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目的观察HbA1c达标(<7%)的T2DM患者血糖波动与糖尿病慢性肾脏疾病(CKD)及血小板源性生长因子-BB(PDGF-BB)水平的关系。方法选取合并CKD的T2DM患者(CKD组)及单纯T2DM患者(T2DM组),各48例,及健康体检者(NC)40名。采用动态血糖监测系统(CGMS)连续监测血糖3d,计算平均血糖标准差(SDBG)、日内平均血糖波动幅度(MAGE)、最大血糖波动幅度(LAGE)、曲线下面积(AUC)、日间血糖绝对差(MODD),另采用ELISA测定血清PDGF-BB水平。结果 CKD组血清PDGF-BB和2hPG水平均高于T2DM组和NC组;CKD组SDBG、MAGE、LAGE、AUC、MODD均高于T2DM组(P<0.05)。相关分析显示,血清PDGF-BB水平与2hPG、SDBG、MAGE、LAGE、AUC、MODD均呈正相关。多元线性回归分析显示,LAGE、SDBG和2hPG是T2DM患者PDGF-BB水平的独立影响因素。结论 HbA1c<7%且合并CKD的T2DM患者较单纯T2DM者血糖波动更大、血清PDGF-BB水平更高;血糖波动与CKD及PDGF-BB水平相关。
Objective To investigate the relationship between blood glucose fluctuation and the level of CKD and PDGF-BB in T2DM patients with HbA1c (<7%) compliance. Methods T2DM patients with CKD (CKD group) and T2DM patients (T2DM group), 48 cases each, and 40 healthy subjects (NC) were selected. The blood glucose was continuously monitored by dynamic blood glucose monitoring system (CGMS) for 3d, and the mean standard deviation of blood glucose (SDBG), average daily blood glucose fluctuation (MAGE), maximum blood glucose fluctuation (LAGE), area under the curve Poor (MODD), the other by ELISA to measure the level of serum PDGF-BB. Results Serum levels of PDGF-BB and 2hPG in CKD group were significantly higher than those in T2DM group and NC group. SDBG, MAGE, LAGE, AUC and MODD in CKD group were significantly higher than those in T2DM group (P <0.05). Correlation analysis showed that serum PDGF-BB levels were positively correlated with 2hPG, SDBG, MAGE, LAGE, AUC and MODD. Multivariate linear regression analysis showed that LAGE, SDBG and 2hPG were independent risk factors for PDGF-BB in T2DM patients. Conclusions T2DM patients with HbA1c <7% and CKD have more fluctuation of blood glucose and higher level of serum PDGF-BB than T2DM. The fluctuation of blood glucose is correlated with the level of CKD and PDGF-BB.