糖化血红蛋白及血脂指标检测在2型糖尿病患者微血管病变中的应用  

Application of glycosylated hemoglobin and blood lipid indexes detection in microangiopathy of patients with type 2 diabetes mellitus

作　　者：李锦超 Li Jinchao(Department of Clinical Laboratory,Jinan Integrated Traditional Chinese and Western Medicine Hospital,Jinan 271100,Shandong,China)

机构地区：[1]济南市中西医结合医院检验科,山东济南271100

出　　处：《实用检验医师杂志》2023年第4期430-433,共4页Chinese Journal of Clinical Pathologist

摘　　要：目的探讨糖化血红蛋白以及血脂指标检测对于罹患2型糖尿病的病例的微血管病变的诊断作用。方法选择2022年3月—2023年3月在济南市中西医结合医院就诊的240例2型糖尿病患者作为研究对象,其中100例糖尿病肾病患者和140例单纯糖尿病患者分别纳入糖尿病肾病组和单纯糖尿病组;另外选择同时间段在济南市中西医结合医院进行健康体检的100例健康志愿者,将其设置成对照组。采集所有受检者空腹血液标本,采用高效液相色谱法(HPLC)测定血清糖化血红蛋白,采用氧化酶法检测总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C);比较各组受检者上述指标水平差异。关于各项检测指标是否与糖尿病肾病的发病存在关联进行分析,相关性分析选择应用Spearman分析法。将糖尿病肾病的诊断“金标准”设为临床确诊结果,以此为参照,计算和对比糖化血红蛋白和血脂指标单独与联合检测对糖尿病肾病的诊断效能。结果糖尿病肾病组的糖化血红蛋白、TC、TG、LDL-C水平均明显高于单纯糖尿病组和对照组[糖化血红蛋白:0.078±0.011比0.064±0.010、0.044±0.008,TC(mmo L/L):6.72±1.43比5.18±0.93、3.94±0.89,TG(mmoL/L):2.39±0.64比1.70±0.51、1.02±0.33,LDL-C(mmoL/L):4.28±1.05比3.09±0.84、2.15±0.67,均P<0.05],且单纯糖尿病组上述指标水平均明显高于对照组(均P<0.05)。糖化血红蛋白、TC、TG、LDL-C水平与糖尿病肾病发病均呈正相关(r值分别为0.793、0.832、0.819、0.840,P值分别为0.006、0.004、0.005、0.003)。糖化血红蛋白、TC、TG、LDL-C联合检测在糖尿病肾病诊断中的灵敏度、特异度、准确度分别为97.00%、97.14%、97.08%,均明显高于各项指标单一检测。结论关于罹患2型糖尿病的病例在肾脏出现微血管病变,显示糖化血红蛋白、TC、TG、LDL-C水平均普遍上调,各指标联合检测对2型糖尿病肾病具有良好的辅助诊断作用。Objective To explore the diagnostic role of glycosylated hemoglobin and blood lipid indicators in microvascular diseases of patients with type 2 diabetes.Methods The 240 patients with type 2 diabetes mellitus treated in Jinan Integrated Traditional Chinese and Western Medicine Hospital from March 2022 to March 2023 were taken as research objects.The 100 cases with diabetes nephropathy and 140 cases with simple diabetes were respectively included in diabetes nephropathy group and simple diabetes group.Additionally,100 healthy volunteers who underwent health examinations at Jinan Integrated Traditional Chinese and Western Medicine Hospital during the same time period were selected,they were set as the control group.The fasting blood samples from all subjects were collected,the level of serum glycated hemoglobin was measured using high-performance liquid chromatography(HPLC),and the levels of total cholesterol(TC),triglycerides(TG)and low-density lipoprotein cholesterol(LDL-C)were detected using oxidase method.The differences of the above indicators among the test subjects in each group were compared.The Spearman analysis method was selected to analyze whether there was a correlation between each test index and the incidence of diabetes nephropathy.The"gold standard"for diagnosis of diabetes nephropathy was set as the clinical diagnosis result,which was used as a reference to calculate and compare the diagnostic efficacy of glycosylated hemoglobin and blood lipid indicators for diabetes nephropathy by separate and joint detection.Results The levels of glycosylated hemoglobin,TC,TG and LDL-C in diabetes nephropathy group were significantly higher than those in simple diabetes group and control group[glycosylated hemoglobin:0.078±0.011 vs.0.064±0.010,0.044±0.008,TC(mmoL/L):6.72±1.43 vs.5.18±0.93,3.94±0.89,TG(mmoL/L):2.39±0.64 vs.1.70±0.51,1.02±0.33,LDL-C(mmoL/L):4.28±1.05 vs.3.09±0.84,2.15±0.67,all P<0.05].Moreover,the above indexes in simple diabetes group were significantly higher than those in control g

关 键 词：2型糖尿病 肾脏微血管病变 糖尿病肾病 诊断 糖化血红蛋白 血脂 

分 类 号：R587.2[医药卫生—内分泌] R446.1[医药卫生—内科学]