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目的探讨糖尿病性眼肌瘫痪患者血糖、糖化血红蛋白(HbA1c)和血液流变学、血脂水平的变化及其关系。方法对36例糖尿病性眼肌瘫痪患者(糖尿病组)与36名健康对照者(正常对照组)进行血HbA1c、空腹血糖(FBG)和餐后2 h血糖(2h-PG)、血液流变学、血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)检测;并进行相关性分析。结果糖尿病组红细胞变形指数与血HDL水平显著低于正常对照组(均P<0.01),HbA1c、FBG、2h-PG水平及其他血液流变学指标和血脂显著高于正常对照组(均P<0.01)。糖尿病组血糖、HbA1c水平与全血黏度(低切、中切、高切)、血浆黏度呈正相关(r=0.42～0.86;均P<0.05),与红细胞变形指数呈负相关(r=-0.53、-0.79;均P<0.01)。结论糖尿病性眼肌瘫痪患者血糖、HbA1c、血脂水平增高,血液流变学异常;高血糖是其血脂和血液流变学异常的重要因素。
Objective To investigate the changes of blood glucose, glycosylated hemoglobin (HbA1c), hemorheology and blood lipid in patients with diabetic ocular paralysis and their relationship. Methods Thirty-six patients with diabetic ocular paralysis (diabetic group) and 36 healthy controls (normal control group) underwent blood HbA1c, fasting blood glucose (FBG) and postprandial 2h blood glucose (2h-PG) , Serum total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) were determined. Results The indexes of erythrocyte deformity and blood HDL in diabetic group were significantly lower than those in normal control group (all P <0.01). The levels of HbA1c, FBG, 2h-PG and other hemorheological indexes and blood lipids in diabetic group were significantly higher than those in normal control group (all P < 0.01). The levels of blood glucose and HbA1c in diabetic group were positively correlated with whole blood viscosity (low, medium and high) and plasma viscosity (r = 0.42-0.86; all P <0.05), and were negatively correlated with erythrocyte deformability index , -0.79; all P <0.01). Conclusions The blood glucose, HbA1c, blood lipid level and abnormal blood rheology in patients with diabetic ocular paralysis are abnormal. Hyperglycemia is an important factor in the abnormal blood lipid and hemorheology.