摘要
目的探讨应激状态下糖化血红蛋白(HbA1c)测定是否能鉴别应激性高血糖与糖尿病性高血糖。方法选择2009年1月-2012年1月收治的有应激因素参与的高血糖患者100例,将其作为临床研究对象。对100例患者进行HbA1c水平检测,2～3周后,所有患者待应激因素消除后,再做口服葡萄糖耐量试验(OGTT),若未达糖耐量异常(IGT)或糖尿病(DM)诊断标准(其中DM的诊断标准采用1999年WHO国际通用标准),则为应激性高血糖。确诊患者中应激性高血糖患者及糖尿病高血糖患者人数,将1例新发糖尿病、2例应激性高血糖患者归为糖尿病组。将再选取体检人员60例作为对照组,分别对糖尿病组高血糖患者、应激组高血糖(SH)患者与对照组进行空腹血糖及HbA1c水平检测。观察并分析三组患者空腹血糖及HbA1c水平。结果 HbA1c诊断的结果与OGTT检测结果接近,在判断糖尿病高血糖和应激性高血糖两者之间的准确性高。糖尿病组高血糖患者和应激组高血糖患者的空腹血糖浓度和HbA1c水平均较对照组提高,糖尿病高血糖患者的空腹血糖浓度和HbA1c水平较应激组患者高(P<0.05)。结论 HbA1c是鉴别应激性高血糖和糖尿病的一个良好指标,可应用于临床鉴别SH与真性DM,值得在临床上广泛推广。
Objective To discuss whether HbA1c test can identify stress hyperglycemia and diabetic hyperglycemia in the stress state.Methods A total of 100 patients with stress hyperglycemia were enrolled in this study from January 2009 to January 2012.Their HbA1c level was tested.OGTT was performed when the stress factors had been eliminated 2 to 3 weeks late.The patients who did not meet the diagnostic criteria of TGT or DM were diagnosed as stress hyperglycemia（SH）.One case of new-onset diabetes patients and two cases of IGT patients were chosen as diabetes group,60 cases of physical examination staff were as control group.The fasting blood-glucose test and HbA1c level test were performed and compared among the three groups.Results HbA1c＇s diagnosis results were similarly to OGTT＇s test results,and both of them had a high veracity on the diagnosis of stress hyperglycemia and diabetic hyperglycemia.The fasting blood-glucose and HbA1c levels in DM group and stress group were higher than those in the control group.The fasting blood-glucose and HbA1c levels in DM group were also higher than those in the stress group,the difference was statistically significant（P0.05）.Conclusion HbA1c is a good indicator for the identification of stress hyperglycemia and diabetic hyperglycemia,and can be used in clinical identification of SHG and real DM.
出处
《中华全科医学》
2013年第3期351-352,共2页
Chinese Journal of General Practice
基金
广西科学研究与技术开发计划项目(桂科攻1016004-3)
关键词
糖化血红蛋白
应激性高血糖
鉴别
Glycosylated hemoglobin
Stress hyperglycemia
Identification diagnosis
