糖化血红蛋白与血糖的相关性分析及其对糖尿病诊断敏感性探讨
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[摘要] 目的：行糖化血红蛋白(HbA1c)与空腹血糖(FPG)、餐后2 h血糖(2 h PG)相关性分析，探讨其在糖尿病(DM)诊断中的价值。方法：同时测定150例门诊就诊者FPG、HbA1c、2 h PG，将HbA1c按不同切点分组计算各自对DM诊断的灵敏性及特异性。结果：150例就诊患者中确诊109例DM患者，其FPG、HbA1c、2 h PG与非DM患者组比较显著增高(P<0.01)；DM组中， HbA1c与FPG、2 h PG正相关；HbA1c对DM诊断的灵敏性较FPG好；HbA1c对DM诊断的最佳切点为6.5%。结论：FBG的波动性较大，2 h PG检查繁琐，HbA1c测定对DM的诊断有一定价值及优势。
[关键词] 糖化血红蛋白；空腹血糖；餐后2 h血糖；糖尿病；灵敏性
[中图分类号] R587.1 [文献标识码] C[文章编号] 1674-4721(2011)07(b)-085-02
To analysis the correlation of glycated hemoglobin and blood glucose and investigate the sensitivity of glycated hemoglobin in diagnosis of diabetes
TAN Guoju, HUANG Huanyi, SU Yong, CHEN Qiaorong
Department of In Section Ⅱ, the People′s Hospital of Yangjiang City, Guangdong Province, Yangjiang 529500, China
[Abstract] Objective: To analyze the correlation among glycated hemoglobin (HbA1c) and fasting plasma glucose (FPG) and postprandial 2 h blood glucose (2 h PG), then exploring the value of HbA1c in diagnosis of diabetes. Methods: To determine the FPG, 2 h PG, HbA1c for 150 cases of outpatients. Then the patients were divided into 3 groups by different hemoglobin concentration, calculating the sensitivity and specificity for diagnosis of diabetes in 3 groups severally. Results: 109 cases were diagnosed DM. FPG, HbA1c and 2 h PG in DM patients were significantly higher (P<0.01) comparing with the non-DM patients. HbA1c had positive correlation with FPG and 2 h PG. The sensitivity of HbA1c was better than the FPG in diagnosis of diabetes and the best concentration was 6.5%. Conclusion: The FBG is fluctuant and 2 h PG is cumbersome in detecting, so there is value and advantages for HbA1c in diagnosis of diabetes.
[Key words] Glycated hemoglobin; Fasting plasma glucose; Postprandial 2 h blood glucose; Diabetes; Sensitivity
糖尿病(DM)是由胰岛素相对或绝对不足引起的一种复杂的代谢性疾病。随着人民生活水平的提高和人口老龄化，DM的患病率也不断增高，DM已日益威胁着人民的身体健康，过去一直以空腹、随机和75 g无水葡萄糖餐后2 h血糖值作为DM的诊断标准，而糖化血红蛋白检测则用于血糖总体控制情况判断、DM预后、DM的病情监测及DM并发症的发生情况。在2010年新的诊断指南中，美国DM学会(ADA)特别推荐，将糖化血红蛋白检测列入2型DM和DM前期的诊断，新指南认为 ......
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