糖化白蛋白在糖尿病伴贫血患者中检测的临床意义  

Different degree of anemia's influence on the determination of glycated albumin level

作　　者：张丽梅[1] 李强[1] 辛瑜[1] 邬艳慧[1] 李鹏杰[1] 

机构地区：[1]哈尔滨医科大学附属第二医院内分泌代谢病科,黑龙江哈尔滨150086

出　　处：《中国实验诊断学》2017年第5期785-788,共4页Chinese Journal of Laboratory Diagnosis

基　　金：黑龙江省卫生厅课题(2012-633)

摘　　要：目的探讨糖化白蛋白在糖尿病伴贫血患者中检测的临床意义。方法选取我院2012年12月-2014年12月住院的80例伴和不伴贫血的糖尿病患者作为研究对象,根据贫血不同程度将糖尿病患者分为四组(无贫血、轻度贫血、中度贫血和重度贫血),分别检测空腹血糖(FBG)、餐后两小时血糖(2h-PG)及糖化血红蛋白(HbA1c)和糖化白蛋白(GA)。实验数据采用单因素方差分析,进一步多重比较Dunentt-t检验;GA(%)和HbA1c(%)使用多个独立样本的非参数检验(Kruskal-Wallis H检验)分析4组间差异有无统计学意义,进一步两两比较Mann-Whitney U检验;Spearman分析GA与FBG和2h-PG的相关性。结果 (1)随着糖尿病患者贫血程度的加重,血红蛋白(HGB)水平逐渐下降,T2DM+轻度贫血、T2DM+中度贫血、T2DM+重度贫血显著低于T2DM组(P均<0.01);FBG和2hPG没有明显变化。(2)GA(%)4组间检验差别无统计学意义(χ~2=6.883,P=0.076)。HbA1c(%)经Kruskal-Wallis H检验,4组间差异有统计学意义(χ~2=8.928,P=0.03);与T2DM组比较,T2DM+轻度贫血组和T2DM+中度贫血组差异没有统计学意义(Z=-1.757,P=0.79;Z=-1.672,P=0.095);T2DM+重度贫血组有差异(Z=-2.95,P=0.003)。(3)GA与FBG和2h-PG均有相关性(r=0.274,P=0.014;r=0.422.P<0.01)。结论不同贫血程度对GA水平无影响,在糖尿病伴贫血患者中GA的检测较HbA1c更有优势。Objective Study of clinical significance about glycated albumin（GA） in diabetic patients with anemia. Methods Select 80 diabetic hospitalized patients with and without anemia as the research object from December 2012 to December 2014. These diabetic patients were divided into four groups according to different degree of anemia（Including no anemia, mild anemia, moderate anemia and severe anemia）, and then to detect fasting blood glucose（FBG）, post-prandial 2 hours blood glucose （2h-PG）,glycosylated hemoglobin（HbAlc） and glycated albumin（GA）. The signal factor a- nalysis of variance and the multiple comparison inspection Dunentt-t were used to test the experimental date. The multiple indepe-ndent samples nonparametric test was used to analyze the differences statistical significance aout GA and HbA1c. Further every two compare with Mann-Whitney U test , then Spearman were used to analyze the correlation of FBG and 2h-PG with GA. Results （1） As the degree of anemia in patients with diabetes is aggravating, HGB level gradually decline,the mild anemia, moderate and severe anemia are significantly lower than that of T2DM group（P〈 0. 01）;there is not obvious change between FBG and 2h-PG. （2）There are no statistically significant between the four groups about GA（chi-square=6. 883 ,P=0.076）. HbA1c was examined by Kruskal-Wallis H test and there are different statistically significant between the four groups（chi-square=8. 928 ,P=0.03）. Compared with T2DM, there are no statistically significant between mild and moderate anemia groups （Z =- 1.757, P = 0.79 ; Z = - 1.672, P = 0.095 ） and there are differences in severe anemia（Z=-2.95 ,P=0. 003）. （3）There are correlation between GA and FBG and 2h- PG（r=-0. 274,P=0. 014;r=0. 422. P〈0.01）. Conclusion There are no influence about the different degree of anemia on glycated albumin. There are more advantages on glycated albumin detection than glyeated hemoglobin detection in patients with anemia with diabetes.

关 键 词：糖尿病 糖化白蛋白 糖化血红蛋白 空腹血糖 餐后2小时血糖 

分 类 号：R556[医药卫生—血液循环系统疾病] R587.1[医药卫生—内科学]