血清甲状腺激素、血清C肽、糖化血红蛋白联合检验在2型糖尿病检测中的临床分析

Clinical analysis of combined test of serum thyroid hormone,serum C-peptide and glycosylated hemoglobin in the detection of type 2 diabetes

目的探索血清C肽+糖化血红蛋白(HbA_(1c))+甲状腺激素(TH)水平检测应用于2型糖尿病(T2DM)中的临床价值。方法选择本院2020年7月—2021年6月就诊的35例T2DM患者作为观察组,选择同期进行体检的35例志愿者作为对照组。2组均采用联合检测方法,包括血清C肽、HbA_(1c)、TH,对比2组HbA_(1c)、C肽、TH指标促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT_(3))及游离TH(FT_(4)),对比T2DM患者及T2DM合并血管病变患者HbA_(1c)、C肽、FT_(3)、FT_(4)指标,并分析血糖代谢与TH关系(对比不同HbA_(1c)水平患者的TH指标差异)。结果观察组FT_(4)、HbA_(1c)指标明显高于对照组,而FT_(3)、C肽餐前、餐后1 h水平明显低于对照组(P<0.05);HbA_(1c)水平>10%组的FT_(4)明显低于<7%、7%~10%组,而FT_(3)明显高于<7%、7%~10%组(P<0.05)。糖尿病血管病变组HbA_(1c)、FT_(4)明显高于对照组,而C肽、FT_(3)明显低于对照组,差异均有统计学意义(P<0.05)。结论T2DM患者血清C肽、HbA_(1c)、TH水平检测有一定的临床价值,可用于判断疾病严重程度,有利于早期筛查及防治。

Objective To explore the clinical value of serum C-peptide+glycosylated hemoglobin(HbA_(1c))+thyroid hormone(TH)level detection for type 2 diabetes mellitus(T2DM).Methods Thirty-five patients with T2DM who visited our hospital from July 2020 to June 2021 were selected as the observation group,and 35 volunteers who underwent physical examination at the same time were selected as the control group.The two groups adopted the combined test method,including serum C-peptide,HbA_(1c) and TH.The indexes of HbA_(1c),C-peptide and TH,thyroid-stimulating hormone(TSH),free triiodothyronine(FT_(3))and free TH(FT_(4))in the two groups were compared,and the indexes of HbA_(1c),C-peptide,FT_(3)and FT_(4) in T2DM patients and T2DM patients with vascular diseases were compared.The relationship between glucose metabolism and TH was also analyzed(to compare the differences of TH index among patients with different HbA_(1c) levels).Results The FT_(4) and HbA_(1c) indicators of the observation group were significantly higher than those of the control group,while the FT_(3)and C-peptide levels 1h before and after meals were significantly lower than those of the control group(P<0.05).FT_(4) in the group with HbA_(1c) level>10%was significantly lower than that in the<7%and 7%-10%groups,while FT_(3) was significantly higher than that in the<7%and 7%-10%groups(P<0.05).HbA_(1c) and FT_(4) in the diabetic angiopathy group were significantly higher than those in the control group,while C-peptide and FT_(3) were significantly lower than those in the control group,with the differences statistically significant(P<0.05).Conclusion The detection of serum C-peptide,HbA_(1c) and TH levels in T2DM patients has certain clinical value.It can be used to judge the severity of the disease.And it is conducive to early screening,prevention and treatment.