血糖波动的意义及临床评估方法_李强.pdfVIP

876 Chinese Journal ofP ractical InternalM edicine ep. 2009 Vol. 29 No. 9 李 强, 李鹏杰 : 1005- 2194( 2009) 09- 0876- 03 : R5 : A : 越来越多的证据显示, 血糖波动独立于糖化血红蛋白 (H bA c), 可能与糖尿病并发症显 相关本文从日 1 内血糖波动日间血糖波动进餐相关性血糖波动严重低血糖危险等 4 个方面介绍评估血糖波动的方法日内 血糖波动的评估指标包括血糖水平的标准差( DBG)血糖波动于某 一范围的时间百分比曲线下面积或频数分 布最大血糖波动幅度( LAGE) M值平均血糖波动幅度(MAGE ); 日间血糖波动的评估指标包括空腹血糖变异 系数( FPGCV)和日间血糖平均绝对差( MODD) ; 餐后血糖波动的评估指标包括平均进餐波动指数 (M IME )和餐 后血糖的时间与曲线下面积增值( IAUC); 严重低血糖危险的评估指标为低血糖指数( LBGI)临床上应根据各 参数特点和评估目的进行合理选择 : 血糖波动; 日内血糖波动; 日间血糖波动; 进餐相关性血糖波动 The clin ical sign ificance and assessm en t m ethod s of glu cose fluctuation. LI Qiang, LI Pengj ie. Department of Endocrinology M etabolism, theSecond Aff iliated osp ital of arbinM edical University, arbin 150086, Ch ina Summ ary: M ore and m ore evidence show s that glucose fluctuation, independent ofH bA c, m ay play a sign ifican t role in 1 the risk for diabetes comp lications. The purpose of th is article is to introduce the assessm ent of glycem ic fluctuation in four aspects, such asw ithinday blood glucose excursions, daytoday b lood glucose excursions, postprand ial blood glucose ex cursions, and the risk of serious hypoglycem ia. The indexes for assessm ent of w ith inday b lood glucose excursions contain standard deviation of b lood glucose ( DBG ), tmi e percentage of blood glucose excursions in a certain range, area under the curve or frequency d istribution, the largest am plitude of glycem ic excursions ( LAGE) , Mvalue, and mean am plitude of glycem ic excursions(MAGE ); the indexes for assessm ent of daytoday blood glucose excursions contain fasting plasm a glucosecoefficient variation( FPGCV) , and absolu te means of daily differences( MODD ); the