血糖、糖化血红蛋白的参考变化值和参考变化因子的应用研究

Application Study of Reference Change Value and Reference Change Factor of Blood Glucose and Glycated Hemoglobin

目的探讨血糖(GLU)、糖化血红蛋白(HbA1c)的参考变化值(reference change value,RCV)和参考变化因子(reference change factor,RCF)在临床的应用。方法根据RCV计算公式:RCV=Z×2^1/2×(CVA^2+CVI^2)^1/2和RCF上、下限计算公式:RCFup=exp(Z×2^1/2×(CVA^2+CVI^2)^1/2/100)以及RCFdown=1/RCFup,分别计算GLU,HbA1c的RCV和RCF在不同概率P<0.05,P<0.01时单双侧值。结果RCV在P<0.05时单双侧值分别为GLU(13.50%,16.04%)和HbA1c(6.03%,7.16%);在P<0.01时单双侧值分别为GLU(19.07%,21.12%)和HbA1c(8.51%,9.42%)。RCF在P<0.05时单双侧的RCFup和RCFdown分别为GLU(1.14,0.87;1.17,0.85)和HbA1c(1.06,0.94;1.07,0.93);P<0.01时,RCF单双侧的RCFup和RCFdown分别为GLU(1.21,0.83;1.24,0.81)和HbA1c(1.09,0.92;1.10,0.91)。结论RCV在相同概率下双侧值大于单侧值;P<0.05的RCV值小于P<0.01的RCV值。RCF在相同概率下,单侧和双侧RCF的上、下限值变化不大;P<0.05的RCF上、下限值大于P<0.01的RCF上、下限值。建议临床实验室在监测糖尿病患者GLU,HbA1c指标时,结合RCV和RCF判读检测结果。

Objective To investigate the clinical application of reference change value(RCV)and reference change factor(RCF)for blood glucose(GLU)and glycated hemoglobin(HbA1c).Methods According to RCV calculation formula:RCV=Z×2^1/2×(CVA^2+CVI^2)^1/2 and RCF upper and lower limit calculation formula:RCFup=exp(Z×2^1/2×(CVA^2+CVI^2)^1/2/100)and RCFdown=1/RCFup.Single and double-sided values of RCV and RCF of GLU and HbA1c were calculated respectively at different probability P<0.05,P<0.01.Results When P<0.05,the unilateral and bilateral values of RCV were GLU(13.50%,16.04%)and HbAIc(6.03%,7.16%).When P<0.01,the unilateral and bilateral values of RCV were GLU(19.07%,21.12%)and HbA1c(8.51%,9.42%).When P<0.05,the RCFup and RCFdown values of unilateral and bilateral RCF were GLU(1.14,0.87 and 1.17,0.85),HbAIc(1.06,0.94 and 1.07,0.93).When P<0.01,the RCFup and RCFdown values of unilateral and bilateral RCF were GLU(1.21,0.83;1.24,0.81),HbA1c(1.09,0.92 and 1.10,0.91).Conclusion The bilateral value of RCV was greater than the unilateral value under the same probability.The value of RCV at P<0.05 was less than its value at P<0.05.Under the same probability,the upper and lower limits of one and two sides of RCF dose not change much.The upper and lower limits of RCF with P<0.05 were greater than those with P<0.01.It was suggested that the clinical laboratory should combine RCV and RCF to interpret the test results when monitoring GLU and HBA1C indicators in diabetic patients.