联合检测糖化血红蛋白、糖化血清蛋白、C肽水平在2型糖尿病患者诊疗中的价值研究

Study on the value of combined detection of glycosylated hemoglobin, glycosylated serum protein and C-peptide in the treatment of patients with type 2 diabetes mellitus

目的分析糖化血红蛋白(HbA1c)、糖化血清蛋白(GSP)、C肽(C-P)联合检测在2型糖尿病患者诊疗中的应用价值。方法选取2020年1月至12月南昌市第一医院临床检测血糖结果超过临界值最高值的50例疑似糖尿病者作为病例组,选取同期50例体检检查结果正常的健康者作为对照组。比较两组的HbA1c、GSP、C-P水平。以空腹血糖(FBG)和口服葡萄糖耐量试验(OGTT)为金标准,比较HbA1c、GSP、C-P单一检测与联合检测的诊断效能。结果病例组HbA1c、GSP水平高于对照组,C-P水平低于对照组,差异有统计学意义(P<0.05)。HbA1c、GSP、C-P单项检测及三项指标联合检测的灵敏度、准确度、阴性预测值比较,差异有统计学意义(P<0.05)。四种检测方法的特异度、阳性预测值比较,差异无统计学意义(P>0.05)。结论HbA1c、GSP、C-P联合检测保证了诊疗的准确性,对2型糖尿病的临床治疗具有监测与指导意义,为临床诊疗提供有力依据。

Objective To analyze the application value of combined glycated hemoglobin(HbA1c),glycated serum protein(GSP),and C-peptide(C-P)testing in the diagnosis and treatment of patients with type 2 diabetes.Methods From January to December 2020,A total 50 suspected diabetic patients whose clinical test blood glucose results exceeded the highest value of the threshold in Nanchang First Hospital were selected as the case group,50 healthy individuals with normal examination results at the same time were selected as the control group.The levels of HbA1c,GSP and C-P in the two groups were detected,and the differences of above indexes between the two groups were observed.The fasting blood glucose(FBG)and oral glucose tolerance test(OGTT)were used as the gold standard.The diagnostic efficacy of HbA1c,GSP,C-P single detection and combined detection were compared.Results The levels of HbA1c and GSP in the case group were higher than those in the control group,and the levels of C-P were lower than those in the control group,with statistically significant differences(P<0.05).There were significant differences in sensitivity,accuracy and negative predictive value among single detection of HbA1c,GSP,and C-P and combined detection(P<0.05).There were no significant differences in the specificity and positive value among the four detection methods(P>0.05).Conclusion The combined detection of HbA1c,GSP and C-P ensures the accuracy of diagnosis and treatment,and has the significance of monitoring and guiding the clinical treatment of type 2 diabetes,providing a strong basis for clinical diagnosis and treatment.