HbA_1c联合空腹血糖在糖尿病诊断中的应用价值

The clinical application value of glycosylated hemoglobin (HbA_1c) plus fasting plasma glucose in diagnosing diabetes

目的比较评价糖尿病患者HbA1c和FPG联合测定的临床价值。方法选取湖北省十堰地区未明确诊断的681例门诊患者,使用-1-Bio-RAD-10糖化血红蛋白分析仪检测HbA1c,OLYM-PUS AU-5400全自动生化分析仪检测FPG,经OGTT复查确诊糖尿病,对其相关性进行分析。结果 681例门诊患者同时测定HbA1c和FPG,确诊糖尿病114例。其中30例FPG正常、HbA1c异常,最后确诊26例为T2DM;92例FPG和HbA1c均异常的患者,确诊糖尿病88例。24例FPG异常、HbA1c正常,确诊3例FPG异常的IFG,2例FPG异常的IGT;FPG正常、HbA1c异常6例,确诊IGT 3例。结论同时测定HbA1c和FPG可提高对糖尿病的诊断和筛选特异性和敏感性,可提高IGT及轻度T2DM的早期诊断的准确性。

Objective To evaluate clinical application value of HbA1c plus fasting plasma glucose（FPG） in diagnosing diabetes mellitus（DM）.Methods 681 patients with DM were from Shiyan.The level of HbA1c by Bio-RAD-10 glycated hemoglobin analyzer,FPG by OLYMPUS AU-5400 automatic biochemistry analyzer.The final diagnosis was made by OGTT.Results In 681 outpatients simultaneously receiving determination of HbA1c and FPG,114 cases were diagnosed as diabetes.26 of 30 cases with normal FPG but abnormal HbA1c were eventually proved to be type 1 diabetes,88 of 92 with both abnormal HbA1c and FPG were proved to be type 2 diabetes.In 24 cases with abnormal FPG but normal HbA1c,3 were diagnosed as impaired fasting glucose,2 were diagnosed as IGT.And among 6 cases with normal FPG and abnormal HbA1c,3 were diagnosed as IGT.Conclusions The simultaneous determination of HbA1c and FPG can improve the specificity and sensitivity in screening and diagnosing diabetes mellitus.And it can improve early diagnostic rates of impaired glucose tolerance and type 2 diabetes.