糖化血红蛋白在糖尿病一级预防中的临床应用及研究

Clinical application and research on glycolated hemoglobin of primary protection of diabetes

目的:探讨糖化血红蛋白参考阈值在糖尿病一级预防中的应用价值。方法:检测重点人群糖化血红蛋白,按结果分为四个区间;根据WHO(1999)糖尿病诊断标准分区间试验,并分为五型糖耐量并统计学处理。结果:凉州区重点人群糖尿病发病率为27.4%,糖调节受损发病率为53.1%。在6.0%≤HbA1C<6.5%区间其糖尿病发病率明显高于5.0%≤HbA1C<6.0%区间。前者糖调节受损发病率69.8%。后者71.2%。前者以空腹血糖受损与DM发病为主占32.3%与28%,后者以糖耐量受损发病为主占58.4%。强化生活方式干预五年,糖尿病发病率下降42.9%。结论:在6.0%≤HbA1C<6.5%区间以干预、治疗空腹血糖受损与筛查DM为主。在5.0%≤HbA1Cc<6.0%区间以干预、治疗糖耐量受损为主。强化生活方式干预对预防糖尿病具决定性作用。

Objective：In order to evaluate the application value of the glycolated hemoglobin reference threshold in the primary prevention of diabetes.Methods： The detection for the glycolated hemoglobin of the focal groups is divided into four groups according to the result： The test is performanced according to the experiment of WHO（1999） on dividing of diagnostic standard,the results are divided into five groups of carbohydrate tolerance and analyzed by statistical method.Results： The incidence of the diabetes of the focal group in the Liang Zhou region is 27.4%,the incidence of IGR is 53.1%.The incidence of interval of 6.0%≤HbA1C6.5% is distinctly higher than 5.0%≤HbA1C6.0%.The incidence of IGR of the former and is respectively 69.8% and 71.2%.The former is based on the principle of IFG and DM which is respectively 32.3% and 28%;the latter is based on the principle of IGT which accounts for 58.4%.The incidence of the diabetes is reduced by 42.9% when the enhancing intervene the patients′ life style are taken to the patients for 5 years.Conclusion： In the interval of 6.0%≤HbA1C6.5%,the patients would be treated based on the principle of intervene,curing IFG and investigating of DM.In the interval of 5.0%≤HbA1C6.0%,the treatment would be based on the principle of intervene and curing IGT.At last,enhancing intervene the patients′ life style plays the decisive role in the treatment.