转化医学杂志2025，Vol.14Issue(5)：91-96,6.DOI:10.3639/j.issn.2095-3097.2025.05.019
2型糖尿病合并慢性肾功能不全患者血液透析过程中血糖波动情况及影响因素分析
Blood Glucose Fluctuation and its Influencing Factors in Patients with Type 2 Diabetes Mellitus and Chronic Renal Insufficiency during Hemodialysis
摘要
Abstract
Objective To explore blood glucose fluctuation and its influencing factors in patients with type 2 diabe-tes mellitus(T2DM)and chronic renal failure(CRF)during hemodialysis(HD).Methods A total of 98 patients with T2DM and CRF who underwent HD in Maanshan People's Hospital were enrolled as the research objects between January 2021 and June 2024.The blood glucose data(24 measurements)within 3 months of regular treatment were collected to calculate blood glucose fluctuation indexes[standard deviation of blood glucose(SDBG),mean amplitude of glycemic excursion(MAGE),large amplitude of glycemic excursion(LAGE)],and blood glucose fluctuation during HD was analyzed.According to the rel-evant guidelines,patients were divided into blood glucose fluctuation group and blood glucose stability group.The influenc-ing factors of blood glucose fluctuation were analyzed by univariate and multivariate Logistic regression analysis.Results In the 98 patients during HD,SDBG,MAGE and LAGE were(2.58±1.16)mmol/L,(4.92±1.47)mmol/L and(6.21±2.98)mmol/L,respectively.There were 54 patients[55.10%(54/98)]with blood glucose fluctuation during HD.According to blood glucose status,patients were divided into blood glucose fluctuation group(n=54)and blood glucose stability group(n=44).Proportions of hypertension history,anxiety/depression,sleep disorders and poor self-management ability,course of DM,insulin dosage on dialysis day,glycosylated hemoglobin and microalbuminuria(mALb)in blood glucose fluctuation group were higher than those in blood glucose stability group,while level of calcium(Ca)and parathyroid hormone(PTH)were lower than those in blood glucose stability group(P<0.05).The results of multivariate logistic regression analysis showed that hypertension history,anxiety/depression,self-management ability and mALb were influencing factors of blood glucose fluctuation in patients with T2DM and CRF during HD(P<0.05).Conclusion The incidence of blood glucose fluctuation is high in patients with T2DM and CRF during HD.The influencing factors of blood glucose fluctuation include hypertension history,anxiety/depression,poor self-management ability and mALb level.关键词
2型糖尿病/慢性肾功能不全/血液透析/血糖波动/影响因素Key words
Type 2 diabetes mellitus/Chronic renal insufficiency/Hemodialysis/Blood glucose fluctuation/Influencing factor分类
医药卫生引用本文复制引用
杜薇,陈卫红,陈萍,沈馨茹,艾方莉,何亮军..2型糖尿病合并慢性肾功能不全患者血液透析过程中血糖波动情况及影响因素分析[J].转化医学杂志,2025,14(5):91-96,6.基金项目
马鞍山市科技计划项目(YL-2024-10) （YL-2024-10）
