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目的建立动态血糖评估参数的正常参考值,为临床应用提供依据。方法采用动态血糖监测系统(CGMS)对48例正常糖调节者进行连续3 d 的血糖监测,并分析24 h 的平均血糖水平(MBG)及其标准差(SDBG)、餐前1 h 及餐后3 h 的 MBG、血糖的时间百分比(PT)、血糖的曲线下面积(AUC)、最大血糖波动幅度(LAGE)、平均血糖波动幅度(MAGE)及日间血糖平均绝对差(MODD)。各参数非正态分布者以百分位数法估计95%的正常参考值范围,呈正态分布者按±1.96 s 计算。结果 (1)除血糖的 PT 及 AUC 呈非正态分布外(P<0.05),其余参数均呈正态分布(P>0.05),各参数在不同性别间的差异无统计学意义(P>0.05)。(2)动态血糖参数的正常参考值上限:24 h MBG<6.5 mmol/L,早、中及晚餐前1 h MBG 分别<6.0 mmol/L、<6.3 mmol/L 和<6.0 mmol/L,早、中及晚餐后3 h MBG 分别<7.0 mmol/L、<6.7 mmol/L 和<7.0 mmol/L,血糖≥7.8 mmol/L 及≤3.9mmol/L 的 PT 分别<9%和<20%,血糖≥5.6 mmol/L 的 AUC<0.9 d·mmol·L~(-1),SDBG<1.4mmol/L,LAGE<5.7 mmol/L,MAGE<3.4 mmol/L,MODD<1.4 mmol/L。(3)24 h MBG 与 MAGE、MODD 及 SDBG 均不相关(P>0.05),MAGE 与 SDBG 显著正相关(r=0.93,P<0.01)。结论初步建立了 CGMS 各血糖参数的正常参考值,应用上述参数能较全面地反映受试者整体血糖水平和血糖稳定性的特征。
Objective To establish a normal reference value of dynamic blood glucose assessment parameters and provide the basis for clinical application. Methods Forty-eight normal glucose regulators were monitored by CGMS for 3 consecutive days. The average blood glucose level (MBG) and its standard deviation (SDBG) at 24 hours, plasma glucose level MBG at 3 h, percentage of blood glucose (PT), area under the curve of blood glucose (AUC), maximum blood glucose fluctuation (LAGE), mean blood glucose fluctuation (MAGE) and mean daytime blood glucose (MODD). The nonnormal distribution of each parameter was estimated by the percentile method 95% of the normal reference range, the normal distribution by ± 1.96 s calculation. Results (1) The PT and AUC except for blood glucose were non-normal distribution (P <0.05), and the other parameters were normal distribution (P> 0.05). There was no significant difference in each parameter between different sexes (P> 0.05). (2) The upper limit of the normal reference value of dynamic blood glucose parameters: MBG <6.5 mmol / L at 24 h, <6.0 mmol / L, <6.3 mmol / L and <6.0 mmol / L at early, , And those with MBG <7.0 mmol / L, <6.7 mmol / L and <7.0 mmol / L, and glucose ≥7.8 mmol / L and ≤3.9 mmol / L were respectively less than 9% and <20% AUC of blood glucose ≥ 5.6 mmol / L was less than 0.9 d · mmol -1, SDBG was less than 1.4 mmol / L, LAGE was less than 5.7 mmol / L, MAGE was less than 3.4 mmol / L, and MODD was less than 1.4 mmol / L. (3) 24 h MBG was not related to MAGE, MODD and SDBG (P> 0.05), MAGE was significantly and positively correlated with SDBG (r = 0.93, P <0.01). Conclusion The normal reference values of CGMS parameters were preliminarily established. The above parameters can reflect the overall blood glucose level and the stability of blood glucose.