2型糖尿病患者液态酶法测定糖化血清白蛋白的临床观察

Clinical study of glycated albumin measurement by enzymatic method in type 2 diabetes mellitus

目的评估液态酶法测定糖化血清白蛋白（GA）作为血糖管理指标的有用性及与糖化血红蛋白（HbAIc）的比较。方法选取新发2型糖尿病患者或血糖不稳定糖尿病患者及75g口服葡萄糖耐量试验血糖正常者，用液态酶法测定GA和HbAlc及其他临床相关指标。结果正常人GA在9％～14％之间，GA正常范围为（12．9±2．3）％。在经过2、4、8周的治疗后，糖尿病患者空腹血糖（FBG）、餐后2h血糖（2hPBG）、GA及HbAlC均有不同程度的下降，但GA在治疗2周时与治疗前比已有显著下降[（23±7．1）％比（22±6．4）％，P〈0．05]，在随后的治疗中GA与之前一个随访时间点相比较均有进一步降低（P〈0．01），而HbAlc在治疗2周时仅略有下降，与治疗前比差异无统计学意义。糖尿病患者中GA与HbAlC显著相关（r=0．8326，P〈0．01））。结论液态酶法测定GA作为血糖控制指标与HbAlc有良好的相关性。GA可有效反映短期内（2—4周）血糖控制情况，优于HbAlc，是糖尿病患者血糖控制情况的良好指标。

Objective To evaluate the clinical significance of glycated albumin（GA） measured by enzymatic method and to compare its effect with glycosylated hemoglobin Ale （HbAlc） in type 2 diabetes meUitus（DM）. Methods 128 type 2 DM patients and 84 normal subjects from the Chinese PLA General Hospital were enrolled for the study. The levels of GA, HbAlc, FBG, PBG in DM patient were detected at baseline and followed visit at 2,4,8 weeks after blood glucose management. The levels of GA, HbAlc, FBG, PBG and 75 g OGTF were also detected in above normal subjects. Results Intra CV and inter CV of enzymatic were （0. 74 - 0.9） % and （0. 94 - 1.49） % respectivly. In normal subjects GA was in the range of （9 - 14） %. At baseline, the GA level was significantly correlated with HbAlc （r =0. 8326, P 〈0. 01 ）, FBG and 2 hour PBG. After 2,4,8 weeks treatment, GA level in DM patients was concomitantly decreased with the improvement of FBG, PBG and HbAlc. At early 2 weeks visit, GA, but not HbAlc, showed significant decrease from its baseline （P 〈 0. 05 ） . Conclusion Enzymatic measuring GA was highly correlated with HbAlc, and changing concomitantly with the decrease of HbAlc, FBG, PBG during the 8 weeks treatment. GA was more sensitive than HbAlc for short-term variations of glycemic control during treatment of diabetic patients. GA can be used as a better index of short term mean level of blood glucose in diabetic patients.