陈菲++陈岭++姚文琦++曹建芬++申丽娜

[摘要] 目的 探讨动态血糖监测系统对糖尿病合并肾病患者的血糖波动幅度及对肾功能影响。 方法 随机选取2016年8—12月于该院就诊的2型糖尿病肾病患者46例为观察组，并选取同期单纯2型糖尿病患者46例作为对照组，采用动态血糖监测系统监测两组患者3d的血糖波动，并观察两组患者肾功能指标变化。 结果 两组患者的日内血糖最大波动幅度、血糖最大值、24 h血糖水平标准差对比差异无统计学意义（P>0.05）；但觀察组患者24 h血糖平均水平、日间血糖平均绝对差、血糖最小值均显著大于对照组（P<0.05）；观察组患者24 h尿蛋白定量（248.62±38.37）mg/24h、尿微量白蛋白（33.71±3.05）mg/g·cr、尿β2-微球蛋白水平（0.56±0.07）mg/L均显著高于对照组（P<0.05）。结论 糖尿病肾病患者的平均血糖高于单纯糖尿病患者，并且持续长时间高血糖状态，日间血糖波动幅度较大，损害患者肾功能。采用动态血糖监测系统监控糖尿病肾病患者的血糖波动，并有效控制血糖，能够减少肾病发生。

[关键词] 动态血糖监测系统；糖尿病肾病患者；2型糖尿病；血糖波动；肾功能

[中图分类号] R587.1 [文献标识码] A [文章编号] 1672-4062（2017）02（b）-0014-04

Analysis of Effect of Dynamic Monitoring System of Blood Glucose on the Blood Glucose Fluctuation Range of Patients with Diabetes and Renal Disease and Renal Function of Patients

CHEN Fei， CHEN Ling， YAO Wen-qi， CAO Jian-fen， SHEN Li-na

Department of Internal Medicine， Ruijin Rehabilitation Hospital of Shanghai（Shanghai Southeast Hospital）， Shanghai， 200023 China

[Abstract] Objective To study the effect of dynamic monitoring system of blood glucose on the blood glucose fluctuation range of patients with diabetes and renal disease and renal function of patients. Methods 46 cases of patients with type 2 diabetic nephropathy diagnosed in our hospital from August to May December 2016 were randomly selected and 46 cases of patients with simple type 2 diabetes at the same period were selected as the control group， and the blood glucose fluctuation at 3d was monitored by the dynamic monitoring system and the renal function index changes of the two groups were observed. Results The differences in the maximum fluctuation range of daily blood glucose， maximum value of blood glucose and 24 h blood glucose level standard deviation between the two groups were not obvious without statistical significance（P>0.05）， but the average level of 24h blood glucose， average absolute difference of daily blood glucose and minimum value of blood glucose were obviously higher than those in the control group（P<0.05）， and the 24 h urine protein quantitation， microalbuminuria and urinary beta-2 microglobulin in the observation group were respectively（248.62±38.37）mg/24h，（33.71±3.05）mg/g·cr and （0.56±0.07）mg/L， which were obviously higher than those in the control group（P<0.05）. Conclusion The average blood glucose in patients with diabetic nephropathy is higher than that of patients with simple diabetes， and the long-time high blood glucose state and big fluctuation range of daily blood glucose can be harm to the renal function of patients， and the dynamic monitoring system of blood glucose fluctuation of patients with diabetic nephropathy and effectively controlling the blood glucose can reduce the occurrence of nephropathy.

[Key words] Dynamic monitoring system of blood glucose； Patients with diabetic nephropathy； Type 2 diabetes； Blood glucose fluctuation； Renal function

糖尿病是代谢性疾病，持续长时间的高血糖状态会导致心血管、肾脏以及神经系统出现严重并发症。糖尿病肾病就是由糖尿病导致的一种慢性并发症，并且是近几年糖尿病患者出现死亡或者残疾的主要原因[1]。有研究称[2]，长时间高血糖状态会导致尿微量白蛋白、尿β2-微球蛋白水平的升高，损伤患者的肾功能[2]。因此，该文采用动态血糖监测系统监测糖尿病肾病的血糖，并分析血糖对肾功能的影响，现报道如下。

1 资料与方法

1.1 一般资料

随机选取2016年8—12月于该院就诊的2型糖尿病肾病患者46例为观察组，并选取同期单纯2型糖尿病患者46例作为对照组，排除感染性疾病、心血管疾病、肾脏功能障碍、脑出血、肿瘤等疾病患者。观察组：男24例，女22例，年龄40～78岁，平均年龄（54.37±5.81）岁，2型糖尿病病程1～14年，平均病程（5.85±1.16）年；对……