糖化血红蛋白和血糖水平检测对精神病患者并发糖尿病的诊断价值

目的探讨糖化血红蛋白(HbA1c)、空腹血糖(FPG)、葡萄糖耐量试验(OGTT)2 h血糖检测对精神病并发糖尿病诊断的临床价值。方法收集重庆市精神卫生中心歌乐山院区老年科及综合科107例精神病并发糖尿病患者纳入观察组,110例非糖尿病的精神病患者纳入疾病对照组,100例职工健康体检者纳入健康对照组。采集血清及抗凝全血标本,采用己糖激酶法测定FPG、OGTT 2 h血糖,采用液相色谱离子交换层析法检测HbA1c水平,比较3组研究对象各项指标水平,并分析观察组各项指标相关性及并发症发生情况。结果观察组患者的FPG、OGTT 2 h血糖、HbA1c水平均明显高于疾病对照组和健康对照组,差异有统计学意义(P<0.05);疾病对照组和健康对照组的FPG、OGTT 2 h血糖、HbA1c水平比较,差异无统计学意义(P>0.05)。观察组中,FPG与HbA1c呈显著正相关(r=0.591,P<0.05);OGTT 2 h血糖水平与HbA1c水平呈显著正相关(r=0.564,P<0.05)。HbA1c>8%患者相关并发症的发生率均明显高于HbA1c≤8%患者,差异有统计学意义(P<0.05)。结论FPG、OGTT和HbA1c水平检测可作为诊断精神病患者并发糖尿病的一项重要指标,且对并发症发生风险具有重要的评估价值。

Detection of glycosylated hemoglobin and blood glucose levels in the diagnosis of diabetes mellitus in psychiatric patients

Objective To explore the clinical value of detection of glycosylated hemoglobin(HbA1c)and fasting blood-glucose(FPG),2 h blood glucose of Glucose Tolerance Test(OGTT)in the diagnosis of diabetes mellitus in psychiatric patients.Methods A total of 107 cases of patients with psychosis complicated with diabetes in Geleshan District of Chongqing Mental Health Center were included in the observation group,110 cases of non-diabetic patients with psychosis were recruited into disease control group,and 100 cases of health examination of workers were recruited into healthy normal group.Serum and anticoagulant whole blood samples were collected,FPG,2 h blood glucose of OGTT were measured by hexokinase method,and HbA1c level was detected by liquid chromatography on exchange chromatography.The differences of these indicators in the three groups were compared,the relationships among these indicators and the occurrence of complications in observation group were analyzed.Results The levels of FPG,2 h blood glucose of OGTT and HbA1c in the observation group were significantly higher than those in the disease control group and the healthy normal group(P<0.05).There were no significant differences on the levels of FPG,2 h blood glucose of OGTT and HbA1c between the disease control group and the healthy normal group(P>0.05).The levels of FPG,2 h blood glucose of OGTT in the observation group positively correlated with the level of HbA1c(r=0.591,0.564,P<0.05).The rate of related complications in the patients with HbA1c more than 8%were significant higher than those in patients with HbA1c was 8%or less than 8%(P<0.05).Conclusion FPG,OGTT and HbA1c detection could be used to diagnosis of diabetes mellitus and evaluated the risk of complications in psychiatric patients.