糖化血红蛋白和总胆红素联合检验与2型糖尿病合并冠心病的相关性  

Correlation between detection of glycosylated hemoglobin combined with total bilirubin and type 2 diabetes mellitus complicated with coronary heart disease

作　　者：于海珍 刘珊珊 Yu Haizhen;Liu Shanshan(Department of Clinical Laboratory,Zhucheng People's Hospital,Weifang 262200,Shandong,China)

机构地区：[1]诸城市人民医院检验科,山东潍坊262200

出　　处：《实用检验医师杂志》2024年第4期354-357,共4页Chinese Journal of Clinical Pathologist

基　　金：山东省潍坊市卫生健康委科研项目(WFWSJK-2023-056)。

摘　　要：目的分析糖化血红蛋白(HbA1c)和总胆红素(TBil)联合检验与2型糖尿病合并冠心病的相关性。方法回顾并分析2021年5月—2023年5月诸城市人民医院收治的60例2型糖尿病合并冠心病患者的临床资料,并将其纳入合并冠心病组;选择同期收治的60例单纯2型糖尿病患者纳入单纯糖尿病组;另外选择同期80例健康体检者纳入健康对照组。采用葡萄糖氧化酶法检测血糖指标〔空腹血糖(FBG)、HbA1c〕,采用酶法检测血脂指标〔总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)〕和尿酸(UA),采用硝基苯肼法测定TBil;采用多因素Logistic回归分析考察2型糖尿病合并冠心病的独立危险因素。结果合并冠心病组的FBG、HbA1c、TG、TC、LDL-C、UA水平均显著高于单纯糖尿病组和健康对照组,HDL-C和TBil水平均显著低于单纯糖尿病组和健康对照组〔FBG(mmol/L):7.72±1.06比6.55±0.74、5.51±0.64;HbA1c:0.078±0.006比0.071±0.005、0.051±0.003;TG(mmol/L):2.56±0.34比1.51±0.14、1.33±0.21;TC(mmol/L):4.81±0.52比4.06±0.43、3.48±0.34;LDL-C(mmol/L):3.64±0.36比2.93±0.24、2.62±0.17;UA(μg/L):448.64±71.58比320.45±74.39、253.54±40.87;HDL-C(mmol/L):1.16±0.07比1.33±0.08、1.45±0.13;TBil(mmol/L):7.81±0.73比10.91±1.31、11.93±1.52;均P<0.05〕,单纯糖尿病组的FBG、HbA1c、TG、TC、LDL-C、UA水平均显著高于健康对照组(均P<0.05)。Logistic回归分析结果显示,HbA1c水平升高和TBil水平降低均为2型糖尿病合并冠心病的独立危险因素〔优势比(OR)分别为1.781、0.592,95%可信区间(95%CI)分别为1.047~3.146、0.345~0.872,均P<0.05〕。结论导致2型糖尿病合并冠心病发病的危险因素为HbA1c水平上升和TBil水平下降,因此HbA1c与TBil联合检验在2型糖尿病合并冠心病患者的临床诊治中有具有较高的应用价值。Objective To analyze the correlation between detection of glycosylated hemoglobin(HbA1c)combined with total bilirubin(TBil)and type 2 diabetes mellitus complicated with coronary heart disease.Methods The clinical data of 60 patients with type 2 diabetes mellitus complicated with coronary heart disease admitted in Zhucheng People's Hospital from May 2021 to May 2023 were reviewed and analyzed,and the patients were included in combined coronary heart disease group.The 60 patients with simple type 2 diabetes mellitus during the same time were included in simple diabetes group.Additionally,80 healthy individuals who underwent physical examinations during the same period were selected and included in healthy control group.Glucose oxidase method was used to detect blood glucose indicators[fasting blood glucose(FBG)and HbA1c],enzyme method was used to detect blood lipid indicators[total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)]and uric acid(UA),and nitrophenylhydrazine method was used to determine TBil.Multivariate Logistic regression analysis was used to investigate the independent risk factors of type 2 diabetes mellitus complicated with coronary heart disease.Results The levels of FBG,HbA1c,TG,TC,LDL-C and UA in combined coronary heart disease group were significantly higher than those in simple diabetes group and healthy control group,and the levels of HDL-C and TBil were significantly lower than those in simple diabetes group and healthy control group[FBG(mmol/L):7.72±1.06 vs.6.55±0.74,5.51±0.64;HbA1c:0.078±0.006 vs.0.071±0.005,0.051±0.003;TG(mmol/L):2.56±0.34 vs.1.51±0.14,1.33±0.21;TC(mmol/L):4.81±0.52 vs.4.06±0.43,3.48±0.34;LDL-C(mmol/L):3.64±0.36 vs.2.93±0.24,2.62±0.17;UA(μg/L):448.64±71.58 vs.320.45±74.39,253.54±40.87;HDL-C(mmol/L):1.16±0.07 vs.1.33±0.08,1.45±0.13;TBil(mmol/L):7.81±0.73 vs.10.91±1.31,11.93±1.52;all P<0.05].The levels of FBG,HbA1c,TG,TC,LDL-C and UA in simple diabetes group were significant

关 键 词：糖化血红蛋白 总胆红素 2型糖尿病 冠心病 

分 类 号：R58[医药卫生—内分泌]