糖化血红蛋白检测在糖尿病微血管病变判断中的意义

目的探讨糖化血红蛋白检测在糖尿病微血管病变判断中的意义。方法回顾性分析2018年6月—2019年6月间该院114例糖尿病患者的临床资料,根据有无微血管病变分为A组(n=54,有微血管病变)、B组(n=60,无微血管病变)。随机选取同期55名健康体检者,作为C组。A组、B组分别在确诊时检测糖化血红蛋白(HbA1c),C组体检时检测,比较检测结果。并分析HbA1c水平与糖尿病微血管病变相关性。结果A组HbA1c水平、HbA1c阳性率高于B组、C组,且B组高于C组(P<0.05);Pearson相关性分析显示,HbA1c水平与糖尿病微血管病变发生呈正相关(P<0.05)。结论糖尿病微血管病变患者存在明显HbA1c异常升高现象,且HbA1c阳性率高于糖尿病无微血管病变患者、健康人,HbA1c水平与糖尿病微血管病变发生呈正相关,临床可经检测HbA1c判断糖尿病微血管病变。     

糖尿病患者糖化血红蛋白检测结果及意义探析

目的 探讨糖尿病患者糖化血红蛋白检测结果及意义.方法 选择该院2019年1—12月收治的79例糖尿病患者作研究组,选择同期79名健康人群作对照组,对比两组糖化血红蛋白检查结果,了解研究组当中糖化血红蛋白和空腹血糖的比例、糖化血红蛋白和并发症发生的关系.结果 ①研究组空腹血糖、餐后2h血糖、糖化血红蛋白均高于对照组,差异...     

2型糖尿病微血管病变与血小板参数的临床研究

目的探讨2型糖尿病微血管病变与患者MPV（血小板体积）及PDW（血小板体积分布宽度）的临床价值。方法选取我院2012年6月至2013年12月收治的2型糖尿病微血管病变（糖尿病肾病、糖尿病眼底病变）患者73例为观察组,选取我院同期无并发症的2型糖尿病患者73例为对照组,对所有患者进行血小板检测,统计其血小板计数及MPV、PDW等数据,进行对比分析,探寻组间差异。结果观察组各项数据均较对照组有差异,其中观察组PLT为（89.42±35.7）×109/L,MPV为（18.33±4.01）fl,PDW为（15.17±1.51）,P-LCR为（26.17±1.51）%,对照组对应数据为（151.08±20.7）×109/L、（11.96±1.07）fl、（16.34±0.97）fl和（36.51±6.01）%,两组对比,差异显著,具有统计学意义（P〈0.05）。结论 2型糖尿病微血管病变患者伴血小板参数异常,及早检测血小板,对疾病的预防具有重要的临床价值。     

授权能力与社区老年糖尿病患者糖化血红蛋白的相关性

目的探讨授权能力与社区老年糖尿病患者糖化血红蛋白(HbA1c)的关系。方法采用便利抽样入户调查法,对满足纳入标准的社区老年糖尿病患者,应用中文版糖尿病授权量表(CM-DES)进行调查并测定HbA1c。结果社区老年糖尿病患者HbA1c平均水平为4.7%~14.6%[平均(8.35±1.33)%]。授权能力总分为(56.43±6.79)分,授权能力处于高、中、低水平的患者分别占12.9%、69.4%、17.7%,HbA1c<7.0%的社区老年糖尿病患者授权能力高于HbA1c≥7.0%患者(P<0.05),且授权能力总分、自我决策、自我调整维度与社区老年糖尿病患者HbA1c平均水平呈负相关(P<0.05)。结论授权能力与社区老年糖尿病患者HbA1c平均水平密切相关,可通过提高患者的授权能力降低患者的HbA1c平均水平,帮助患者提高生活质量。     

血清糖化血红蛋白、C反应蛋白及微量白蛋白水平与老年糖尿病肾病患者肾微血管病变的相关性

目的探讨老年糖尿病肾病(DN)患者血清糖化血红蛋白(HbA1c)、C-反应蛋白(CRP)、微量白蛋白(mALB)与肾脏微血管病变程度的相关性。方法根据尿蛋白排泄率(UAER)大小将126例老年DN患者分为临床蛋白尿组(UAER≥300 mg/24 h)和m ALB组(30 mg/24 h≤UAER300 mg/24 h),同时选取63例无DN的老年糖尿病患者作为糖尿病对照组,并选取63例无糖尿病的健康老年人作为健康对照组,测定4组血清HbA1c、CRP及mALB水平,并分析老年DN患者HbA1c、CRP及mALB与肾脏微血管病变程度之间的关系。结果临床蛋白尿组、mALB组、糖尿病对照组血清HbA1c、CRP均显著高于健康对照组(P0.05),糖尿病对照组与健康对照组mALB无显著差异(P0.05);临床蛋白尿组、mALB组HbA1c、CRP及mALB均显著高于糖尿病对照组(P0.05);临床蛋白尿组HbA1c、CRP及mALB均显著高于微量蛋白尿组(P0.05);多元线性回归分析结果表明DN患者血清mALB与UAER呈线性相关关系(P0.05),HbA1c、CRP与UAER呈正相关(P0.05)。结论高血糖及炎症反应参与了DN患者肾微血管的病变过程,血清HbA1c、CRP及mALB与DN患者肾微血管病变程度呈正相关,可作为DN患者肾微血管病变的早期预测指标。     

2型糖尿病视网膜病变患者血管内皮生长因子及糖化血红蛋白变化的意义

为探讨血管内皮生长因子(VEGF)和糖化血红蛋白(GHbA1c)在2型糖尿病(T2DM)视网膜病变早期诊断中的意义,2002年3月至2002年12月,我们检测了158例T2DM患者的血清VEGF和GHbA1c现报告如下。     

血小板参数、血糖及血脂检测在2型糖尿病微血管病变防治中的临床意义

目的探讨血小板参数、血糖及血脂检测在2型糖尿病(T2DM)微血管病变防治中的临床意义。方法选择2013年1月至2015年1月来该院治疗的T2DM患者37例作为治疗组,同时选择33例健康体检者作为对照组,主要检测的指标包括血小板参数、血糖及血脂数据,其中血小板参数包括血小板计数(PLT)、平均血小板体积(MPV)以及血小板分布宽度(PDW),血糖则选择空腹血糖(FPG)作为监测指标,血脂指标选择低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、胆固醇(TC)、甘油三酯(TG)以及血尿酸(UA)等,主要对比两组治疗前后指标差异。结果治疗前,治疗组TG、TC、MPV、PDW、UA等指标高于对照组,PLT低于对照组(P0.05),其余指标对比无统计学意义(P0.05),治疗组接受治疗后,血脂水平得到改善,TG、TC、LDL-C及UA水平降低,HDL-C水平升高(P0.05);对治疗组治疗前指标进行双变量相关性分析显示,FPG、MPV呈正相关(r=0.24,P0.05),MPV、PDW呈正相关(r=0.31,P0.05),其他各项指标间无相关性;糖尿病微循环血管病变的主要危险因素为FPG(OR=7.658)、TG(OR=6.932)、TC(OR=6.841)、PDW(OR=4.324)(P0.05)。结论血小板及血脂参数在糖尿病患者存在异常是T2DM微血管病变的主要危险因素,对T2DM微血管病变的预防需要密切监测患者血小板参数和血脂变化。     

2型糖尿病视网膜病变患者血红蛋白糖化指数和尿白蛋白/肌酐比值变化的意义研究

目的 探讨DR患者血红蛋白糖化指数（HGI）和UACR变化的意义。方法 选取2019年1月至2020年12月于宿迁市第一人民医院内分泌科住院的T2DM患者268例。根据眼底检查结果分为单纯T2DM组（T2DM,n=159）及T2DM合并DR组（DR,n=109）。根据FPG和HbA1c计算HGI,定义HGI≥0为高水平,HGI<0为低水平。比较两组一般资料和实验室生化指标,分析DR的危险因素;比较两组高HGI、UACR发生率及HGI+UACR对DR的诊断价值。结果 Logistic回归分析结果显示,HGI、UACR是DR的危险因素。DR组高HGI、高UACR发生率高于T2DM组（P<0.05）。受试者工作特征（ROC）曲线分析显示,HGI+UACR可有效预测DR,ROC曲线下面积为0.76(P<0.01)。结论 HGI与UACR与DR发病密切相关,对DR有一定预测价值,HGI联合UACR可用于DR个性化评估和风险预测。     

2型糖尿病肾病早期诊断中应用糖化血红蛋白和尿微量白蛋白联合检测的临床价值

目的 分析2型糖尿病肾病早期诊断中采取糖化血红蛋白与尿微量白蛋白联合检测方式的临床价值.方法 抽取2020年1月—2021年6月期间在该院进行诊治的2型糖尿病肾病患者(31例)作为观察组,并选择同期在该院进行体检的健康者(31名)作为对照组,两组受检者均进行糖化血红蛋白与尿微量蛋白联合检测方式,对两组受检者的检查结果进...     

OGTT和糖化血红蛋白测定在妊娠期糖尿病患者临床筛查的价值研究

目的 研究 OGTT和糖化血红蛋白测定在妊娠期糖尿病患者临床筛查的价值.方法 测定利用糖激酶法,糖化血红蛋利用高效液相色谱分析法.结果 GDM组的 OGTT 及 HbAlc水平均高于 GNGT,OGTT 联合 HbA1c检测的一次成功率高于单独检测的患者.联合筛查的阳性率高于单独检测的患者.结论 OGTT 和糖化血红蛋...     

Elevated glycosylated hemoglobin in diabetic neuropathy

Summary Glycosylated hemoglobin (GHb) levels were measured in 36 patients with established symptomatic neuropathy and in an identical number of matched controls. Strict criteria were employed in the selection of subjects and all had neuropathy of at least 12 months’ duration. The diagnosis of neuropathy was supported by estimation of motor conduction velocities and vibration perception threshold. A semi-automated colorimetric technique, employing the reaction between thiobarbituric acid and 5-hydroxy-methyl furfural, was used for the estimation of GHb. Those patients with neuropathy had significantly higher GHb levels (58.2 ± 11.3 mmol HMF/mol Hb) than the controls (50.0 ± 8.9 mmol HMF/mol Hb) (p<0.01). This suggests that hyperglycemia or related metabolic abnormalities are important factors in established symptomatic neuropathy.     

Lack of knowledge of glycosylated hemoglobin in patients with diabetic retinopathy

We surveyed 220 patients with diabetic retinopathy attending a tertiary eye hospital in Australia, and found that knowledge of HbA_1c, and the proportion achieving target level of <7%, remained low in patients with diabetic retinopathy. These data re-emphasize the gap between clinical guidelines and actual management of patients with diabetes.     

The clinical utility of glycosylated hemoglobin

Measurement of glycosylated hemoglobins in diabetic patients has been available to clinicians for about five years. Such measurements correlate with mean serum glucose determinations over time; therefore, they have stimulated a number of studies to determine (1) if these assays are useful in diagnosing diabetes, (2) the clinical utility of determinations of minor hemoglobins in monitoring diabetic control, and (3) the relationship of glucose "control" (as indicated by concentrations of glycosylated hemoglobins) to abnormalities or "sequelae" of the diabetic state. High concentrations of glycosylated hemoglobins are highly specific for diabetes, and positive findings provide a useful diagnostic test. However, this measurement is less sensitive than a glucose tolerance test. As a clinical tool, these hemoglobins are most useful in labile diabetes, i.e., juvenile-onset diabetes and diabetes in pregnancy. In adult-onset diabetes, the fasting serum glucose concentration is apt to correlate well with the concentration of hemoglobins A1a-c. A correlation between several abnormalities associated with diabetes mellitus and concentrations of hemoglobins A1a-c have been reported. These abnormalities include abnormalities of the erythrocyte, leukocyte, platelet, and coagulation cascade and hormonal profiles in juvenile-onset diabetes and diabetes in pregnancy. In addition, correlation have been reported between certain risk factors or abnormalities, associated with vascular disease and concentrations of minor hemoglobins, including lipid profiles microvascular disease as reflected by retinal changes and quadriceps capillary basement membrane thickening, and macrovascular disease as reflected by pulse volume recordings. These studies have led to a reevaluation of the role of glucose "control" in contributing to diabetic sequelae, and, thus, have stimulated new approaches to the management of diabetes.     

The level of glycosylated hemoglobin A1c in the erythrocytes of patients with diabetic angio- and polyneuropathies

The level of glycosylated Hb A1c in erythrocytes of 173 patients with types I and II diabetes mellitus was analyzed with regard to compensation of disease, the presence and a degree of expression of diabetic angiopathies. An elevated level of Hb A1c in decompensation of diabetes decreased after achieving normoglycemia and aglycemia without reaching the normal level. The development of severe diabetic angiopathies, especially nephro- and retinopathies was accompanied by a decrease in the level of Hb A1c in decompensation up to values which could be observed during compensation of diabetes mellitus. A conclusion is that the level of Hb A1c in erythrocytes of patients with diabetes mellitus as an indicator of carbohydrate metabolic compensation can be used only in persons with unaffected vessels or at the early stages of the development of vascular affection.     

Increased platelet aggregation in diabetic patients with microangiopathy despite good glycemic control

The pathogenesis of diabetic micro- and macroangiopathy cannot be fully explained by hyperglycemia alone. To clarify diabetic complications mediated by increased platelet activity, we have studied platelet aggregation and its second messenger molecules such as protein kinase C (PKC), RhoA, and phosphatidylinositol 3-kinase (PI3- kinase), in six diabetic patients with diabetic retinopathy and other diabetic complications in spite of good glycemic control. Their HbA 1c levels throughout the observation period had been less than 6% with diet treatment alone, despite which diabetic retinopathy developed to the pre-proliferative stage during 2-8 years observation. Low-dose thrombin (< 0.5 U/ml)-stimulated platelet aggregation in the diabetic patients was enormously elevated compared with healthy control subjects. PKC, RhoA and PI3-kinase activities in the cytosol- and membrane-associated fractions were examined in the platelets from the two patients (Cases 2 and 4). Platelet membrane-associated RhoA and PI3-kinase activity in Case 2 were increased before the stimulation. Platelet RhoA and PI 3-kinase activities in Case 4 were increased after the stimulation with low-dose thrombin (0.01 U/ml). Membrane-associated immunoreactive PKC f , but not PKC g in Cases 2 and 4 was elevated. Although platelet hyperactivity in these four patients was observed, PKC and RhoA in mononuclear leukocytes from these patients were not different from healthy subjects. Membrane-associated PKC f and RhoA immunoreactivities also increased in the other three cases. These results suggest that hyperreactivity of PKC f may lead to increased RhoA and PI3-kinase activities and platelet hyperfunction in diabetic patients with good glycemic control, and that raised platelet PKC f may be implicated in the pathogenesis of diabetic complications.     

治疗牙周炎对老年2型糖尿病患者糖化血红蛋白的影响

目的观察牙周基础治疗对老年2型糖尿病伴牙周炎患者的糖化血红蛋白(glycosylatedhemoglobin,HbAIc)水平的影响。方法选择门诊治疗中伴牙周炎的老年2型糖尿病患者,根据患者的病情和要求分为牙周治疗组和不做牙周治疗的对照组各20例。治疗组给予牙周基础治疗,记录牙周治疗组治疗前和治疗后4、12、24周时的牙周探诊深度(probingdepth,PD),出血指数(bleedingindexBI),菌斑指数(plagueindex,PLI)和HbA1c的情况;对照组于入选时及入选后24周观察上述指标。结果牙周治疗组于治疗后4、12、24周时各项牙周临床指标均有下降,与治疗前比较,差异有统计学意义(P<0.01);该组HbA1c于治疗后12、24周时分别为(7.88±0.45)、(7.80±0.87)%,与治疗前(9.06±0.71)%比较,差异有统计学意义(P<0.01)。对照组各项牙周指标及HbA1c在24周内无明显变化(P>0.01)。结论对患有牙周炎的老年2型糖尿病患者,牙周基础治疗可改善牙周状况,降低HbA1c水平。