| 2型糖尿病合并下肢动脉闭塞症患者手术前后血糖控制情况的研究 |
| 投稿时间：2014-12-06 修订日期：2014-12-29 点此下载全文 |
| 引用本文：许建萍,肖新华.2型糖尿病合并下肢动脉闭塞症患者手术前后血糖控制情况的研究[J].医学研究杂志,2015,44(4):25-28,36 |
| DOI：
10.11969/j.issn.1673-548X.2015.04.008 |
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| 基金项目:国家自然科学基金资助项目(81170736);国家卫生和计划生育委员会(原卫生部)内分泌临床重点专科基金资助项目 |
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| 中文摘要:目的 观察一组糖尿病下肢动脉闭塞症患者手术前后的血糖控制情况。 方法 选取2002~2012年在北京协和医院血管外科行手术治疗的糖尿病下肢动脉闭塞症患者,并以同期门诊就诊的2型糖尿病且不合并下肢动脉闭塞的患者为对照组,监测血压、血糖和血脂。观察两组患者的空腹、3餐后2h及平均血糖差异,并比较有动脉闭塞症的患者手术前后血糖变化情况。同时比较基线时两组的血压和血脂。组间比较采用t检验和方差分析。 结果 共纳入有下肢动脉闭塞症的2型糖尿病患者60例,对照组65例。两组患者年龄比较,差异无统计学意义(65.8±8.9岁 vs 63.0±10.0岁),合并下肢动脉闭塞的患者病程较长(12.2±7.1 vs 7.7±5.9年),下肢动脉闭塞组与对照组术前血糖相比两组空腹血糖(8.3±2.7 vs 7.7±2.3mmo/L)、早、午餐后(10.7±2.9 vs 9.0±2.4mmol/L、10.6±3.1 vs 8.9±4.1mmol/L)和平均血糖闭塞组(9.7±2.1 vs 7.6±3.6mmol/L)显著高于对照组,晚餐后血糖(8.9±2.3 vs 9.9±3.2mmol/L)差异无统计学意义。下肢动脉闭塞组手术前后所用胰岛素剂量不变的情况下,空腹血糖(7.7±2.1 vs 6.8±2.8mmol/L)、早餐后血糖(10.5±2.5 vs 8.5±3.4mmol/L)、午餐后血糖(10.5±3.1 vs 8.7±3.8mmol/L)和平均血糖(9.6±1.8 vs 8.2±2.9mmol/L)有明显下降,晚餐后血糖(9.8±3.1 vs 9.0±4.0mmol/L)差异无统计学意义。 结论 2型糖尿病合并下肢动脉闭塞症的患者与对照组相比,糖尿病的病程相对较长,血糖控制较差。在治疗不变的情况下,行手术治疗下肢动脉闭塞症可使血糖控制情况明显改善。当糖尿病患者血糖控制不良时,应寻找病因,及时处理合并症,可使血糖控制得更加理想。 |
| 中文关键词:2型糖尿病 外周动脉疾病 手术 血糖 |
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| Investigation on Glycemin Control in Type 2 Diabetes Patients with Lower Extremity Arterial Occlusive Disease |
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| Abstract:Objective To investigate the status of glycemic control in a group of type 2 diabetes mellitus patients combined with peripheral arterial disease before and after operation. Methods Patients with lower extremity arterial occlusive disease who were in charge in vascular surgery of Peking Union Medical College Hospital from 2002 to 2012 were involved.Type2 DM out patient without lower extremity arterial occlusive disease were involved as control.We measured blood pressure,blood glucose and blood lipid.Fasting,2hPG and average plasma glucose of two groups patients were Compared,at the same time we observed the difference of plasma glucose before and after operation.The Student's t test and ANOVA analysis were used to compare the difference of before and after operation and between groups. Results Total of sixty DM patients with lower extremity arterial occlusive disease were involved,and sixty five patients were involved in control group.There was no difference in age between two groups(65.8±8.9 vs 63.0±10.0years).The DM patients with lower extremity arterial occlusive disease had longer duration of DM(12.2±7.1 vs 7.7±5.9years).PAD group had higher fasting plasma glucose(8.3±2.7 vs 7.7±2.3mmol/L),post breakfast and lunch plasma glucose (10.7±2.9 vs 9.0±2.4mmol/L,10.6±3.1 vs 8.9±4.1mmol/L)than control group.There was no significant difference in post dinner plasma glucose of two groups.Patients with PAD obtained a good plasma glucose after they made an operation but insulin volumn had no change,which was as fasting plasma glucose(7.7±2.1 vs 6.8±2.8mmol/L),breakfast (10.5±2.5 vs 8.5±3.4mmol/L),lunch(10.5±3.1 vs 8.7±3.8mmol/L)and average plasma glucose(9.6±1.8 vs 8.2±2.9mmol/L). Post dinner plasma glucose had no difference in two groups. Conclusion Type 2 DM patients combined with lower extremity arterial occlusive disease had a longer duration of diabetes and higher plasma glucose.At the same,therapy and operation can improve blood glucose control.If a DM patient has a poor plasma glucose,we should find its reason,and deal with complication,then plasma glucose can be controlled better. |
| keywords:Type 2 diabetes mellitus Peripheral arterial disease Operation Plasma glucose |
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