糖基化Hb糖尿病患者皮肤组织血管变化与病程的相关性

Mymensingh medical journal : MMJ Pub Date : 2023-04-01
K Akter, A N Rahman, A Shirin, S Khatun, U Biswas
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引用次数: 0

摘要

皮肤是人体最大的器官和外壳。它在我们的可见外观中起着很大的作用。人类对皮肤病的意识更强,因为它是美容的重中之重。符合选择标准的病例将被纳入研究样本,以观察与糖基化Hb、血管变化和糖尿病持续时间的相关性。这项横断面研究于2017年3月至2019年2月在孟加拉国达卡BIRDEM皮肤与VD科和病理学科进行。研究人群均为在BIRDEM医院皮肤科就诊的糖尿病皮肤病患者。选取90例糖尿病患者行皮肤活检。以皮肤活检组织和血液样本为材料,确定血糖控制满意和不满意患者的皮肤病变类型;糖尿病皮肤病变与糖尿病病程的关系评估糖尿病患者皮肤或真皮毛细血管的变化及其与HbA1c水平和糖尿病病程的相关性。90例患者年龄31 ~ 85岁,平均年龄55.06±12.10岁。41 ~ 50岁患者最多(32.2%)。在本研究中,糖尿病皮肤疾病在女性中更为常见。几乎四分之三的患者血糖状况不理想。血糖满意17例(18.9%),血糖不满意73例(81.1%)。本研究中90例患者的平均HbA1c血糖状态不理想。在本研究中,女性患者的平均HbA1c更令人不满意。最常见的病变组为杂类病变组,占37.7%,其次为与糖尿病有强弱相关性的皮肤病。血糖满意和血糖不满意患者不同类型的皮肤病变无显著差异。大多数病例(37.8%)发生在诊断为糖尿病的10年后,糖尿病治疗后皮肤反应的患者平均病程最长(10.04±6.19)。真皮毛细血管基底膜厚度随糖尿病病程变化明显。血管周围浸润与毛细血管基底膜厚度呈显著负相关。
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Correlation of Vascular Changes in Skin Tissue of Diabetic Patients with Glycosylated Hb and duration of Disease.

Skin is the largest organ and outer covering of human body. It plays a great role in our visible appearance. Humans are more conscious about skin disease because it has a cosmetic priority. The cases that fulfil the selection criteria will be enrolled as study samples with a view to see correlation with glycosylated Hb, vascular changes and duration of DM. This cross-sectional study was performed in the Department of Skin and VD and the Department of Pathology of BIRDEM, Dhaka, Bangladesh from March 2017 to February 2019. Study population was all diabetic patients with skin diseases attending dermatology department of BIRDEM hospital. Among them 90 patients were selected who will do skin biopsy with diabetes mellitus. Skin biopsy tissue and blood sample were taken as materials to determine the type of skin lesion in patients with satisfactory and unsatisfactory glycaemic control; the relationship of diabetic skin lesions with duration of diabetes; and assessing the cutaneous or dermal capillary vascular changes was in Diabetes Mellitus and its correlation with HbA1c level and duration of Diabetes Mellitus. Among 90 cases age ranged from 31 to 85 years with mean age of the patients 55.06 ± 12.10 years. Maximum patients were in age group 41-50 years (32.2%). Skin disorders in Diabetes mellitus are more common in female in this study. Almost three fourth of the patients glycemic status was unsatisfactory. Satisfactory glycemic patients were 17 cases (18.9%) and unsatisfactory glycemic patients were 73 cases (81.1%). Mean HbA1c shows unsatisfactory glycemic status among 90 cases in this study. Mean HbA1c is more unsatisfactory in female patients in this study. Most common group of lesion was 37.7 % belong to miscellaneous group followed by skin diseases with strong to weak association with DM. There were no significant differences in different types of skin lesions between satisfactory and unsatisfactory blood glucose patients. Majority of the cases (37.8%) occurred after 10 years of diagnosis of DM. Mean duration of DM was highest among the patients with skin reaction to diabetic treatment (10.04±6.19). There is marked variation in thickness of dermal capillary basement membrane with duration of diabetes. There was a significant inverse correlation between perivascular infiltration and capillary basement membrane thickness.

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