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      标题:血糖波动与老年2型糖尿病患者认知功能障碍的关系
      作者:李堃宜,李芝,钟志鹏    (佛山市顺德区第二人民医院内四科,广东 佛山 528305)
      卷次: 2018年29卷19期
      【摘要】 目的 探讨血糖波动与老年2型糖尿病患者认知功能障碍的关系,以期为临床上早期识别、阻断认知功能障碍提供指导。方法 选择佛山市顺德区第二人民医院内四科2017年1月至2018年4月期间收治的43例老年2型糖尿病患者为研究对象,根据简易精神状态检查表(MMSE)评分将评分>26分者纳入正常组(n=17),评分≤26分纳入认知功能障碍组(观察组,n=26)。比较两组患者的空腹血糖(FPG)、糖化血红蛋白(HbAlc)水平,以及空腹血糖平均值、高血糖(>11.1 mmol/L)时间比、低血糖(<3.9 mmol /L)时间比、血糖波动系数(BGFC)等血糖波动指标。结果 观察组患者血HbAlc水平为(7.21±2.12)%,明显高于正常组的(6.04±1.23)%,差异有统计学意义(P<0.05);观察组患者的高血糖时间比、空腹血糖平均值、BGFC分别为(5.36±1.86)%、(6.24±2.05) mmol/L、(2.58±0.52),明显高于正常组的(2.12±0.49)%、(5.34±1.03) mmol/L、(1.59±0.39),差异均有统计学意义(P<0.05);两组患者的FBG、低血糖时间比比较差异均无统计学意义(P>0.05)。结论 老年2型糖尿病患者认知功能障碍的发生与糖化血红蛋白及血糖波动关系密切,临床上对于老年2型糖尿病患者,在做好糖化血红蛋白达标的同时,应该尽量避免血糖波动。
      【关键词】 2型糖尿病;血糖波动;糖化血红蛋白;认知功能障碍;相关性
      【中图分类号】 R587.1 【文献标识码】 A 【文章编号】 1003—6350(2018)19—2689—03
Relationship between blood glucose fluctuation and cognitive impairment in elderly patients with type 2 diabetesmellitus. LI Kun-yi, LI Zhi, ZHONG Zhi-peng. The Fourth Department of Medicine, the Second People's Hospital of ShundeDistrict of Foshan, Foshan 528305, Guangdong, CHINA
      【Abstract】 Objective To explore the relationship between blood glucose fluctuation and cognitive dysfunctionin elderly patients with type 2 diabetes mellitus (T2DM), and to provide guidance for early recognition and interruptionof cognitive dysfunction. Methods A total of 43 aged T2DM patients, who treated in the Fourth Department of Medi-cine, the Second People's Hospital of Shunde District of Foshan from January 2017 to April 2018, were selected as the re-search subjects. According to the simple mental state examination table (MMSE) score, the patients with score>26 pointswere included into the normal group (the control group, n=17), and the patients with score was≤26 points were includ-ed into the cognitive impairment group (the observation group, n=26). The fasting blood glucose (FPG), glycated hemo-globin (HbAlc), and blood glucose fluctuations included fasting blood glucose mean, hyperglycemia (>11.1 mmol/L)time ratio, hypoglycemia (<3.9 mmol /L) time ratio, blood glucose fluctuation coefficient (BGFC) in the two groupswere compared. Results The blood HbAlc in the observation group was (7.21±2.12)%, which was significantly higherthan (6.04±1.23) of the control group (P<0.05). The time ratio of hyperglycemia, the average value of fasting blood glu-cose, and BGFC in the observation group were (5.36±1.86)%, (6.24±2.05) mmol/L, and (2.58±0.52), respectively, whichwere significantly higher than corresponding (2.12±0.49)%, (5.34±1.03) mmol/L, and (1.59±0.39) in the control group(P<0.05), and there was no significant difference in the FBG and hypoglycemia time ratio (P>0.05). Conclusion Theoccurrence of cognitive dysfunction in elderly patients with type 2 diabetes is closely related to glycosylated hemoglobinand blood glucose fluctuation. It is suggested that in elderly patients with T2DM, glycosylated hemoglobin should bestandardized, and blood glucose fluctuation should be avoided as much as possible.
      【Key words】 Type 2 diabetes mellitus (T2DM); Blood glucose fluctuation; Glycosylated hemoglobin; Cognitiveimpairment; Relationship·论 著·doi:10.3969/j.issn.1003-6350.2018.19.007
      基金项目:广东省佛山市科技计划项目(编号:20170324)

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