HbA1c、血液流变学及凝血指标检验在2型糖尿病并发微血管病变中的诊断价值

摘要/Abstract

摘要： 目的分析糖化血红蛋白（glycated hemoglobin A_1c,HbA_1c）、血液流变学指标和凝血指标的检测在2型糖尿病（T2MD）并发微血管病变中的诊断价值。方法选择2023年4月—2024年4月日照市妇幼保健院收治的200例2型糖尿病患者作为研究对象,根据是否并发微血管病变将其分为对照组（n=110）和微血管病变组（n=90）,比较两组HbA_1c、血浆黏度（plasma viscosity,PV）、全血黏度、血沉（erythrocyte sedimentation rate,ESR）、血小板平均体积（mean platelet volume,MPV）、血小板分布宽度（platelet distribution width,PDW）。分析T2MD患者并发微血管病变的危险因素,绘制受试者工作特征曲线（ROC）,以曲线下面积（AUC）评估诊断价值。结果微血管病变组HbA_1c、PV、全血高切黏度、全血低切黏度、ESR、纤维蛋白原（contractinogen,FIB）、MPV、PDW高于对照组,差异有统计学意义（P<0.05）。logistic回归分析结果显示,HbA_1c、PV、全血低切黏度、FIB均为T2MD患者是否并发微血管病变的危险因素,差异有统计学意义（P<0.05）。HbA_1c、PV、全血低切黏度、FIB及四者联合诊断T2MD患者并发微血管病变的AUC值分别为0.799、0.802、0.841、0.797、0.907（P<0.05）,且四者联合的AUC值更高,差异有统计学意义（P<0.05）。结论 HbA_1c、PV、全血低切黏度、FIB为T2MD并发微血管病变的高危因素,四者联合更有助于诊断T2MD并发微血管病变。

关键词: 糖化血红蛋白, 血液流变学, 凝血, 微血管病变, 2型糖尿病

Abstract: Objective To analyze the diagnostic value of hemoglobin a_1c (HbA_1c), hemorheology index and coagulation index in type 2 diabetes mellitus (T2MD) patients with microangiopathopathy. Methods 200 patients with type 2 diabetes admitted to Rizhao Maternal and Child Health Hospital from April 2023 to April 2024 were divided into control group (n=110) and microangiopathopathy group (n=90) according to whether they had microangiopathopathy. HbA_1c, plasma viscosity(PV), whole blood viscosity, erythrocyte sedimentation rate (ESR), mean platelet volume (MPV) and platelet distribution width (PDW) were compared between the two groups. The risk factors of microangiopathopathy in T2MD patients were analyzed, and the receiver operating characteristic curve (ROC) was plotted, and the area under the curve (AUC) was used to evaluate the diagnostic value. Results HbA_1c, PV, whole blood high tangential viscosity, whole blood low tangential viscosity, ESR, FIB, MPV and PDW in microvascular disease group were higher than those in control group, the difference was statistically significant (P<0.05). Logistic regression analysis showed that HbA_1c, PV, whole blood low tangency viscosity and FIB were all risk factors for the complication of microangionopathy in T2MD patients(P<0.05). The AUC values of HbA_1c, PV, whole blood low tangency viscosity, FIB and the combination of HBA_1c and PV were 0.799, 0.802, 0.841, 0.797, 0.907, respectively (P<0.05), and the AUC values of the combination of HBA_1c and PV were higher(P<0.05). Conclusion HbA_1c, PV, whole blood low tangential viscosity and FIB are the risk factors for T2MD complicated with microangularity, and the combination of the four factors is more helpful for the diagnosis of T2MD complicated with microangularity.

Key words: glycosylated hemoglobin A_1c, hemorheology, blood clotting, microangiopathy, type 2 diabetes

中图分类号:

R587.1

李仕琪, 徐硕, 王孟文. HbA_1c、血液流变学及凝血指标检验在2型糖尿病并发微血管病变中的诊断价值[J]. 中华养生保健, 2025, 43(9): 179-183.

LI Shi-qi, XU Shuo, WANG Meng-wen. Diagnostic Value of HbA_1c, Hemorheology and Coagulation Indexes in Microangiopathopathy in Patients With Type 2 Diabetes[J]. ZHONGHUA YANGSHENG BAOJIAN, 2025, 43(9): 179-183.

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