摘要
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.
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 patien
出处
《中华内科杂志》
CAS
CSCD
北大核心
2015年第6期506-510,共5页
Chinese Journal of Internal Medicine
关键词
肝硬化
糖化血清白蛋白
糖化血红蛋白A1c
Liver cirrhosis
Glycosylated hemoglobin A1c
Glycated serum albumin
