HbA1c在鉴别颅脑外伤患者应激性血糖升高与糖尿病血糖升高的探讨

The discussion of HbA1C in differentiation of stress hyperglycemia and diabetes hyperglycemia in craniocerebral trauma patients

目的：探讨糖化血红蛋白（HbA1c）在鉴别颅脑外伤患者应激性血糖升高与糖尿病血糖升高中的应用价值。方法：回顾性分析我院于2012年5月-2013年4月收治的210例因颅脑外伤住院且血糖升高患者的临床资料，所有患者均进行糖化血红蛋白检测，同时选取健康体检人员60例作为对照组，前两组患者均给予相应的治疗，观察治疗过程中血糖和糖化血红蛋白的变化规律以及对照组患者的空腹血糖和HbA1c水平变化规律。结果：根据糖化血红蛋白是否升高将其分为两组，HbA1c正常组（应激性血糖升高117例）与HbA1c升高组（糖尿病血糖升高93例）。较于对照组，两组的HbA1c含量均有提高，而且糖尿病血糖升高患者组的HbA1c含量明显高于应激性血糖升高组，对比差异有统计学意义。结论：HbA1c是鉴别颅脑外伤患者应激性血糖升高和糖尿病血糖升高的一个良好指标，在颅脑外伤病人入院后应该把糖化血红蛋白检测作为治疗方案的分组依据，以采取及时正确的治疗方案。

Objective：To investigate the glycosylated hemoglobin （HbA1c） increased value and diabetes blood sugar rise high in the differential diagnosis of craniocerebral trauma patients with stress hyperglycemia.Methods：Retrospective analysis of our hospital in 2012 May -2013 year in April 210 cases with craniocerebral trauma hospitalized and hyperglycemia in patients with clinical data, al patients were glycosylated hemoglobin, and selected healthy persons as control group of 60 cases, two patients were given corresponding treatment, to observe the changes of blood glucose and glycosylated hemoglobin in the course of treatment and the control of blood glucose and HbA1c level changes in patients with fasting group.Results：According to the glycosylated hemoglobin levels wil be divided into two groups, HbA1c group （117 cases of low stress hyperglycemia） and high HbA1c group （93 cases of diabetic hyperglycemia）. Compared with the control group, two groups were HbA1c content increased, the content of HbA1c and diabetic hyperglycemia group was significantly higher than that of stress hyperglycemia group, there are significant differences in contrast.Conclusions：HbA1c is a good index for identification of patients with craniocerebral trauma stress hyperglycemia and diabetic hyperglycemia in patients after craniocerebral injury, should put the glycosylated hemoglobin detection as a packet according to the treatment plan, to take timely and proper treatment.