血清C肽与糖化血红蛋白联合检验对糖尿病诊断的临床意义

目的探讨血清C肽与糖化血红蛋白（HbA1c）联合检测在糖尿病患者临床诊断中的意义与作用。方法选择2011-03～2012-12间于我院就诊的84例糖尿病患者,将其中56例单纯2型糖尿病患者作为糖尿病组,28例糖尿病肾病患者作为糖尿病肾病组,另筛选同期我院体检中心健康成人体检人员30例作为对照组。检测各组HbA1c、空腹血糖（FBG）、餐后2 h血糖、血清C肽等相关指标并做统计学分析。结果 （1）糖尿病组、糖尿病肾病组患者血清HbA1c、FBG、餐后2 h血糖均显著高于对照组,血清C肽水平显著低于对照组（P〈0.05）。（2）糖尿病组与糖尿病肾病组的FBG、餐后2 h血糖水平比较,差异均无统计学意义（P〉0.05）;糖尿病肾病组HbA1c水平显著高于糖尿病组,血清C肽水平显著低于对照组（P〈0.05）。（3）HbA1c与FBG呈正相关（r=0.443,P〈0.05）,与C肽呈负相关（r=-0.628,P〈0.05）。结论糖尿病患者HbA1c与血清C肽水平发生异常,其结果可以作为反映胰岛素分泌功能和疾病严重程度的指标,两者联合检验对糖尿病肾病辅助诊断有一定价值。

Clinical Significance of Serum C Peptide and Glycosylated Hemoglobin Combined Examination of in the Diagnosis of Diabetes

Objective To investigate the serum C peptide combined with glycosylated hemoglobin in the diagnosis of diabetes. Methods Selecting 84 patients of diabetes mellitus during March,2011 and December,2012,of which patients with simple type 2 diabetes as DM group,28 patients with diabetic nephropathy as diabetic nephropathy group,and 30 health adults in the hospital in physical examination personnel examination center during the same period as control group. Detecting HbA1c,fasting blood glucose（ FBG）,2h glucose,C peptide and other related indicators after meal. Results（ 1） DM group,diabetic nephropathy group,serum HbA1c,FBG,2h postprandial blood glucose were significantly higher than those in the control group,and the serum C peptide levels were significantly lower than those in the control group（ P〈0. 05）.（ 2） Diabetic nephropathy group HbA1c was significantly higher than that in DM group,and C peptide levels were significantly lower than those in the control group（ P〈0. 05）.（ 3） The HbA1c was positively correlated with FBG（ r = 0. 443,P〈0.05）,and negatively correlated with C peptide（ r =-0. 628,P〈0. 05）. Conclusion Diabetes in patients with HbA1c and the level of serum C peptide are abnormal. The result can reflect the insulin secretion function and disease severity index. The combination of the two tests has a certain value in diagnosis of diabetic nephropathy.