葡萄糖与糖化血红蛋白检测在糖尿病诊断中的应用比较的论文.docVIP

葡萄糖与糖化血红蛋白检测在糖尿病诊断中的应用比较 摘要 目的　比较使用空腹血葡萄糖与糖化血红蛋白在糖尿病（DM）诊断中的关系。方法对188例未诊断糖尿病的对象，同时检测空腹血葡萄糖（FPG）和糖化血红蛋白（HbA1c）。分别按1999年WHO诊断糖尿病标准（FPG≥7.0mmol/L）和美国糖尿病协会新标准（HbA1c≥6.5%），对研究对象进行分组（DM和非DM组），比较两个检测指标在诊断DM中的差异。以FPG为诊断DM金标准，计算HbA1c诊断DM的灵敏度、特异性、预期值、似然比等诊断性能。结果　以FPG和HbA1c相应的标准诊断糖尿病：①FPG均值：在2组DM患者之间有统计学差异（P＜0.05），在2组非DM患者之间则无统计学差异（P＞0.05）。②HbA1c均值：在2组DM组无统计学差异（P＞0.05），在2组非DM组有统计学差异（P＜0.05）。③HbA1c诊断糖尿病性能：灵敏度100%、特异性93%、阴性似然比0.00和阳性似然比14.28。结论　与FPG相比较，HbA1C诊断糖尿病有极高的诊断灵敏度和特异性，是具有纳入和排除糖尿病诊断的理想实验指标。 关键词：葡萄糖，糖化血红蛋白，糖尿病 COMPARISON BETWEEN THE FASTING PLASMA GLUCOSE AND GLYCATED HEMOGLOBIN A1C TESTING IN THE DIAGNOSIS OF DIABETES MELLITUS ABSTRACT To compare the relationship between fasting plasma glucose（FPG）and glycated hemoglobin A1c (HbA1c) testing in the diagnosis of diabetes mellitus. The levers of FPG and HbA1c in 188 subjects with undiagnosed diabetes mellitus were measured at the same time. The DM and non-DM groups were classified according to the standard (FPG ≥ 7.0mmol / L) of WHO for diagnosing DM in 1999 and the new standard (HbA1c ≥ 6.5%) of the American Diabetes Association for diagnosing DM，respectively. The two kinds of testings in DM and non-DM groups were compared in the diagnosis of DM. The sensitivity, specificity and likelihood ratios of HbA1c for diagnostic performance were calculated with the current gold standard for diagnosis of DM. The results of FPG and HbA1c were as follows：①For means of FPG measurements, there were significant difference between two DM groups（P＜0.05）and no significant difference in two non-DM groups（P＞0.05）. ②For means of HbA1c measurements, there were significant difference in two DM groups（P＜0.05）and no significant difference between two non-DM groups（P＞0.05）. ③The sensitivity, specificity and likelihood ratios of HbA1c for diagnostic performance were 100%, 93%, 0.00 and 14.28，respectively.HbA1C had high sensitivity and specificity in diagnosis of diabetes compared with FPG and was a newly ideal indicator for both inclusion and exclus