【摘要】 目的对比研究临床糖尿病诊断中常规检验与生化检验的价值。方法 271例疑似糖尿病患者,均进行常规检验、生化检验,并将糖尿病诊断标准作为金标准,比较两种检验方法的灵敏度、准确度、特异度、阳性预测值、阴性预测值,比较糖尿病患者与非糖尿病者空腹血糖、糖化血红蛋白水平。结果金标准诊断结果显示, 271例疑似糖尿病患者中糖尿病196例、非糖尿病75例。常规检验灵敏度为61.73%(121/196),准确度为66.79%(181/271),特异度为80.00%(60/75),阳性预测值为88.97%(121/136),阴性预测值为44.44%(60/135);生化检验灵敏度为88.27%(173/196),准确度为87.82%(238/271),特异度为86.67%(65/75),阳性预测值为94.54%(173/183),阴性预测值为73.86%(65/88);生化检验方法的灵敏度、阴性预测值、准确度均高于常规检验,差异具有统计学意义(P<0.05);两种检验方法的特异度、阳性预测值比较,差异无统计学意义(P>0.05)。非糖尿病者空腹血糖、糖化血红蛋白水平均低于糖尿病患者,差异具有统计学意义(P<0.05)。结论常规检验和生化检验在糖尿病诊断中均具有一定的临床价值,而生化检验的灵敏度、准确度更高。更多还原

【Abstract】 Objective To compare and study the value of routine examination and biochemical tests in clinical diabetes diagnosis. Methods A total of 271 suspected diabetes mellitus patients all received routine test and biochemical test, and the diagnostic criteria of diabetes mellitus were used as gold standard. The sensitivity, accuracy, specificity, positive predictive value and negative predictive value of the two methods were compared. The fasting blood glucose and glycosylated hemoglobin levels of diabetic patients and non-diabetic patients were compared. Results According to the gold standard diagnosis, 196 cases of diabetes mellitus and 75 cases of non diabetes mellitus were found in 271 suspected diabetic cases. The sensitivity, accuracy, specificity, positive predictive value and negative predictive value by routine test were 61.73%(121/196), 66.79%(181/271), 80.00%(60/75), 88.97%(121/136) and 44.44%(60/135) respectively. The sensitivity, accuracy, specificity, positive predictive value and negative predictive value by biochemical test were 88.27%(173/196), 87.82%(238/271), 86.67%(65/75), 94.54%(173/183) and 73.86%(65/88). The sensitivity, negative predictive value and accuracy of biochemical tests were all higher than those of routine tests, and the difference was statistically significant(P<0.05). There was no statistically significant difference in specificity and positive predictive value between two test methods(P>0.05). The fasting blood glucose and glycosylated hemoglobin levels of non-diabetic patients were lower than diabetic patients, and the difference was statistically significant(P<0.05). Conclusion Both routine test and biochemical tests have certain clinical value in the diagnosis of diabetes, and the sensitivity and accuracy of biochemical tests are higher.更多还原