糖化血红蛋白、尿微量白蛋白测定判断2型糖尿病患者肾损害程度的分析

Determination of Glycosylated Hemoglobin and Urinary Microalbumin to Determine the Degree of Renal Damage in Type 2 Diabetes Patients

目的研究糖化血红蛋白(Glycosylated Hemoglobin A1c,HbA1c)和尿微量白蛋白(Microalbuminuria,尿mAlB)检测对判断2型糖尿病(Type 2 Diabetes Mellitus,T2DM)患者肾损害程度的应用价值。方法选取三明市第一医院于2021年5月—2022年12月收治的80例T2DM患者为研究对象并作为观察组,选择同期的健康体检者80名作为对照组,比较两组的HbA1c和尿mAlB水平。并根据患者肾损伤程度将观察组分为A组、B组、C组,进一步对比3组的HbA1c和尿mAlB水平。结果观察组HbA1c、尿mAlB显著高于对照组,差异有统计学意义(P均<0.05)。观察C组HbA1c、尿mAlB显著高于观察B组和观察A组,观察B组HbA1c、尿mAlB显著高于观察A组,差异有统计学意义(P均<0.05)。根据Pearson相关性分析,HbA1c、尿mAlB水平和肾损伤程度呈正相关(r=0.812、0.864,P均<0.05)。结论HbA1c、尿mAlB与肾损伤程度存在正相关关系,患者HbA1c、尿mAlB水平越高,提示患者肾损伤程度更严重。通过对T2DM患者HbA1c、尿mAlB水平测定能够初步判定患者肾损伤严重程度,可将HbA1c、尿mAlB作为观测、评价T2DM患者肾功能的重要依据,监控T2DM肾病的进展,具有较高临床价值。

Objective To investigate the application value of glycosylated hemoglobin A1c(HbA1c)and microalbuminuria(urinary mAlB)in evaluating the degree of renal damage in patients with type 2 diabetes mellitus(T2DM).Methods A total of 80 cases of T2DM patients and 80 people of healthy physical examination subjects from May 2021 to December 2022 in Sanming First Hospital were randomly selected as the observation group and the control group,respectively,to analyze the levels of HbA1c and urinary mAlB in the two groups.According to the degree of renal damage,the patients in the observation group were divided into three groups:group A,group B and group C,and the HbA1c and urinary mAlB levels of the three groups were further compared.Results HbA1c and urinary mAlB in observation group were significantly higher than those in control group,the differences were statistically significant(both P<0.05).HbA1c and urinary mAlB in observation group C were significantly higher than those in observation group B and observation group A,and HbA1c and urinary mAlB in observation group B were significantly higher than those in observation group A,and the differences were statistically significant(all P<0.05).According to Pearson correlation analysis,HbA1c and urinary mAlB levels were positively correlated with the degree of renal damage(r=0.812,0.864,both P<0.05).Conclusion There is a positive correlation between HbA1c,urinary mAlB and the degree of renal damage.The higher the level of HbA1c and urinary mAlB,the more serious the degree of renal damage is.Determination of HbA1c and urinary mAlB levels in T2DM patients can initially determine the severity of renal damage in patients with T2DM.HbA1c and urinary mAlB can be used as an important basis for observation and evaluation of renal function in T2DM patients and monitoring the progression of T2DM nephropathy,which has high clinical value.