【摘要】 目的 探讨以HbA1c作为评价血糖控制状况的指标所反映的T2DM患者血糖的控制情况。 方法 对52例T2DM患者行72 h动态血糖监测，以HbA1c值分为<7.0%(A组)、7.0%≤HbA1c<10%(B组)、≥10%(C组)。 结果 (1)3组患者平均血糖波动幅度、早餐后高血糖曲线下面积、夜间低血糖曲线下面积、早餐以及午餐后高血糖持续时间、夜间低血糖持续时间、三餐前后血糖漂移差异无统计学意义(>0.05)，平均血糖、血糖标准差、血糖最大波动幅度、午餐以及晚餐后高血糖曲线下面积、午餐后高血糖持续时间差异有统计学意义(P<0.05)。(2)多重线性回归分析显示，以HbA1c为因变量只有平均血糖进入了最终方程;以平均血糖波动幅度为因变量，只有血糖标准差和晚餐后高血糖曲线下面积进入了最终方程。 结论 HbA1c主要反映平均血糖，平均血糖波动幅度主要反映血糖变异性，两者反映了不同的血糖控制情况。

　　【关键字】 T2DM HbA1c 动态血糖监测系统 血糖波动

　　Correlation between the HbA1C level and glucose fluctuation in T2DM patients LÜ Xiao-feng, ZHOU Shu-jing. Beijing Military General Hospital, Beijing 100700, China

　　　【Abstract】 Objective To investigate the glycemic control of the T2DM patients when taking HbA1c as an index in evaluation. Methods Fifty-two T2DM patients were observed with 72h continuous glucose monitoring system, and they were divided into groups A, B, and C based on the level of HbA1c which was <7.0%, 7.0%≤ HbA1c<10%, and ≥10% respectively. Results (1). The mean amplitude of glycemic excursions (MAGE), area under the curve of breakfast hyperglycemia, area under the curve of night hypoglycemia, duration of breakfast and lunch hyperglycemia, duration of night hypoglycemia, and postprandial glycemic excursion of the three groups were not statistically different (P>0.05), while the mean blood glucose, blood glucose standard deviation, largest amplitude of glycemic excursion, area under the curve of lunch and supper hyperglycemia, and duration of lunch hyperglycemia were statistically different (P<0.05). (2). The multiple linear regression analysis showed that, HbA1c was made as the dependent variable only when the mean blood glucose came into the final equation, and MAGE was made as the dependent variable, only when the blood glucose standard deviation and area under the curve of supper hyperglycemia came into the final equation. Conclusion HbA1c is mainly reflecting the average level of blood glucose, and MAGE is mainly distinguishing the blood glucose variability. They two reflect the glycemic control from different aspects.

　　【Key words】 Diabetes mellitus, type 2 (T2DM); Hemoglobin Alc (HbA1c); Continuous glucose monitoring system; Blood glucose fluctuations