糖尿病患者C肽与糖化血红蛋白联合检测相互关系探讨

Discussion on the mutual relations between joint detection of C peptide and glycosylated hemoglobin in diabetes mellitus patients

目的探讨在糖尿病患者中,血清C肽(CP)与糖化血红蛋白(HbA1c)的测定结果数值间的相关性,分析其在糖尿病诊断与治疗中的临床意义。方法选取该院2010年至2012年间收治的30例HbA1c7.5%～10%间的轻度糖尿病患者(A组)、30例HbA1c>10%的重度糖尿病患者(B组)及30例健康对照者(C组)。抽取患者晨起空腹静脉血检测空腹血糖(FBG)、HbA1c、空腹CP(FCP);进餐2h后再抽血检测患者餐后2h血糖(2hBG)、2h血清CP(2hCP),并对检验结果进行统计处理。结果随着HbA1c的升高,患者CP测定值呈现不同区间内的不同改变。在轻度糖尿病患者组中,患者FCP、2hCP测定结果明显高于健康组,两组间有统计学差异(P<0.05),HbA1c与FCP、2hCP呈正相关。但是在重度糖尿病患者组中,患者FCP、2hCP测定结果低于健康组,两组间有统计学差异(P<0.05)。其中,HbA1c与FCP、2hCP呈现负相关,常伴有CP减低。结论轻度糖尿病患者,FCP、2hCP与HbA1c的测定结果呈正相关,重度糖尿病患者则相反。这种改变可能与患者体内胰岛素分泌与作用的功能状态相关。CP与HbA1c的联合测定,对于糖尿病患者的诊断与疗效监测具有重要的临床意义。

Objective To study the mutual relations between glycosylated hemoglobin（HbA1c） and C peptide（CP） in patients with diabetes,and to analyze the clinical significance of HbA1c and CP in the diagnosis and treatment of diabetes.Methods The patients with diabetes were selected from 2010 to 2012 in our hospital,and they were divided into 3 study groups with different conditions： group A including 30 patients with mild diabetes（HbA1c 7.5%~10%）,group B including 30 patients with severe diabetes（HbA1c 10%）,and group C with healthy people.HbA1c,CP,FBG,and 2 h BG were detected in all group members with corresponding methods.Results With the increase of HbAlc,CP in patients with measured values showed different changes in different interval.In mild diabetes group,patients with FCP,2 hCP were significantly higher than that of the healthy group,the difference was statistically significant（P0.05）,HbAlc was positively related to FCP,2 hCP.In severe diabetic group,patients with FCP,2 hCP were lower than in the healthy group,the difference was statistically significant（P0.05）.Among them,HbAlc and FCP,2 hCP showed a negative correlation,often accompanied by the decreased CP.Conclusion The correlation between HbA1c and CP is not simply positive or negative.Both the positive and the negative changes reflect the function of pancreas islet and the regulation capability.Combined detection of HbA1c and CP was important to the diagnosis and treatment on diabetes.