袁光勇

[摘要]目的 研究HbA1c与BNP检测在糖尿病合并慢性心力衰竭临床诊斷中的应用价值。方法 选取我院2014年9月～2016年1月收治的90例2型糖尿病合并心脏病患者作为研究对象，根据是否合并慢性心力衰竭，将患者分为对照组和观察组，各45例。观察两组患者的HbA1c与BNP水平以及观察组HbA1c与BNP水平的相关性。结果 观察组的BNP与HbA1c水平均明显高于对照组，差异有统计学意义（P<0.05）；观察组Ⅱ、Ⅲ、Ⅳ级心功能患者的BNP与HbA1c水平比较，差异有统计学意义（P<0.05）；BNP水平随HbA1c水平提高而逐渐上升，成正相关（r=0.77，P<0.001）。结论 HbA1c与BNP检测对糖尿病合并慢性心力衰竭患者的病情诊断、疗效评价以及预后评估具有重要的参考价值。

[关键词]HbA1c；BNP；糖尿病；慢性心力衰竭；应用价值

[中图分类号] R541.6 [文献标识码] A [文章编号] 1674-4721（2017）11（c）-0117-03

Application value of HbA1c and BNP in the clinical diagnosis of diabetes mellitus complicated with chronic heart failure

YUAN Guang-yong

Department of Clinical Laboratory，the Second People′s Hospital of Jingdezhen City in Jiangxi Province，Jingdezhen 333000，China

[Abstract]Objective To investigate the application value of HbA1c and BNP in the diagnosis of diabetes mellitus complicated with chronic heart failure.Methods From September 2014 to January 2016，90 patients with type 2 diabetes mellitus complicated with heart disease in our hospital were selected and divided into the control group and the observation group according to whether combined with chronic heart failure，45 cases in each group.The levels of HbA1c and BNP in the two groups and the correlation between HbA1c and BNP levels in the observation group were observed.Results The levels of BNP and HbA1c in the observation group were significantly higher than those in the control group，with significant difference （P<0.05）.There was significant difference in the level of BNP and HbA1c between the grade Ⅱ，Ⅲ，Ⅳ of cardiac function in the observation group （P<0.05），the level of BNP with the HbA1c level increased gradually increases，which showed positive correlation （r=0.77，P<0.001）.Conclusion HbA1c and BNP have important reference value to clinical diagnosis，curative effect evaluation and prognosis of diabetes for the patients with diabetes mellitus complicated with chronic heart.

[Key words]HbA1c；BNP；Diabetes mellitus；Chronic heart failure；Diagnostic significance

糖化血红蛋白（GHB）是红细胞内血糖与血红蛋白的结合产物，GHB由多种物质组成，HbA1c是其中一种，占GHB构成的60%～70%，由于HbA1c具有结构稳定性，因此临床常将GHB与HbA1c视为同义[1]。HbA1c的形成具有不可逆性，且HbA1c浓度与每日血糖波动、食物以及运动无关，仅与红细胞寿命以及该时期血糖平均浓度相关，所以HbA1c常常反映6～8周内平均血糖浓度，因此，国际上将HbA1c作为评估糖尿病患者血糖控制的金指标[2]。B型尿钠肽（BNP）是心肌细胞合成的具有生物学活性的天然激素，常在心室间表达，当心功能不全时，心肌扩张快速释放BNP入血，调节心脏功能，因此，BNP水平常常反映慢性心力衰竭患者的心功能状态，对心力衰竭诊断、程度以及疗效评价均具有重要意义[3]。本研究对我院收治的糖尿病合并慢性心力衰竭患者进行HbA1c与BNP检测，探讨HbA1c与BNP水平变化对糖尿病合并慢性心力衰竭患者的诊断价值，现报道如下。

1资料与方法

1.1一般资料endprint

选取2014年9月～2016年1月我院收治的90例2型糖尿病合并心脏病患者作为研究对象，根据是否合并慢性心力衰竭將患者分为对照组和观察组，各45例。……