创伤性骨折患者血糖和糖化血清蛋白检测价值比较

摘要

Objective To study the fact of blood glucose (Glu)rising being the result of diabetes mellitus or post-traumatic stress response of body through detecting the changes of Glu and glycated serum protein (GSP).Methods The 87 patients with acute traumatic fracture were classified into 3 groups according to the presence or absence of type 2 diabetes mellitus,traumatic fracture with diabetes group(1 7 cases),traumatic fracture with unknown diabetes group (22 cases diagnosed as diabetes after hospitalization)and traumatic fracture without diabetes group (48 cases).The Glu and GSP levels of each group were measured by glucose oxidase method and fructosamine assay when hospitalized and cured.A total of 30 healthy subjects were enrolled as healthy controls.Results The Glu levels of acute traumatic fracture groups were significantly higher than that of control group (P <0.05 ),especially traumatic fracture with unknown diabetes group,and there was statistical significance (P <0.05).The level of GSP of traumatic fracture with unknown diabetes group was higher than those of the other 3 groups (P <0.05),while the GSP levels of the other 3 groups had no statistical significance (P >0.05).The Glu level of acute traumatic fracture groups returned to normal level when cured,while the GSP level of traumatic fracture with unknown diabetes group increased and was significantly higher than those of the other 3 groups (P <0.05),due to high level of Glu.The Glu level of traumatic fracture without diabetes group when cured was significantly lower than that when hospitalized (P <0.05),while there was no significant difference for GSP level (P >0.05).Conclusions The detection of Glu could be used as a method of monitoring and evaluating the prognosis of acute traumatic fracture.GSP level could be the important reference of distinguishing Glu rising because of diabetes mellitus or post-traumatic stress response of body.%目的：通过检测急性创伤性骨折后血糖（Glu）和糖化血清蛋白（GSP）变化，了解创伤后患者Glu升高是糖尿病还是创伤后机体的应激反应所致。方法将87例急性创伤性骨折患者按入院时有无2型糖尿病分为创伤性骨折已知糖尿病组（17例）、创伤性骨折未知糖尿病组（22例，入院后确诊有糖尿病）、创伤性骨折无糖尿病组（48例），于入院时和治愈出院时分别采集患者外周血，采用葡萄糖氧化酶法和果糖胺法检测 Glu 和 GSP 水平。以30名健康体检者作为正常对照组。结果急性创伤性骨折各组入院时 Glu 水平均明显高于正常对照组（P 均＜0．05），以创伤性骨折未知糖尿病组升高最为明显，各组间比较差异均有统计学意义（P 均＜0．05）；创伤性骨折未知糖尿病组 GSP 水平高于其余3组（P 均＜0．05），而创伤性骨折已知糖尿病组、创伤性骨折无糖尿病组和正常对照组之间 GSP 水平差异无统计学意义（P ＞0．05）。急性创伤性骨折各组治愈出院时 Glu 水平均恢复正常；而创伤性骨折未知糖尿病组由于前期的高 Glu 导致 GSP 升高，因此，GSP 结果仍明显高于创伤性骨折已知糖尿病组、创伤性骨折无糖尿病组和正常对照组（P 均＜0．05）。创伤性骨折无糖尿病组治愈出院时 Glu 水平明显低于入院时（P ＜0．05），而 GSP 水平治愈出院时和入院时无明显差异（P ＞0．05）。结论Glu 检测可以作为急性创伤性骨折患者监测病情、评估预后的一种方法。GSP 检测结果可以作为鉴别急性创伤性骨折患者 Glu升高是属于应激性反应还是糖尿病性升高的重要依据。