摘要
目的:评估终末期糖尿病肾病患者的糖代谢特点及腹膜透析(PD)对糖代谢的影响。方法:选取我院终末期糖尿病肾病患者19例,使用动态血糖监测系统分别监测患者PD前后24 h血糖,计算日间与夜间平均血糖、标准差、最高血糖、最低血糖、平均血糖波动幅度(MAGE)、最大血糖波动幅度(LAGE)、高血糖及低血糖的构成比,测定每组患者的糖化血红蛋白(HbA1c)、空腹及餐后2 h C肽水平,并根据HbA1c估算平均血糖。结果:PD后患者的外源性胰岛素用量、空腹及餐后2 h C肽水平均较PD前显著增高;PD前后按HbA1c估算的平均血糖值与实际测得的血糖值存在显著差异;PD前低血糖及高血糖比例、日间及夜间MAGE及LAGE均高于PD后。结论:PD后患者的胰岛素使用量虽显著增加,但PD可改善终末期糖尿病肾病患者的血糖波动。HbA1c不能准确反映终末期糖尿病肾病患者的平均血糖水平。
Objective： To evaluate the characteristics of glucose metabolism in patients with end stage diabetic nephropathy and to investigate the effects of peritoneal dialysis （PD） on glucose metabolism in the patients. Methods ： Nineteen cases of patients with end stage diabetic nephropathy were observed by CGMS for 24 hours. The mean blood glucose, standard deviation, MAGE, LAGE, ratio of high and low blood glucose readings were calculated, and the levels of HbA1 c, fasting and 2-hour postprandial C-peptide were detected. Relevant indicators were compared before and after receiving PD. Results： The insulin dosage, fasting and 2-hour postprandial C- peptide level were significantly elevated after receiving PD. The mean blood glucose value calculated from HbAlc was different from the actual mean blood glucose measured by CGMS. The ratio of high and low blood glucose readings, level of MAGE and LAGE before receiving PD were higher than those after PD. Conclusions ： Despite the increase of insulin dosage, blood glucose fluctuations in patients with end stage diabetic nephropathy are amelioratedafter receiving PD. The level of HbA1 c may not accurately reflect blood glucose status for a prolonged period.
出处
《现代医学》
2016年第4期496-499,共4页
Modern Medical Journal
关键词
腹膜透析
糖尿病肾病
糖代谢
peritoneal dialysis
diabetic nephropathy
glucose metabolism
