CAJ | 학술논문

目的：探讨冠心病患者中糖化血红蛋白(HbA1c)诊断糖尿病(DM)的理想切点及可行性。方法选择经冠脉造影确诊的冠心病患者158例,所有患者均行空腹血糖、2 h OGTT和糖化血红蛋白检测,采用受试者工作特征曲线( ROC曲线)进行判断,得到诊断DM的HbA1c值,计算最佳切点。结果158例入选的冠心病患者中,平均HbA1c为(6.27±1.04)%；诊断为正常糖耐量(NGT)37例,HbA1c为(5.32±0.08)%；糖调节受损(IGR)52例,HbA1c为(6.03±0.36)%；DM 69例,HbA1c为(6.96±1.11)%。糖代谢异常的发生率为76.6%。通过绘制ROC曲线,得到HbA1c与诊断DM 相关的临界点为6.35%,敏感性和特异性分别为67%和95%,曲线下面积为0.88(95%CI 0.823-0.935)。结论 HbA1c≥6.35%作为筛查DM切点具有较高敏感度与特异度,可作为临床DM 筛查的切点。
목적：탐토관심병환자중당화혈홍단백(HbA1c)진단당뇨병(DM)적이상절점급가행성。방법선택경관맥조영학진적관심병환자158례,소유환자균행공복혈당、2 h OGTT화당화혈홍단백검측,채용수시자공작특정곡선( ROC곡선)진행판단,득도진단DM적HbA1c치,계산최가절점。결과158례입선적관심병환자중,평균HbA1c위(6.27±1.04)%；진단위정상당내량(NGT)37례,HbA1c위(5.32±0.08)%；당조절수손(IGR)52례,HbA1c위(6.03±0.36)%；DM 69례,HbA1c위(6.96±1.11)%。당대사이상적발생솔위76.6%。통과회제ROC곡선,득도HbA1c여진단DM 상관적림계점위6.35%,민감성화특이성분별위67%화95%,곡선하면적위0.88(95%CI 0.823-0.935)。결론 HbA1c≥6.35%작위사사DM절점구유교고민감도여특이도,가작위림상DM 사사적절점。
Objective To investigate the optimal cut-off point and feasibility of glycated hemoglobin( HbA1c) for diagnosing diabetes mellitus( DM) in patients with coronary artery diseases by coronary angiography. Methods A total of 158 patients with coronary heart diseases diagnosed by coronary angiography were included. The fasting glucose,2 h OGTT and glycosylated hemoglobin were detected in all patients. A receiver operating characteristic curve was used to calculate the optimal cut-off point of diagnosing DM by HbA1c. Re-sults The average HbA1c of 158 cases of coronary heart diseases was (6. 27 ± 1. 04)%. HbA1c was (5. 32 ± 0. 08)% in 37 cases of normal glucose tolerance(NGT),and (6. 03 ± 0. 36)% in 52 cases of impaired glucose regulation(IGR),and (6. 96 ± 1. 11)% in 69 cases of DM. The incidence of abnormal glucose metabolism was 76. 6%. The optimal cut-off point of diagnosing DM by HbA1c was 6. 35%,and the sensitivity and specificity of diagnosing DM by HbA1c were 67% and 95%,respectively, and the area under the curve was 0. 88(95%CI 0. 823-0. 935). Conclusion HbA1c ≥6. 35% as the cut-off point has high sensitivity and specificity,and can be used to clinically screen DM.