冠心病患者检测糖化血红蛋白诊断2型糖尿病的可行性  

Feasibility of Hb A1c for diagnosing type 2 diabetes in patients with coronary artery diseases

作　　者：蔡振明[1] 刘瑞杰[1] 兰军[1] 陈本发[1] 

机构地区：[1]南方医科大学附属东莞石龙人民医院心血管内科,东莞523326

出　　处：《山西医科大学学报》2014年第12期1166-1168,共3页Journal of Shanxi Medical University

摘　　要：目的探讨冠心病患者中糖化血红蛋白(Hb A1c)诊断糖尿病(DM)的理想切点及可行性。方法选择经冠脉造影确诊的冠心病患者158例,所有患者均行空腹血糖、2 h OGTT和糖化血红蛋白检测,采用受试者工作特征曲线(ROC曲线)进行判断,得到诊断DM的Hb A1c值,计算最佳切点。结果 158例入选的冠心病患者中,平均Hb A1c为(6.27±1.04)%;诊断为正常糖耐量(NGT)37例,Hb A1c为(5.32±0.08)%;糖调节受损(IGR)52例,Hb A1c为(6.03±0.36)%;DM 69例,Hb A1c为(6.96±1.11)%。糖代谢异常的发生率为76.6%。通过绘制ROC曲线,得到Hb A1c与诊断DM相关的临界点为6.35%,敏感性和特异性分别为67%和95%,曲线下面积为0.88(95%CI 0.823-0.935)。结论 Hb A1c≥6.35%作为筛查DM切点具有较高敏感度与特异度,可作为临床DM筛查的切点。Objective To investigate the optimal cut-off point and feasibility of glycated hemoglobin （HbA1 c） for diagnosing diabetes mellitus（DM） in patients with coronary artery diseases by coronary angiography.Methods A total of 158 patients with coronary heart diseases diagnosed by coronary angiography were included.The fasting glucose,2 h OGTT and glycosylated hemoglobin were detected in all patients.A receiver operating characteristic curve was used to calculate the optimal cut-off point of diagnosing DM by HbA1c.Results The average HbA1 c of 158 cases of coronary heart diseases was （6.27 ± 1.04）％.HbA1 c was （5.32 ± 0.08） ％ in 37 cases of normal glucose tolerance（NGT）,and （6.03 ±0.36） ％ in 52 cases of impaired glucose regulation（IGR）,and （6.96 ± 1.11） ％ in 69 cases of DM.The incidence of abnormal glucose metabolism was 76.6％.The optimal cut-off point of diagnosing DM by HbA1c was 6.35％,and the sensitivity and specificity of diagnosing DM by HbA1c were 67％ and 95％,respectively,and the area under the curve was 0.88 （95 ％ CI 0.823-0.935）.Conclusion HbA1 c ≥ 6.35％ as the cut-off point has high sensitivity and specificity,and can be used to clinically screen DM.

关 键 词：糖化血红蛋白 糖尿病 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病]