血清HbA1c、BNP联合GA水平检测在2型糖尿病合并冠心病患者中的早期诊断价值

Early diagnostic value of serum HbA1c, BNP and GA levels in patients with type 2diabetes mellitus complicated with coronary heart disease

目的探究血清糖化血红蛋白(HbA1c)、B型脑钠钛(BNP)联合糖化白蛋白(GA)水平检测在2型糖尿病(T2DM)合并冠心病患者中的早期诊断价值。方法选取兴平市人民医院2011年10月至2016年12月收治的T2DM合并冠心病患者126例为研究组,另选同期单纯T2DM患者121例为对照组。两组患者均行血清HbA1c、BNP、GA水平检测。比较两组患者的血清HbA1c、BNP、GA水平,分析血清HbA1c、BNP、GA单独及联合检测诊断T2DM合并冠心病的价值。结果研究组患者的血清HbA1c、BNP、GA水平均明显高于对照组,差异有统计学意义(P<0.05);血清HbA1c、BNP、GA联合检测诊断T2DM合并冠心病的AUC为0.946,高于血清HbA1c、BNP、GA单项诊断的0.802、0.880、0.843。联合检测的灵敏度为92.86%,特异度为81.82%,其中血清HbA1c Cut-Off值为7.289%,血清BNP Cut-Off值为215.656 pg/mL,血清GA Cut-Off值为14.424%。结论血清HbA1c、BNP、GA联合检测可显著提高T2DM合并冠心病早期筛查的特异度、灵敏度及准确度,有助于T2DM合并冠心病的临床控制及治疗,预防意义重大。

Objective To explore the early diagnostic value of serum glycosylated hemoglobin (HbA1c), B-type brain natrium and titanium (BNP) combined with glycosylated albumin (GA) in patients with type 2 diabetes mellitus (T2DM) complicated with coronary heart disease. Methods A total of 126 patients with T2DM complicated with coronary heart disease admitted in the People's Hospital of Xingping City from October 2011 to December 2016 were selected as study group. Another 121 patients with T2DM alone were selected as control group. All patients were given serum HbA1c, BNP and GA levels detection, the value of single and combined detection of serum HbA1c, BNP and GA in the diagnosis of T2DM complicated with coronary heart disease were analyzed. Results The levels of serum HbA1c, BNP and GA in the study group were significantly higher than those in the control group (P<0.05). The AUC of combined detection of serum HbA1c, BNP and GA was 0.946, which was higher than 0.802, 0.880 and 0.843 of single diagnosis of serum HbA1c, BNP and GA. The sensitivity and specificity of combined detection were 92.86% and 81.82% respectively. The Cut-Off value of serum HbA1c was 7.289%, which of the serum BNP was 215.656 pg/mL, of the serum GA was 14.424%. Conclusion The combined detection of serum HbA1c, BNP and GA can significantly improve the specificity, sensitivity and accuracy of early screening for T2DM complicated with coronary heart disease. It is helpful to the clinical control and treatment of T2DM complicated with coronary heart disease, and is of great significance for prevention.