空腹血糖与糖化血红蛋白联合检测对糖尿病筛查的价值

目的：探讨空腹血糖（FPG）与糖化血红蛋白（HbA1C）联合检测筛查糖尿病的临床价值。方法选取糖尿病高危人群8634例，抽取空腹静脉血，使用全自动生化仪对FPG和HbA1C水平进行检测。结果 FPG阳性率为8．61％，HbA1C阳性率为7．20％，2项分别进行筛查阳性率差异无统计学意义（P＞0．05）。 FPG 联合HbA1C进行筛查，其中一项及以上为阳性者共941例，占10．90％，明显高于 FPG 阳性、HbA1C阳性或阴性及FPG阳性或阴性、HbA1C阳性两种情况者，差异有统计学意义（P＜0．05）。分别有319例（3．69％）和198例（2．29％）患者仅FPG或HbA1C阳性，明显少于FPG阳性或HbA1C阳性。按照体检人群FPG水平将其分为在年龄和体质量方面有可比性的3组。与FPG＜6．1 mmol/L相比，FPG为6．1～6．9 mmol/L组FPG和 HbA1C水平均有明显升高，且差异有统计学意义（P＜0．05）；FPG＞6．9 mmol/L组FPG和 HbA1C平均水平明显高于 FPG＜6．1 mmol/L、FPG为6．1～6．9 mmol/L两组，差异有统计学意义（P＜0．05）。2项指标呈正相关。结论采用FPG与HbA1C筛查糖尿病具有一定的漏诊率，将2项联合检测，可以降低漏诊率，提高检出率，有重要的临床意义。

The combined detection of fasting plasma glucose and glycosylated hemoglobin for screening diabetes

Objective To investigate the clinical value of fasting blood glucose （FPG） and glycosylated hemo-globin joint detection for screening diabetes .Methods 8 634 cases at high risk of diabetes were collected ,then detec-ted their fasting venous blood .Automatic biochemical analyzer was used to detect the FPG and HbA1C levels . Results FPG positive rate was 8 .61% ,the HbA1c positive rate was 7 .20% ,the difference between two methods for screening was not significant（P〉0 .05） .The FPG united HbA1c screening one and above was positive in a total of 941 cases ,accounting for 10 .90% ,Significantly higher than the FPG positive ,HbA1C positive or negative and FPG positive or negative ,HbA1C positive （P6 .9 mmol/L FPG levels were significantly higher than the other two groups （P〈0 .05） .There was a positive correlation between the two indicators .Conclusion The FPG and HbA1C screening for diabetes has a certain rate of misdiagnosis ,the two inspection methods in combination could reduce the rate of misdiagnosis and improve the detection rate has important clinical significance .