HbA_(1C)在住院患者隐性糖尿病筛查中的应用

Application of the glycated haemoglobin in screening undiagnosed diabetes in hospitalised patients

目的探讨糖化血红蛋白(HbA_(1C))作为住院患者中隐性糖尿病患者筛查方法的效率及经济效能。方法通过电子病历选择合适的住院患者:要求成年人(年龄≥18周岁),因糖尿病住院的患者除外,排除半年内有过输血史者;利用患者血细胞计数常规检查的标本进行随机HbA_(1C)的检测,以HbA_(1C)的水平为诊断依据,筛查出隐性糖尿病患者。结果共检测HbA_(1C)1 012例,其中入院前已知糖尿病患者78例,从未诊断过糖尿病者934例;在这934例患者中,按照HbA_(1C)≥6.5%(48 mmol/mol)作为诊断标准,共筛查出隐性糖尿病患者51例,住院患者中隐性糖尿病患病率约为5.46%,平均每筛查出一名隐性糖尿病患者花费1 098元。结论 HbA_(1C)作为一项方便、经济的筛查指标,可以显著提高糖尿病诊断效率;及时发现早期患者,从而延缓并发症的发生,减少患者的医疗支出。

Objective To assess the economic efficiency of glycated haemoglobin(HbA1C)determination in screening the undiagnosed diabetes among hospitalised patients.Methods Exclusive criteria were made based on the information of the electronic patient history,including age<18years,hospitalization for diabetes treatment,and having received a transfusion within half a year.Pathology samples from participants were collected for blood routine analysis and HbA1C screening test.Screening the undiagnosed diabetes was based on the level of HbA1C.Results In this study,1012patients were enrolled,78patients with diabetes,and934patients haven′t been diagnosed before.Among the934patients,HbA1C level of51patients was over6.5%(48mmol/mol).These51patients(5.46%)were determined to have previously unknown diabetes.The prevalence of undiagnosed diabetes was5.46%during the study period.The cost of HbA1C test was￥1098per new diagnosis of diabetes.Conclusions HbA1C is a simple,inexpensive screening test for diabetes,which can significantly improve the diagnostic efficiency,and the early detection of diabetes can slow the progression of complication and reduce the medical care expenditures.