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目的探讨非内分泌科室联合检测HbA1c与FPG筛查高血糖的最佳方法。方法选取心内科和骨科新入院,且随机血糖≥7.0mmol/L或FPG≥5.0mmol/L的非糖尿病患者,检测FPG、HbA1c、糖化血清蛋白(GA),评估患者糖代谢状态。结果 (1)心内科IGR、糖尿病和糖耐量正常(NGT)者分别为185例、178例、163名,骨科分别为116例、130例、107名。(2)75g OGTT受试者工作特征曲线(ROC)显示,以FPG为诊断糖尿病切点,心内科为5.81mmol/L,骨科为6.24mmol/L;以HbA1c为诊断切点,心内科为6.15%,骨科为5.75%;以GA为诊断切点,心内科为254.50μmol/L,骨科为250.89μmol/L。(3)FPG和HbA1c联合诊断价值与75g OGTT比较有效性更高[曲线下面积(AUC>0.8)]。结论 HbA1c与FPG联合检测能进一步提高非内分泌科住院患者的高血糖筛查效率。
Objective To explore the best method to screen hyperglycemia by HbA1c and FPG in non-endocrine department. Methods FPG, HbA1c and glycosylated serum protein (GA) were detected in patients with nondiabetic patients who were newly admitted in cardiology and orthopedics and were randomized to receive blood glucose≥7.0mmol / L or FPG≥5.0mmol / L. Results (1) There were 185 cases, 178 cases and 163 cases of IGR, diabetes mellitus and normal glucose tolerance in cardiology, respectively. There were 116 cases, 130 cases and 107 cases of orthopedics. (2) The working characteristic curve (ROC) of 75g OGTT subjects showed that FPG was 5.81mmol / L for diagnosing diabetes, and 6.24mmol / L for orthopedics. HbA1c was used as the diagnostic cutoff point, and the cardiology was 6.15 %, Orthopedic 5.75%; with GA as diagnostic cutoff point, cardiology was 254.50μmol / L, orthopedic was 250.89μmol / L. (3) The combined diagnostic value of FPG and HbA1c was more effective than 75 g OGTT [area under the curve (AUC> 0.8)]. Conclusion The combination of HbA1c and FPG can further improve the screening efficiency of non-endocrinology inpatients.