CAJ | 학술논문

目的：探讨空腹胰岛素（INS）、C 肽、糖化血红蛋白（HbAlc）水平变化在Ⅱ型糖尿病肾病（T2DN）诊断中的临床价值。方法选择2013年12月-2014年6月在枣阳市第一人民医院糖尿病门诊确诊的79例2型糖尿病（T2DM）患者和76例同期进行健康体检者，分别在贝克曼 DXI 800和罗氏 Cobax 601全自动化学发光分析仪上采用化学发光法检测 INS 和 C 肽，奥林巴斯全自动生化分析仪（AU2700）上采用免疫比浊法检测 HbAlc，采用酶法检测血糖（GLU），并对检测结果进行统计分析。结果实验组检测空腹 GLU、INS、C 肽和 HbA1c 水平高于正常对照组，组间比较差异有统计学意义或高度统计学意义（P ＜0．05或 P ＜0．01）；早期糖尿病肾病组和中晚期糖尿病肾病组 GLU和 HbAlc 检测水平高于单纯糖尿病组，组间比较差异无统计学意义（P ＞0．05），早期糖尿病肾病组 INS 和 C 肽检测水平高于单纯糖尿病组，组间比较差异有高度统计学意义（P ＜0．01）；中晚期糖尿病肾组 INS 和 C 肽检测水平低于单纯糖尿病组，组间比较差异有统计学意义（P ＜0．05）；中晚期糖尿病肾组 INS 和 C 肽检测水平低于早期糖尿病肾病组，组间比较差异有统计学意义（P ＜0．05）。结论联合检测 INS、C 肽和 HbAlc 有助于较准确地了解胰岛β细胞的功能状况以及早期了解糖尿病患者的肾功能状况，其水平变化对判定 T2DN 患者的胰岛β细胞功能、血糖水平监控、诊断、病情控制及指导治疗等方面有较高的临床应用价值。
목적：탐토공복이도소（INS）、C 태、당화혈홍단백（HbAlc）수평변화재Ⅱ형당뇨병신병（T2DN）진단중적림상개치。방법선택2013년12월-2014년6월재조양시제일인민의원당뇨병문진학진적79례2형당뇨병（T2DM）환자화76례동기진행건강체검자，분별재패극만 DXI 800화라씨 Cobax 601전자동화학발광분석의상채용화학발광법검측 INS 화 C 태，오림파사전자동생화분석의（AU2700）상채용면역비탁법검측 HbAlc，채용매법검측혈당（GLU），병대검측결과진행통계분석。결과실험조검측공복 GLU、INS、C 태화 HbA1c 수평고우정상대조조，조간비교차이유통계학의의혹고도통계학의의（P ＜0．05혹 P ＜0．01）；조기당뇨병신병조화중만기당뇨병신병조 GLU화 HbAlc 검측수평고우단순당뇨병조，조간비교차이무통계학의의（P ＞0．05），조기당뇨병신병조 INS 화 C 태검측수평고우단순당뇨병조，조간비교차이유고도통계학의의（P ＜0．01）；중만기당뇨병신조 INS 화 C 태검측수평저우단순당뇨병조，조간비교차이유통계학의의（P ＜0．05）；중만기당뇨병신조 INS 화 C 태검측수평저우조기당뇨병신병조，조간비교차이유통계학의의（P ＜0．05）。결론연합검측 INS、C 태화 HbAlc 유조우교준학지료해이도β세포적공능상황이급조기료해당뇨병환자적신공능상황，기수평변화대판정 T2DN 환자적이도β세포공능、혈당수평감공、진단、병정공제급지도치료등방면유교고적림상응용개치。
Objective Discuss the fasting Insulin (INS),C-peptide,Glycosylated hemoglobin A1c (HbAlc)levels in type 2 diabetic nephropathy (T2DN)in the diagnosis of clinical value.Methods The choice of 2013 December-2014 year in June in type 2 diabetes mellitus(T2DM)in zaoyang first people's hospital diagnosed 79 cases of diabetes mellitus patients and 76 cases of healthy persons,on DxI800 and Cobax 601 automatic chemiluminescence analyzer using chemi-luminescence testing of INS and C-peptide,OLYMPUS automatic biochemical analyzer (AU2700)by immune than HbAlc in detecting the turbidimetric method,using enzymatic detection of blood glucose (GLU),and the testing results are statistical analysis.Results The experimental group GLU,INS,fasting C-peptide and HbA1c levels higher than the normal control group,there were statistically significant or highly significant differences between groups (P <0.05 or P<0.01);early diabetic nephropathy group and advanced diabetic nephropathy group GLU and HbAlc testing level higher than that of simple diabetes group,no significant differences between groups (P >0.05),the early diabetic ne-phropathy group INS and C-peptide testing level higher than the simple diabetes group,there are statistically significant differences between groups (P <0.01);advanced diabetic kidney in groups INS and C-peptide testing level is lower than the simple sugar diabetes group,there were statistically significant differences between groups (P <0.05);advanced di-abetes kidney group INS and C-peptide level lower than the testing level of early diabetic nephropathy group,there were statistically significant differences between groups (P <0.05).Conclusion The combined tseting of INS,C-peptide and HbAlc contributes to accurately understand the status and function of islet beta cell early to understand the status of re-nal function in patients with diabetes mellitus,and its level have higher for judging the islet beta cell function,blood glu-cose level of T2DN patients,diagnosis,monitoring of disease control and guide treatment and other aspects of the value of clinical application.