucose detection and insulin pump therapy,while the patients in the study group received insulin pump therapy assisted by GS1 type CGMS produced by Shenzhen Sili-based Sensor company.The treatment period of the two groups was extended to 14 days.Primary outcome measures:time in range(TIR,3.9-10.0 mmol/L);secondary outcomes:hemoglobin A1c(HbAlc),fasting blood glucose(FBG),2-hour postprandial blood glucose(2hPBG),frequency of hypoglycemia,mean amplitude of glycemic excursion(MAGE),mean of daily differences(MODD),time above range(TAR,>10.0 mmol/L) and time below the target range(TBR,<3.9 mmol/L),and other metabolic indicators.Results After 14 days of treatment,the blood glucose indexes of the two groups were significantly improved compared with those before treatment.The main index TIR in the study group(78.65%±8.23%) was significantly higher than that in the control group(62.34%±9.56%)(P<0.001).Among the secondary indexes,the improvement of HbAlc,FBG and 2hPBG and the reduction of MAGE and MODD in the study group were significantly better than those in the control group(P<0.05).The incidence of hypoglycemia(2.5%),TBR(1.82%±0.95%) and TAR(19.53%±7.81%) in the study group were significantly lower than those in the control group(20%,5.68%±1.32%,31.98%±8.64%)(P<0.05).The ambulatory glucose profile(AGP) of the study group showed that blood glucose fluctuation was more stable,the difference between peak and trough was reduced,and TIR distribution was more concentrated.Conclusions Real-time CGMS can accurately capture blood glucose fluctuation by providing continuous and complete blood glucose data,provide scientific basis for insulin pump parameter adjustment,significantly improve the proportion of time to reach the target blood glucose,optimize the overall blood glucose control effect,and effectively reduce the risk of hypoglycemia events and blood glucose deviation from the target range.It is an important auxiliary method for intensive insulin pump therapy in patients with type 2 diabetes.
论著

Th17/Treg与2型糖尿病患者胰岛素抵抗及胰岛β细胞功能的关系

Relationship among Th17/Treg,insulin resistance and islet β cell function in type 2 diabetic patients

:1372-1377
 
目的 观察辅助性T17细胞(Th17)与调节性T细胞(Treg)比值与2型糖尿病(T2DM)患者胰岛素抵抗及胰岛β细胞功能的关系。方法 纳入2022年4月—2023年4月在贵州医科大学第二附属医院内分泌科住院及健康体检人群各100例, 分为糖耐量正常组(NGT组, n=100)和T2DM组(n=100), 分别测定糖化血红蛋白(HbA1c)、空腹血糖(FPG)、甘油三酯(TG)等生化指标, 电化学发光法测定空腹胰岛素(FINS), 稳态模型计算胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)及胰岛素敏感指数(HOMA-ISI)。流式细胞术检测Th17、Treg水平。HOMA-IR、HOMA-β和HOMA-ISI的影响因素采用多元线性回归分析。结果 与NGT组相比, T2DM组BMI、FPG、HbA1c、LDL-C 、TG、TC、FINS、HOMA-IR、Th17及Th17/Treg水平均升高(P<0.01), HDL-C、HOMA-β、HOMA-ISI、Treg水平均降低, 且差异有统计学意义(P<0.01)。Th17与BMI(r=0.251, P<0.001)及HOMA-IR(r=0.305, P<0.001)呈正相关; 与HOMA-β(r=-0.204, P<0.001)及HOMA-ISI(r=-0.359, P<0.001)呈负相关。Treg与HOMA-ISI之间呈正相关(r=0.170, P=0.008), 而与HOMA-IR呈负相关(r=-0.153, P=0.017); Th17/Treg与BMI(r=0.332, P<0.001)及HOMA-IR(r=0.374, P<0.001);与HOMA-β(r=-0.249, P<0.001)及HOMA-ISI(r=-0.427, P<0.001)呈负相关。多元线性回归分析显示, Th17/Treg是HOMA-IR(β=5.915)升高及HOMA-ISI(β=-2.557)下降的影响因素(P<0.01)。结论 Th17/Treg可能通过影响胰岛素抵抗、降低胰岛素敏感性参与T2DM的发生。
Objective To explore the relationship among the proportion of helper T17 cells(Th17)to regulatory T cells(Treg), insulin resistance, and the function of islet beta cells.Methods One hundred cases of hospitalized patients and 100 cases of health check-ups people in the Department of Endocrinology of the Second Affiliated Hospital of Guizhou Medical University from April 2022 to April 2023 were included.Patients were divided into normal glucose tolerance group(NGT group, n=100)and type 2 diabetes mellitus group(T2DM group, n=100).The biochemical indexes of HbA1c, fasting blood glucose(FPG), triglyceride(TG)and fasting insulin(FINS)were determined by electrochemiluminescence.Islet beta cell function index(HOMA-β), insulin resistance index(HOMA-IR)and insulin sensitivity index(HOMA-ISI)were calculated in homeostasis model.The levels of Th17 and Treg were detected by flow cytometry.Spearman was used to analyze the correlation between indicators, and multiple linear regression analysis was used to analyze the influencing factors of HOMA-IR, HOMA-β and HOMA-ISI.Results In contrast to the NGT group, the T2DM group exhibited elevated levels of BMI, FPG, HbA1c, LDL-C, TG, TC, FINS, HOMA-IR, Th17 and Th17/Treg, with these variances being signifincantly different(P<0.01).There was a notable reduction in the levels of HDL-C,HOMA-β,HOMA-ISI,Treg,with those changes being significantly different(P<0.01).Th17 was positively correlated with BMI(r=0.251, P<0.001)and HOMA-IR(r=0.305, P<0.001), it was negatively correlated with HOMA-β(r=-0.204, P<0.001)and HOMA-ISI(r=-0.359, P<0.001).Treg was positively correlated with HOMA-ISI(r=0.170, P=0.008), while it was negatively correlated with HOMA-IR(r=-0.153, P=0.017).The ratio of Th17/Treg was positively correlated with BMI(r=0.332, P<0.001)and HOMA-IR(r=0.374, P<0.001), it was negatively correlated with HOMA-β(r=-0.249, P<0.001)and HOMA-ISI(r=-0.427, P<0.001).Multiple linear regression analysis showed that Th17/Treg was an influential factor in the increase of HOMA-IR(β=5.915)and the decrease of HOMA-ISI(β=-2.557)(P<0.01).Conclusions Th17/Treg may be involved in the development of T2DM by affecting insulin resistance and reducing insulin sensitivity.
论著

25-羟维生素D和糖化血红蛋白水平与2型糖尿病外周血管病变的相关性分析

:945-949
 
目的 分析2型糖尿病患者25-羟维生素D[25(OH)D]、糖化血红蛋白(HbA1c)水平和外周血管病变(PVD)的相关性,为疾病的预防及早期诊断提供参考。方法 分析于南通市中西医结合医院进行治疗的2型糖尿病患者基本资料,检测其25(OH)D、HbA1c以及肌酐、血钙等多项实验室指标,按照彩色多普勒超声检查结果将所有82例患者分为PVD阳性和阴性两组,通过样本检测分析PVD的影响因素。结果 经彩色多普勒超声诊断,82例T2DM中PVD阳性50例、阴性32例;PVD阳性患者病程、BMI、LDL-C、HbA1c、高于阴性组,25(OH)D低于阴性组(P<0.05);经Logistic回归分析,患者BMI、糖尿病病程、HbA1c以及LDL-C是PVD的影响因素(P<0.05);82例患者中HbA1c控制不佳62例,维生素D缺乏者PVD发生率71.43%,明显高于维生素D充足患者的45.00%(χ2=4.055,P=0.044)。结论 患者BMI、糖尿病病程、HbA1c、LDL-C以及25(OH)D水平均会对PVD的发生起到重要影响作用,且对于HbA1c控制不佳患者,出现维生素 D 缺乏时发生PVD的概率更高。
护理研究

远程药学管理模式联合延续护理在2型糖尿病合并冠状动脉病变患者居家用药中的研究

Study on home medication of type 2 diabetes patients with coronary artery disease by remote pharmaceutical management mode combined with continuous nursing

:427-431
 
目的 探讨远程药学管理模式联合延续护理在2型糖尿病(T2DM)合并冠状动脉病变患者居家用药中的应用效果。方法 选取2021年6月—2023年6月在广州医科大学附属第三医院诊治的200例T2DM合并冠状动脉病变患者为研究对象,根据干预方式不同分为常规组100例和研究组100例。常规组患者给予院内院外常规护理,研究组在常规组的基础上给予远程药学管理模式联合延续护理。评估患者用药依从性、饮食依从性、运动依从性、自我管理能力、生活质量[36条目简明健康量表(SF-36)]及心血管事件发生情况。结果 研究组用药、饮食、运动依从性均高于常规组(P<0.05)。相较于干预前,两组患者在干预后的自我管理机能、自我责任感、自我概念及健康知识分值均升高,且研究组高于常规组(P<0.05)。相较于干预前,两组患者在干预后的活力(VT)、精神健康(MH)、情感职能(RE)、躯体疼痛(BP)、生理功能(PF)、社会功能(SF)、生理职能(RP)、总体健康(GH)分值均升高,且研究组高于常规组(P<0.05)。研究组与常规组患者心血管不良事件发生率分别为2例(2.00%)、15例(15.09%),研究组高于常规组(χ2=10.865,P<0.05)。结论 远程药学管理模式联合延续护理能够提高T2DM合并冠状动脉病变患者的用药管理依从性,提高患者自我管理能力,改善生活质量,降低不良心血管事件的发生率。
Objective To explore the application effect of remote pharmacy management mode combined with continuous nursing in the home medication of type 2 diabetes mellitus(T2DM)patients with coronary artery disease.Methods A total of 200 patients with T2DM complicated with coronary artery diseases who were diagnosed and treated in the Third Affiliated Hospital of Guangzhou Medical University from June 2021 to June 2023 were selected as the study subjects.They were divided into a conventional group of 100 patients and a study group of 100 patients based on different intervention methods.The patients in the conventional group received routine care both in and out of the hospital,while the study group received remote pharmaceutical management mode combined with continuous care on the basis of the conventional group.Patient medication compliance,dietary compliance,exercise compliance,self-management ability,quality of life[36 item concise health scale(SF-36)] and incidence of adverse cardiovascular events were assessed.Results The compliance of medication,diet and exercise in the study group were significantly higher than those in the conventional group(P<0.05).Compared to before intervention,the self-management function,sense of responsibility,self-concept and health knowledge scores of both groups of patients were significantly increased after intervention,and the scores of the study group were significantly higher than those in the conventional group(P<0.05).Compared to before intervention,the Vitality(VT),Mental Health(MH),Emotional Function(RE),Physical Pain(BP),Physiological Function(PF),Social Function(SF),Physiological Function(RP)and Overall Health(GH)scores of both groups of patients were significantly increased after intervention,and the scores of the study group was significantly higher than those of the conventional group(P<0.05).The incidence of cardiovascular adverse events in the study group and the conventional group were 2 cases(2.00%)and 15 cases(15.09%),respectively,with the study group significantly higher than the conventional group(χ2=10.865,P<0.05).Conclusions The combination of remote pharmaceutical management mode and continuous care can significantly improve the medication management compliance of T2DM patients with coronary artery disease,improve their self-management ability,improve the quality of their life and reduce the incidence of adverse cardiovascular events.
论著

CircRNA-0003340在2型糖尿病大鼠肝脏组织中的表达及意义

CircRNA-0003340 expression and significance in the liver of T2DM rats

:7-13
 
目的 观察2型糖尿病大鼠肝脏组织中circRNA-0003340的表达,并探讨与糖尿病的关系。方法 选取健康雄性SD大鼠30只,随机分为2组,正常对照组(NC组,n=10)与2型糖尿病组(T2DM组,n=20),检测FPG、FINs、HbA1c、TC、TG、HDL-C、LDL-C、AST、ALT;行腹腔注射糖耐量实验和胰岛素耐量实验,计算胰岛素抵抗指数(HOMA-IR);HE染色观察胰岛细胞形态;RT-PCR检测大鼠肝脏组织circRNA-000334的表达量。结果 与NC组比较,T2DM组的AST、ALT、FPG、HAb1c、FINs、HOMA-IR、TG、TC、LDL-C均升高(P<0.05),HDL-C降低(P<0.05)。circRNA-0003340在T2DM组肝脏组织中的表达较NC组肝脏组织中的表达是下调的,差异有统计学意义(P<0.05)。Sperman相关分析示大鼠肝脏组织中circRNA-0003340表达水平与FPG、TG及TC呈负相关(P<0.05)。结论 circRNA-003340的表达水平可能与T2DM大鼠的糖脂代谢密切相关,circRNA-003340在肝脏组织中的表达水平下调可能参与T2DM的发生发展。
Objective To observe the expression of circRNA-0003340 in the liver tissue of type 2 diabetes mellitus (T2DM)rats and to explore its relationship with diabetes.Methods A total of 30 healthy male SD rats were randomly divided into two groups,normal control group(NC group,n=10)and T2DM group(n=20),and fasting plasma glucose(FPG),fasting insulins(FINS),glycated hemoglobin(HbA1c),total cholesterol(TC),triglyceride (TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),aspartate aminotransferase(AST),alanine aminotransferase(ALT)levels were detected.Intraperitoneal glucose tolerance test and insulin tolerance test were performed to calculate the insulin resistance index(HOMA-IR),HE staining was used to observe islet cell morphology,the expression of circRNA-000334 in rat liver tissue was detected by RT-PCR.Results Compared with the NC group,the T2DM group had increased AST,ALT,FPG,HAb1c,FINs,HOMA-IR,TG,TC,LDL-C(P<0.05)and decreased HDL-C(P<0.05).The expression of circRNA-0003340 in liver tissue in T2DM group was down-regulated compared with that in NC group,with statistically significant difference(P<0.05).Sperman correlation analysis showed that the expression level of circ-0003340 in rat liver tissue was negatively correlated with FPG,TG and TC(P<0.05).Conclusions The expression level of circRNA-003340 may be closely related to the glycolipid metabolism of T2DM rats,and the downward regulation of the circRNA-003340 expression level in liver tissues may be involved in the occurrence and development of T2DM.
综述

2型糖尿病自我管理水平的研究进展

Research progress on self-management levels of type 2 diabetes

:107-111
 
目的 分析近年来2型糖尿病自我管理水平的研究进展,讨论其自我管理水平的影响因素及给出相应的建议。方法 通过中国知网、万方医学、迈特思创外文期刊等检索工具,搜索“2型糖尿病”“自我管理”等关键词,收集2000年—2022年相关文献资料,采用文献研究方法进行分析。结果 共检索相关文献1 053条,通过阅读文献以及文献引文,共筛选出重要文献35篇。结论 归纳总结介绍了近年来有关2型糖尿病自我管理水平的研究进展、自我管理的各个方面,包括概念、评估工具、影响因素、与糖尿病并发症的关系及提升方法等,最后文章的总结部分提出了未来研究的方向和挑战。
Objective To analyze the research progress on self-management levels of type II diabetes in recent years,discuss the influencing factors of self-management levels,and provide corresponding suggestions.Methods This article collected relevant literature from 2000 to 2022 by searching tools such as CNKI,Wanfang Medical and Medline for keywords such as “type II diabetes”and“self-management”,and analyzed the literature using a literature research method.Results A total of 1,053 relevant literature were retrieved,and 35 important literature were selected through reading literature main body and citation.Conclusions This article summarizes the research progress on self-management levels of type II diabetes in recent years,including various aspects of self-management such as concepts,evaluation tools,influencing factors,the relationship with diabetic complications,and improvement methods.The conclusion part of the article proposes directions and challenges for future research.
临床诊疗

2型糖尿病患者发生慢性肾脏病的危险因素及与肥胖的相关性研究

:105-110
 
目的 探讨2型糖尿病(T2DM)患者慢性肾脏病(CKD)发生的危险因素以及其与肥胖之间的相关性。方法 选择2019年3月—2021年12月我院收治的552例T2DM患者作为研究对象,根据是否发生CKD进行分组,其中合并CKD患者136例、未合并CKD患者416例,对2组患者的一般资料及实验室指标进行单因素回归分析比较;对于未合并CKD的T2DM患者进行为期1年的随访,统计T2DM患者CKD的发生率,并针对随访群体的一般资料及实验室指标进行对比分析,通过单因素Logistic回归分析患者发生CKD的影响因素,了解T2DM患者CKD的发生与肥胖之间的关系。结果 合并CKD和未合并CKD的T2DM患者间的年龄、病程、肝功能指标、血脂指标中的低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、肾功能指标中的尿酸、肾小球滤过率(eGFR)比较差异均无统计学意义(均P>0.05),组间在性别构成、BMI、血压、白蛋白、血红蛋白、血脂指标中的总胆固醇(TC)及甘油三酯(TG)、血糖及肾功能指标中尿白蛋白/肌酐比(UACR)比较差异均有统计学意义(均P<0.05)。396例未合并CKD的T2DM患者随访结果显示,随访期间发生CKD患者123例、未发生CKD患者293例,组间的性别构成、BMI、舒张压、血红蛋白、丙氨酸氨基转移酶、白蛋白、总胆红素、TC、LDL-C、HDL-C、尿酸、糖化血红蛋白及eGFR比较差异均无统计学意义(均P>0.05),而组间年龄、病程、收缩压、天冬氨酸氨基转移酶、TG、空腹血糖(FPG)及UACR比较差异均有统计学意义(均P<0.05)。单因素Logistic回归分析结果显示,T2DM患者发生CDK的独立危险因素包括肥胖和收缩压、TG及FPG等指标升高(P<0.05)。T2DM患者的BMI与CKD的发生有关,当患者的BMI在28~31 kg/m2之间时,其CKD的发生率明显增加。结论 T2DM患者的CKD发生与肥胖因素有一定相关性,危险因素包括肥胖、血脂血压血糖异常等,T2DM患者的BMI在28~31 kg/m2之间时,其发生CKD的风险会有所增加,故需要对患者的BMI进行有效控制,降低CKD发生率,以避免病情恶化。
论著

绝经后2型糖尿病女性性激素水平与体质指数的关系

Relationship between sex hormone levels and body mass index in postmenopausal women with type 2 diabetes mellitus

:39-43
 
目的 探讨绝经后2型糖尿病人群性激素水平与体质指数(BMI)的关系。方法 收集2022年1月—2023年1月在我院住院的2型糖尿病患者,随机选取自然绝经后女性184例,根据其BMI分组,其中肥胖组23例、超重组74例、BMI正常组87例,比较3组间临床资料及性激素差异。结果 3组间腰围、空腹血糖(FPG)、甘油三酯、高密度脂蛋白胆固醇、血尿酸、卵泡刺激素(FSH)、黄体生成素(LH)、雌激素(E2)比较差异均有统计学意义(均P<0.05),肥胖组和超重组的E2高于正常组,FSH及LH低于正常组。3组间年龄、糖化血红蛋白、收缩压、舒张压、总胆固醇、低密度脂蛋白胆固醇、催乳素、睾酮、孕酮比较差异均无统计学意义(均P>0.05)。Logistic回归分析显示,过高的腰围和较低的FSH、LH是绝经后2型糖尿病女性肥胖的影响因素。结论 2型糖尿病绝经后女性应控制腹型肥胖,定期复查LH、FSH,提早干预。
Objective To investigate the relationship between sex hormone levels and body mass index(BMI)in postmenopausal women with type 2 diabetes mellitus(T2DM).Methods A total of 184 cases of natural postmenopausal women with T2DM admitted to our hospital from January 2022 to January 2023 were randomly selected,including 23 cases of obesity,74 cases of over weight and 87 cases of normal BMI.The clinical data and sex hormones among the three groups were analyzed.Results Waist circumference,fasting plasma glucose(FPG),triglyceride,high density lipoprotein cholesterol,uric acid,follicle-stimulating hormone(FSH),luteinizing hormone(LH)and oestrogen(E2)levels were significantly different among the three groups(P<0.05).E2 levels of the obesity group and the over weight group were significantly higher than that of the normal group,while FSH and LH levels were significantly lower than that of the normal group.There was no significant difference in age,hemoglobin A1c,systolic blood pressure,diastolic blood pressure,total cholesterol,low density lipoprotein cholesterol,prolactin,testosterone and progesterone levels among the three groups(P>0.05).Logistic regression analysis showed that higher waist circumference and lower FSH and LH levels were significantly correlated with obesity in postmenopausal women with T2DM.Conclusions Abdominal obesity should be controlled in postmenopausal women with T2DM,and LH and FSH should be periodically reviewed,in order to treat in advance.
论著

乙型病毒性肝炎不同状态合并2型糖尿病临床特征

Clinical analysis of different viral hepatitis B status with type 2 diabetes

:7-11
 
目的 探究乙型病毒性肝炎不同状态合并2型糖尿病患者的临床特点。方法 对62例乙型肝炎病毒携带合并2型糖尿病(组1)、129例乙型病毒性肝炎合并2型糖尿病(组2)和83例乙型病毒性肝炎肝硬化合并2型糖尿病(组3)患者的临床资料进行回顾性分析。结果 各组间在性别和年龄上差异有统计学意义(χ2=11.133、P=0.004,F=7.640、P=0.001)。3组研究对象糖化血红蛋白(HbA1c)、总胆固醇(Tch)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血清白蛋白(ALB)、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)和总胆汁酸(TBA)水平差异有统计学意义(F=4.028、P=0.019,F=4.140、P=0.017,F=3.172、P=0.044,F=6.701、P=0.002,F=53.156、P<0.001,F=4.920、P=0.008,F=4.173、P=0.017,F=7.181、P=0.001,F=9.170、P<0.001)。进一步两两比较,肝炎肝硬化组HbA1c、Tch 、LDL-C、ALB水平降低,但TBIL、IBIL、TBA增高,分别与另2组比较差异有统计学意义(P<0.05);组2空腹血糖(FBG)、HDL-C水平最高,前者高于组1,后者高于组3。各组糖尿病并发症居前三的都是周围神经病变、糖尿病肾病和糖尿病视网膜病变。结论 乙型病毒性肝炎合并2型糖尿病时其不同状态间具有不同的疾病特点,主要体现在携带状态Tch、TG、LDL-C高水平,肝炎状态FBG高水平,肝炎肝硬化状态HbAlc、ALB低水平但胆红素、胆汁酸水平高,在糖尿病并发症方面均以周围神经病变、糖尿病肾病和糖尿病视网膜病变为主。
Objective To study the clinical feature of different viral hepatitis B status with type 2 diabetes. Methods A retrospective analysis was carried out on 62 hepatitis B virus carriers with type 2 diabetes (group 1),129 viral hepatitis B patients with type 2 diabetes (group 2) and 83 viral hepatitis B cirrhosis patients with type 2 diabetes (group 3). Results The differences in gender and age among the three groups were significantly different (χ2=11.133, P=0.004 and F=7.640,P=0.001). The levels of HbA1c, total cholesterol (Tch), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), serum albumin (ALB), total bilirubin(TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL)and total bile acid (TBA)in three groups were significantly different (F=4.028, P=0.019.F=4.140, P=0.017.F=3.172, P=0.044.F=6.701, P=0.002.F=53.156, P<0.001.F=4.920, P=0.008.F=4.173, P=0.017.F=7.181, P=0.001.F=9.170, P<0.001). In further pairwise comparison, the levels of HbA1c, Tch, LDL-C and ALB of group 3 decreased significantly compared with other two groups, but the levels of TBIL, IBIL and TBA increased, with significant differences.The levels of fasting blood glucose(FBG) and HDL-C in group 2 were the highest,and the FBG was significantly higher than that in group 1, while the HDL-C was significantly higher than that in group 3.In the three groups, the top three diabetic complications were peripheral neuropathy, diabetic nephropathy and diabetic retinopathy. Conclusion Different statuses of viral hepatitis B with type 2 diabetes had different disease characteristics, mainly reflected in the high levels of Tch, TG and LDL-C in the hepatitis B virus carriers, high FBG level in the viral hepatitis B patients, low levels of HbAlc and ALB but high levels of bilirubin and bile acid in the cirrhosis patients.Peripheral neuropathy, diabetic nephropathy and diabetic retinopathy were the main complications of diabetes.
临床诊疗

分析2型糖尿病患者的肾糖阈及相关因素

Analysis of renal glucose threshold and its related factors of T2DM patients

:138-141
 
目的 探究2型糖尿病患者的肾糖阈(RTG)及相关因素。方法 本院对2014年12月—2018年9月466例2型糖尿病患者为研究对象,正常肾糖阀值为8.9~10 mmol/L,据此将患者分为高阀值组、中等阀值组以及低阀值组,不同组肾糖范围分别为RTG>10 mmol/L、8.9 mmol/L≤RTG≤10 mmol/L、RTG<8.9 mmol/L,以此对各组生化特征进行分析。结果 高阀值组与中等阀值组相比,RTG值、年龄、病程、空腹血糖(FPG)、体质量指数(BMI)、总胆固醇(TC)、血糖均值(MBG)、24 h血糖对比差异明显,P<0.05。高阀值组与低阀值组相比,RTG值、性别、FPG、BMI、TC、MBG、糖化血红蛋白(HbA1C)对比有差异,P<0.05。性别、年龄、BMI、HbA1C、TC以及低密度酶蛋白胆固醇(LDL-C)与2型糖尿病相关,且呈正比关系,P<0.05;通过多元线性回归分析发现,2型糖尿病的影响因素主要有BMI、HbA1C、LDL-C,数据具有统计学意义,P<0.05。结论 较多2型糖尿病患者肾糖阀值较高,且肾糖阀值与HbA1C、LDL-C相关。
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