糖化血清白蛋白的检测对2型糖尿病短期疗效的判断价值

Value of the Detection of Giycated Albumin in Evaluating the Short-term Therapeutic Effect of Type 2 Diabetes Mellitus

【目的】评价糖化血清白蛋白（GA）作为反映近期（2周内）血糖控制总体水平的指标在糖尿病人群中的临床应用价值。【方法】收集本院住院的523例2型糖尿病（T2DM）患者，测定空腹血糖（FPG）、餐后2小时血糖（2hPG）、1日指尖血糖谱均值（MBG）、GA、糖化血红蛋白（HbAlc）等，并对其中132例住院近2周的患者分别在入院后d6及d12复查上述指标。【结果】①523例患者中，GA与HbAlc（r=0．792、）、FPG（r=0．542）、2hPG（r=0．457）、MBG（r=0．402）均呈正相关（P均〈O．01）。②132例住院近2周的T2DM患者入院后d6GA为（27．2±5．46）％、入院d12为（22．78±4．35）％，均显著低于入院d1的（30．32±6．76）％（P〈0．01）。③132例入院d6和d12的GA较入院d。分别下降3．12％和7．54％（均P〈0．01），平均降幅分别为10．2％和23．6％；HbAlC在入院后d6和d12分别下降0．31％和0．78％，平均降幅为2．58％和6．45％，GA的降幅显著大于HbAlc（P〈O．01）。【结论】GA可以及时、准确的反映短期内（1～2周）平均血糖水平的变化，并与长期血糖控制的金标准HbAlC有良好的相关性，是糖尿病患者血糖控制情况的良好监测指标。

[Objective]To evaluate the clinical value of glycated albumin（GA） as the indicator to reflect glucose control level in patients with type 2 diabetes mellitus （T2DM） in recent period（within 2 weeks）. [Methods] Totally 523 patients with T2DM in our hospital were collected. The fasting plasma glucose（FPG）, post-prandial plasma glucose（2hPG）, one-day mean blood glucose（MBG） at finger tip, GA and HbAlc were measured. The above parameters in 132 patients hospitalized for about 2 weeks on d6 and dlz after admission were measured again. [Results] Among 523 patients, GA levels were positively correlated with HbAlc（r= 0. 792）, FPG（r=0. 542）, 2hPG（r=0. 457） and MBG（r=0. 402） （all P〈0.01）. GA levels in 132 patients hospitalized for about 2 weeks on d6 and d12 after admission were （27.2±5.46）% and （22.78±4.35）% re- spectively, which were significantly lower than those on dl after admission[-（30.32 ±6.76）% ] （ P 〈：0.01）. Compared with dl after admission, GA levels in 132 patients on d6 and dlz after admission decreased by 3.12% and 7.54% respectively（all P〈0.01）, and the average decreasing level was 10.2% and 23.6%, respectively. HbAlc value on d6 and d12 after admission decreased by 0.31% and 0.78% respectively, and the average de- creasing level was 2.58% and 6.45% respectively. The decreasing level of GA was significantly higher than that of HbAlc（ P d0.01）. [Conclusion] GA can promptly and accurately reflect the change of mean blood glucose level in short time（l^2 weeks）, and has good relation with the gold standard of HbAlc which reflects the long-term glucose control. Therefore, it is a good indicator to monitor blood glucose control in patients di- abetes mellitus.