空腹血葡萄糖及糖化血红蛋白在慢性肝病患者中诊断糖尿病的对比研究  

Comparison between Fasting Plasma Glucose and Glycated Hemoglobin Alc in Diagnosis of Diabetes Mellitus in Hepatopathy

作　　者：王征[1] 郭新会[1] 徐斌[1] 窦爱华[1] 何佳丽[1] 魏琳琳[1] 

机构地区：[1]首都医科大学附属北京佑安医院肝病内分泌科,北京100069

出　　处：《现代生物医学进展》2012年第35期6853-6855,共3页Progress in Modern Biomedicine

基　　金：首都医科大学基础临床课题重大项目(2010JL10)

摘　　要：目的:比较空腹血葡萄糖(FPG)和糖化血红蛋白(HbA1c)在肝病人群中糖尿病(DM)诊断中的意义。方法:对142例未诊断为DM的对象同时检测FPG和HbA1c。分别按1999年世界卫生组织(WHO)诊断糖尿病标准(FPG≥7.0 mmol/L)和美国糖尿病协会(ADA)新标准(HbA1c≥6.5%),对研究对象进行分组(DM和非DM组),比较2个检测指标在诊断DM中的差异。以FPG为诊断DM的金标准,计算HbA1c诊断DM的灵敏度、特异度、预测值、似然比等诊断性能。结果:FPG均值在2种标准诊断的DM患者之间差异有统计学意义(P<0.05),在2种标准诊断的非DM患者之间差异则无统计学意义(P>0.05)。HbA1c均值在2种标准诊断的DM患者间差异无统计学意义(P>0.05),在2种标准诊断的非DM患者间差异无统计学意义(P>0.05)。HbA1c≥6.5%诊断糖尿病的灵敏度(S)为100%。特异度(Sp)为93%,阴性似然比(-LR)为0.00和阳性似然比(+LR)为14.29。结论:HbA1c在肝病人群中诊断糖尿病有较高的诊断灵敏度和特异度。Objective： To compare the value of fasting plasma glucose（FPG） and glycated hemoglobin Alc（HbA1c）in the diagnosis of diabetes mellitus（DM）in hepatopathy.Methods： Levels of FPG and HbA1c were measured in 142 subjects with suspected diabetes mellitus.The diagnosis of DM was made according to 1999 WH0 diagnosis criteria for DM（FPG≥7.0 mmol/L）or the new diagnostic criteria of American Diabetes Association for DM（HbA1c≥6.5%）.The diagnosis of DM using these two criteria was compared,and the diagnostic sensitivity,specificity and likelihood ratio of HbA1c were calculated using FPG as reference.Results： There was significant difference in mean FPG level between DM diagnosed by FPG and HbA1c（P0.05） and no significant difference was observed between non-DM groups diagnosed by these two criteria（P0.05）.For mean of HbA1c,there was no significant difference between the DM groups diagnosed by FPG and HbA1c（P0.05）and no significant difference was observed between the non-DM groups diagnosed by these two criteria（P0.05）.The diagnostic sensitivity.Specificity and negative and positive likelihood ratios of HbA1c using FPG as reference were 100%,93%,0.00and 14.29,respectively.Conclusions： HbA1c has high sensitivity and specificity in diagnosing diabetes and is an ideal indicator for both the inclusion and exclusion of diabetes mellitus.

关 键 词：糖尿病 肝病 空腹血葡萄糖 糖化血红蛋白 诊断 

分 类 号：R575[医药卫生—消化系统] R587.1[医药卫生—内科学]