中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2015年
6期
506-510
,共5页
肝硬化%糖化血红蛋白A1c%糖化血清白蛋白
肝硬化%糖化血紅蛋白A1c%糖化血清白蛋白
간경화%당화혈홍단백A1c%당화혈청백단백
Liver cirrhosis%Glycosylated hemoglobin A1c%Glycated serum albumin
目的 探讨糖化血红蛋白(HbA1c)与糖化血清白蛋白(GA)在肝硬化伴高血糖(LCH)患者中的应用价值.方法 选取100例LCH患者作为研究对象(LCH组),以血红蛋白110 g/L为切点将该组分为贫血组与无贫血组,再以血清白蛋白30 g/L为切点对无贫血组再分组;以100例无肝硬化的2型糖尿病(T2DM)患者作为对照组(T2DM组);所有患者行HbA1c、GA、空腹血糖(FPG)、餐后2h血糖(2hPG)、血红蛋白及白蛋白检测,收集数据进行统计学分析.结果(1)LCH组贫血组HbA1c水平(6.76±2.20)％低于T2DM组(7.34±1.23)％,P=0.06;该组的GA水平(19.10±7.47)％显著高于T2DM组(16.68 ±2.90)％ (P ＜0.01),2hPG也显著高于T2DM组[(12.09 ±3.39)mmoL/L比(10.84±2.95) mmol/L,P＜0.05].(2)LCH组无贫血组白蛋白＜30 g/L亚组的GA水平(18.79±2.28)％明显高于白蛋白30～＜40 g/L亚组(16.71±2.42)％和白蛋白≥40 g/L的T2DM组(16.73±2.96)％,P值均＜0.01;而3组HbA1c差异无统计学意义.(3)LCH组无贫血组与T2DM组比较,HbA1c水平差异无统计学意义(P＞0.05),LCH组无贫血组白蛋白30～＜40 g/L亚组与T2DM组比较,GA差异无统计学意义(P＞0.05).(4)LCH组及T2DM组的HbA1c与FPG均呈正相关,r值分别为0.45、0.76,P值均＜0.001;与2hPG也均呈正相关,r值分别为0.33、0.81,P值均＜0.001;GA与FPG均呈正相关,r值分别为0.48、0.74,P值均＜0.001;GA与2hPG也呈正相关,r值分别为0.39、0.76,P值均＜0.001.结论 LCH患者合并贫血(Hb ＜110 g/L)时,不宜采用HbA1c评估血糖水平;合并低蛋白血症(白蛋白＜30 g/L)时,不宜采用GA评估血糖水平.
目的 探討糖化血紅蛋白(HbA1c)與糖化血清白蛋白(GA)在肝硬化伴高血糖(LCH)患者中的應用價值.方法 選取100例LCH患者作為研究對象(LCH組),以血紅蛋白110 g/L為切點將該組分為貧血組與無貧血組,再以血清白蛋白30 g/L為切點對無貧血組再分組;以100例無肝硬化的2型糖尿病(T2DM)患者作為對照組(T2DM組);所有患者行HbA1c、GA、空腹血糖(FPG)、餐後2h血糖(2hPG)、血紅蛋白及白蛋白檢測,收集數據進行統計學分析.結果(1)LCH組貧血組HbA1c水平(6.76±2.20)％低于T2DM組(7.34±1.23)％,P=0.06;該組的GA水平(19.10±7.47)％顯著高于T2DM組(16.68 ±2.90)％ (P ＜0.01),2hPG也顯著高于T2DM組[(12.09 ±3.39)mmoL/L比(10.84±2.95) mmol/L,P＜0.05].(2)LCH組無貧血組白蛋白＜30 g/L亞組的GA水平(18.79±2.28)％明顯高于白蛋白30～＜40 g/L亞組(16.71±2.42)％和白蛋白≥40 g/L的T2DM組(16.73±2.96)％,P值均＜0.01;而3組HbA1c差異無統計學意義.(3)LCH組無貧血組與T2DM組比較,HbA1c水平差異無統計學意義(P＞0.05),LCH組無貧血組白蛋白30～＜40 g/L亞組與T2DM組比較,GA差異無統計學意義(P＞0.05).(4)LCH組及T2DM組的HbA1c與FPG均呈正相關,r值分彆為0.45、0.76,P值均＜0.001;與2hPG也均呈正相關,r值分彆為0.33、0.81,P值均＜0.001;GA與FPG均呈正相關,r值分彆為0.48、0.74,P值均＜0.001;GA與2hPG也呈正相關,r值分彆為0.39、0.76,P值均＜0.001.結論 LCH患者閤併貧血(Hb ＜110 g/L)時,不宜採用HbA1c評估血糖水平;閤併低蛋白血癥(白蛋白＜30 g/L)時,不宜採用GA評估血糖水平.
목적 탐토당화혈홍단백(HbA1c)여당화혈청백단백(GA)재간경화반고혈당(LCH)환자중적응용개치.방법 선취100례LCH환자작위연구대상(LCH조),이혈홍단백110 g/L위절점장해조분위빈혈조여무빈혈조,재이혈청백단백30 g/L위절점대무빈혈조재분조;이100례무간경화적2형당뇨병(T2DM)환자작위대조조(T2DM조);소유환자행HbA1c、GA、공복혈당(FPG)、찬후2h혈당(2hPG)、혈홍단백급백단백검측,수집수거진행통계학분석.결과(1)LCH조빈혈조HbA1c수평(6.76±2.20)％저우T2DM조(7.34±1.23)％,P=0.06;해조적GA수평(19.10±7.47)％현저고우T2DM조(16.68 ±2.90)％ (P ＜0.01),2hPG야현저고우T2DM조[(12.09 ±3.39)mmoL/L비(10.84±2.95) mmol/L,P＜0.05].(2)LCH조무빈혈조백단백＜30 g/L아조적GA수평(18.79±2.28)％명현고우백단백30～＜40 g/L아조(16.71±2.42)％화백단백≥40 g/L적T2DM조(16.73±2.96)％,P치균＜0.01;이3조HbA1c차이무통계학의의.(3)LCH조무빈혈조여T2DM조비교,HbA1c수평차이무통계학의의(P＞0.05),LCH조무빈혈조백단백30～＜40 g/L아조여T2DM조비교,GA차이무통계학의의(P＞0.05).(4)LCH조급T2DM조적HbA1c여FPG균정정상관,r치분별위0.45、0.76,P치균＜0.001;여2hPG야균정정상관,r치분별위0.33、0.81,P치균＜0.001;GA여FPG균정정상관,r치분별위0.48、0.74,P치균＜0.001;GA여2hPG야정정상관,r치분별위0.39、0.76,P치균＜0.001.결론 LCH환자합병빈혈(Hb ＜110 g/L)시,불의채용HbA1c평고혈당수평;합병저단백혈증(백단백＜30 g/L)시,불의채용GA평고혈당수평.
Objective To evaluate the diagnostic value of glycosylated hemoglobin A1c (HbA1c)and glycated albumin(GA) in hyperglycemia patients with liver cirrhosis (LCH).Methods One hundred LCH patients were divided into anemia and no-anemia group by Hb 110 g/L The no-anemia group was further divided into low albumin (serum albumin ＜ 30 g/L),and high albumin group (serum albumin 30-＜40 g/L).One hundred type 2 diabetes without liver cirrhosis were included as control group (T2DM).HbA1c,GA,fasting plasma glucose (FPG),postprandial 2h plasma glucose (2hPG) were collected for statistical analysis.Results (1) The HbA1c level in LCH with anemia tended lower than that in T2DM subjects [(6.76 ±2.20)％ vs (7.34 ± 1.23)％,P =0.06];though the level of GA [(19.10 ±7.47)％vs (16.68 ±2.90)％,P＜0.01] and 2hPG [(12.09 ±3.39) mmol/L vs (10.84 ±2.95) mmol/L,P＜0.05] were significantly higher than that in T2DM group.(2) No-anemia subjects in LCH group with albumin ＜ 30 g/L had obviously higher GA levels than those with albumin 30-＜ 40 g/L and T2DM (albumin≥40 g/L) [(18.79 ±2.28)％ vs (16.71 ±2.42)％ and (16.73 ±2.96)％,P＜0.01];though the level of HbA1c of three groups above has no significant difference.(3) The level of HbA1c between LCH without anemia group and T2DM group had no significant difference (P ＞ 0.05);and the level of GA between LCH without anemia group with albumin 30-＜ 40 g/L and T2DM group had no significant difference(P ＞0.05).(4) The HbA1c has a positive correlation with FPG and 2hPG in LCH (FPG∶r =0.45,P＜0.001;2hPG∶r =0.33,P=0.001) and T2DM subjects (FPG∶ r =0.76,P＜0.001;2hPG∶r =0.81,P ＜ 0.001).GA also has a positive correlation with FPG and 2hPG in LCH (FPG∶ r =0.48,P ＜0.001;2hPG:r=0.39,P ＜0.001) and T2DM subjects (FPG∶ r =0.74,P ＜0.001;2hPG∶ r =0.76,P ＜0.001).Conclusion It is unfavorable to use HbA1c to evaluate the blood glucose level in liver cirrhosis patients with Hb ＜ 110 g/L and to use GA in patients with serum albumin ＜ 30 g/L.
