糖尿病性视网膜病变与糖化血红蛋白水平关系
Relationship between glucosylated hemoglonin and retiopathy
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摘要:目的 研究糖尿病性视网膜病变与血糖、糖化血红蛋白的关系, 探索未发生糖尿病视网膜病变的血糖水平。方法 回顾性调查糖尿病视网膜病变及非病变组的血糖、糖化血红蛋白等指标, 在非条件Logistic回归分析的基础上, 运用受试者工作特征曲线(ROC)分析方法, 绘制ROC曲线。结果 早餐前血糖对视网膜病变发生影响要大于糖化血红蛋白的影响。视网膜病变发生率与空腹血糖、糖化血红蛋白水平呈明显正相关; 单独考虑早餐前血糖作用, 血糖控制在7.6~8.3mmol/L水平可作为预防视网膜病变发生的安全参考值; 单独考虑HbA1c的作用, HbA1c水平控制在7.7%~8.2%可作为预防视网膜病变发生的安全参考值; 将两个因素结合起来考虑预防视网膜病变发生的血糖控制水平。HbA1c < 9%时, 早餐前血糖水平控制在7.8~8.6mmol/L; HbA1c≥9%时, 早餐前血糖水平控制在7.1~7.8mmol/L, 可做为预防视网膜病变发生的安全参考值。结论 血糖、HbA1c不同水平组合并发视网膜病变的危险性有所不同, 应将二者结合起来考虑, 才能有效地预防视网膜病变的发生。Abstract:Objective To study the relatio nship between blood sugar, glucosylated hemoglobin and retinopathy of diabetes mellitus and to explore the level of blood sugar, which did not produce retinopathy of diabetes mellitus.Methods Case reference study on the indexes of blood sugar and glucosylated hemoglobin in the group of retinopathy and nonretinpathy.one Receiver Operating characteristic (ROC) curve was made by ROC analysis method based on logistic regression.Results The blood sugar before breakfasthad greater effect on producing retinopathy than that of glucosylated hemoglobin.The rate of retinopathy had positive relation with the levels of limosis blood glucose and glucosylated hemoglobin; the 7.6-8.3 mmol/L blood sugar was considered as the safe reference index when it was singlely analysised; the 7.7-8.2 mmol/L HbA1c was considered as the safe reference index when it was singlely analysised.When HbA 1c < 9%, bllod sugar was controlled at 7.8-8.6 mmol/L before breakfast; when HbA1c≥9%, blood sugar was controlled at 7.1-7.8 mmol/Lbefore breakfast.They were the safe reference indexes when the two variable were combined.Conclusion To prevent the retinopathy the two factors should be considered at the same time.
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