血清C肽、糖化血红蛋白联合空腹血糖检验在糖尿病患者中的诊断价值

Diagnostic Value of Serum C-peptide,Glycated Hemoglobin A1c Com⁃bined with Fasting Plasma Glucose Test in Diabetes Mellitus Patients

目的分析血清C肽、糖化血红蛋白(glycated hemoglobin A1c,HbA1c)联合空腹血糖(fasting plasma glucose,FPG)诊断在糖尿病(diabetes mellitus,DM)患者临床检验中的应用价值。方法选取2021年1—12月东平县疾病预防控制中心检验科收治的62例疑似DM患者为研究对象,全部患者接受血清C肽、HbA1c与FPG检测,以糖耐量试验为金标准,比较血清C肽、HbA1c、FPG单一指标及联合检测对DM的诊断效能。结果糖耐量试验结果显示,62例疑似DM患者中阳性为57例,阴性为5例;血清C肽、HbA1c联合FPG诊断DM的真阳性为53例,真阴性为4例。联合检测诊断的准确度、灵敏度、特异度高于FPG、HbA1c和血清C肽单一指标检测,差异有统计学意义(P均<0.05)。不同检查方法的阳性预测值和阴性预测值比较,差异无统计学意义(P均>0.05)。结论与单一指标的检测相比,FPG、HbA1c和血清C肽联合检测DM患者的诊断效能较高,因此,可将三者联合作为DM的临床检验措施,可进一步提升DM的诊断准确度。

Objective To analyze the application value of serum C-peptide,glycated hemoglobin A1c(HbA1c)com⁃bined with fasting plasma glucose(FPG)in the clinical examination of patients with diabetes mellitus(DM).Methods A total of 62 patients with suspected DM admitted to the Department of Laboratory of Dongping County Center for Disease Control and Prevention from January to December 2021 were selected as the research objects.All patients received se⁃rum C-peptide,HbA1c and FPG detection.The glucose tolerance test was used as the gold standard to compare the di⁃agnostic efficacy of serum C-peptide,HbA1c,FPG single index and combined detection for DM.Results The results of glucose tolerance test showed that 57 cases were positive and 5 cases were negative in 62 patients with suspected DM.There were 53 cases of true positive and 4 cases of true negative in the diagnosis of DM by serum C-peptide,HbA1c combined with FPG.The accuracy,sensitivity and specificity of combined examination were higher than those of FPG,HbA1c and serum C-peptide single index detection,and the differences were statistically significant(all P<0.05).There were no significant differences in positive predictive value and negative predictive value between different exami⁃nation methods(both P>0.05).Conclusion Compared with the detection of single index,the combined detection of FPG,HbA1c and serum C-peptide in the diagnosis of DM patients is higher.Therefore,the combination of the three can be used as a clinical test measure of DM,which can further improve the diagnostic accuracy of DM.