控制糖化血红蛋白在儿童糖尿病中的临床应用

目的:观察糖尿病患儿糖化红血蛋白(HbA1c)控制情况,了解其在糖尿病控制中的应用价值。方法:选取2009年1月1日～12月31日已确诊的糖尿病在北京儿童医院内分泌科复诊的患儿591例,检测其HbA1c水平。按性别分为男、女两组;按发育情况分为青春前期组和青春发育期组;按HbA1c的控制情况,在年龄分组的基础上分为控制理想、可接受、较差、差4组。用SPSS软件进行统计学分析。结果:男性患儿的HbA1c平均水平为(8.81±4.24)%,女性患儿的HbA1c平均水平为(8.77±3.77)%;不同性别之间HbA1c水平差异无统计学意义(P>0.05)。青春前期组的HbA1c平均水平为(7.97±1.60)%;青春发育期HbA1c平均水平为(9.28±2.47)%,两个年龄组之间差异有统计学意义(P<0.01),青春发育期HbA1c水平明显高于青春前期组。青春前期组患儿HbA1c控制较理想的比例明显高于青春发育期组(P<0.05),青春发育期组患儿HbA1c控制差的比例明显高于青春前期组(P<0.01)。结论:青春前期组的患儿因由家长监督依从性较好,HbA1c水平控制较好,青春发育期组的糖尿病患儿应加强糖尿病知识的健康教育,加强精神心理方面的治疗,制定个性化的治疗方案,减少并发症。

The clinical applications of control conditions of glycosylated hemoglobin in children's diabetes

Objective:To study the clinical applications of glycosylated hemoglobin(HbA1c)in children's diabetes by observing the control conditions of HbA1c. Methods:591 children made a definite diagnosis with diabetes were rechecked and researched during in 2009 The levels of HbA1c of children were detected.According to different genders,the children were divided into male groupand female group;according to developmental conditions,the children were divided into before adolescence group and adolescence group;according to the control conditions of HbA1c,the children were divided into ideal control group,acceptable control group,bad control group and worse control group.The data were analyzed by spss. Results:The average level of HbA1c in male group was(8.81±4.24)%.The average level of HbA1c in female group was(8.77 ±3.77)%.There were not obvious significance of HbA1c in different gender groups(P>0.05).The average level of HbA1c in before adolescence group was(7.97±1.60)%.The average level of HbA1c in adolescence group was(9.28±2.47)%.There were obvious significance of HbA1c in different age groups(P<0.05).The average levels of HbA1c in adolescence group were obviously higher than before adolescence group.The rate of ideal control of before adolescence group was obviously higher than adolescence group(P<0.05).The rate of worse control of adolescence group was obviously higher than before adolescence group(P<0.01). Conclusion:There are the better control conditions in before adolescence group because of the better compliance.It is necessary for adolescence group to strengthen the education of diabetes and emphasize mental therapy.At the same time,it is important to treat the children with individual programs and reduce complications.