应用ROC曲线评价糖化血红蛋白在妊娠期糖尿病诊断中的临床价值  

The clinical value evaluating of glycosylated hemoglobin A1c detection in diagnosis of gestational diabetes mellitus by using ROC curves

作　　者：梁瑞莲[1] 周远青[1] 谢健敏[1] 张婷[2] 梁玉全[1] 刘传桂 吴建辉[1] 罗建伟[1] 

机构地区：[1]南方医科大学附属顺德第一人民医院检验科,广东顺德528300 [2]南方医科大学附属顺德第一人民医院产科,广东顺德528300 [3]顺德区均安医院检验科,广东顺德528329

出　　处：《国际检验医学杂志》2012年第23期2826-2827,2829,共3页International Journal of Laboratory Medicine

基　　金：佛山市科技局医学类科技攻关项目(201108257);佛山市卫生局医学科研立项课题(2011474)

摘　　要：目的探讨糖化血红蛋白(HbA1c)在妊娠期糖尿病(GDM)诊断中的临床价值。方法收集59例正常妊娠妇女(正常妊娠组)和66例GDM患者(GDM组),采用高效液相色谱法(HPLC)检测各组静脉血HbA1c水平,使用受试者工作特征曲线(ROC曲线)对HbA1c在GDM诊断中的统计学指标进行评价,统计工具采用SPSS17.0统计软件。结果正常妊娠组和GDM组的HbA1c检测结果分别为(5.36±0.26)%和(5.95±0.85)%,GDM组明显高于正常妊娠组,P<0.01。HbA1c用于诊断GDM的ROC曲线下面积(AUC)为0.843,P<0.01;HbA1c对GDM的诊断截断值为5.65%,其诊断灵敏度和特异度分别为69.7%和84.7%。结论 HbA1c检测具有简便、快速、准确、影响因素少的优点,可作为GDM筛查和辅助诊断的理想指标。Objective To explore the clinical value of glycosylated hemoglobin（HbAlc） detection in diagnosis of gestational dia betes mellitus（GDM）. Methods 58 cases normal pregnant women and 66 cases gestational diabetes mellitus patients were enrolled in the study. The HbAlc levels of vein blood of the each group were detected by high performance liquid chromatography（HPLC）. The receiver operating characteristic curve（ROC） was used to evaluate the value of HbAlc for GDM diagnosis. Statistical analysis was performed with SPSS17.0 statistical software. Results The HbAlc levels of the normal pregnancy group and the GDM group were（5.36±0.26） and（5.95±0.85） ,respectively. There were significant differences in the comparison of the HbAlc level be tween the GDM group and the normal pregnancy group（P〈0.01）. The HbAlc levels of the GDM group was higher than that of normal pregnancy group. The area under receiver operating characteristic curve（AUC）of HbAlc was 0. 843 for GDM diagnosis, P〈0.01,and with the optimal cut-off value of 5. 65% ,HbAlc showed a diagnostic sensitivity of 69.7% and specificity of 84.7%. Conclusion The HbAlc detection has the advantage of simple, rapid, accurate, and impact factors less, it can be used in clinical screening and auxiliary diagnosis of GDM.

关 键 词：ROC曲线 血红蛋白A 糖基化 糖尿病.妊娠 

分 类 号：R714.25[医药卫生—妇产科学] R446.1[医药卫生—临床医学]