糖尿病肾病筛查诊断中糖化血红蛋白、血清C肽、尿微量白蛋白检验的作用

The Role of Glycated Hemoglobin,Serum C Peptide,and Urine Microalbu⁃min Tests in the Screening and Diagnosis of Diabetic Nephropathy

目的探究糖化血红蛋白(glycated hemoglobin A1c,HbA1c)、血清C肽(C-peptide,C-PR)、尿微量白蛋白(urinary microalbumin,UmAlb)在糖尿病肾病筛查中的检验效果。方法选取2020年6月—2021年8月盐城市第一人民医院收治的80例糖尿病患者为研究对象,依据疾病不同分为合并肾病组(观察组,37例)与未合并肾病组(对照组,43例),同期选择30名健康者为健康组,均采用HbA1c+UmAlb、C-PR+UmAlb、HbA1c+C-PR+UmAlb检测,分析对比3组HbA1c、C-PR、UmAlb检验效能。结果观察组C-PR、UmAlb、HbA1c指标水平较对照组高,差异有统计学意义(P<0.05)。HbA1c+C-PR+UmAlb阳性检出率、灵敏度、特异度、准确度高于HbA1c+UmAlb、C-PR+UmAlb,差异有统计学意义(P<0.05)。结论在对糖尿病肾病筛查时,C-PR、UmAlb、HbA1c指标联合检验准确度较单一检验高,可为制订规范化治疗方案发挥重要作用。

Objective To investigate the testing effect of glycosylated hemoglobin A1c(HbA1c),serum C-peptide(C-PR),and urinary microalbumin(UmAlb)in the screening of diabetic nephropathy.Methods 80 diabetic patients ad-mitted to Yancheng First People's Hospital from June 2020 to August 2021 were selected as study subjects.They were divided into combined nephropathy group(observation group,37 cases)and uncomplicated nephropathy group(control group,43 cases)according to the different diseases,and 30 cases healthy people were selected as healthy group in the same period,all of which were tested by HbA1c+UmAlb,C-PR+UmAlb,and HbA1c+C-PR+UmAlb,and HbA1c+C-PR+UmAlb testing was used to analyze and compared the test efficacies of HbA1c,C-PR,and UmAlb in the three groups.Results The levels of C-PR,UmAlb,and HbA1c indexes in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).The positive detection rate,sensitivity,specificity,and accuracy of HbA1c+C-PR+UmAlb were higher than those of HbA1c+UmAlb and C-PR+UmAlb,and the difference was statistically significant(P<0.05).Conclusion In the screening of diabetic nephropathy,the combined test of C-PR,UmAlb,and HbA1c indexes is more accurate than the single test,and can play an impor-tant role in the development of standardized treatment plan.