探究生化检验和尿常规检验对糖尿病诊断 的价值

Exploration of the Value of Biochemical Test and Routine Urine Test in the Diagnosis of Diabetes

摘要: 目的：比较并评价生化检验空腹血糖(FBG)、餐后2小时血糖(2hrPPG)、糖化血红蛋白(GHb)与尿常规检验尿糖(GLU)单独及联合应用在糖尿病诊断中的价值。方法：选取2024年1月~2026年2月就诊的疑似糖尿病患者48例，依据临床综合诊断分为糖尿病组(26例)和非糖尿病组(22例)。所有受试者均接受空腹静脉血采集(检测FBG、GHb)、口服葡萄糖耐量试验(检测2hrPPG)及晨尿留取(检测GLU)。生化指标采用己糖激酶法(FBG, 2hrPPG)和高效液相色谱法(GHb)检测，GLU采用葡萄糖氧化酶法检测。以临床综合诊断为金标准，计算并比较生化检验、尿常规检验单独及联合检测的诊断效能指标。结果：糖尿病组FBG、2hrPPG、GLU、GHb水平均显著高于非糖尿病组，组间差异具有高度统计学意义(P < 0.05)；以临床综合诊断为金标准，生化检验与尿常规联合检测检出真阳性25例、假阳性2例、假阴性1例、真阴性21例，对应灵敏度为96.15%，特异度为95.45%，准确度为95.83%，阳性预测值为96.15%，阴性预测值为95.45%，显著高于单项检测(P < 0.05)。结论：生化检验与尿常规检验联合应用可显著提高糖尿病筛查的灵敏度、特异度和诊断准确率，其综合诊断效能优于任何单项检测，推荐作为临床初筛的优化策略。

Abstract: Objective: To compare and evaluate the individual and combined value of biochemical examination of fasting blood glucose (FBG), postprandial blood glucose (2hrPPG), glycosylated hemoglobin (GHb) and routine urine examination of urine glucose (GLU) in the diagnosis of diabetes. Methods: 48 patients with suspected diabetes from January 2024 to February 2026 were selected and divided into diabetes group (26 cases) and non-diabetes group (22 cases) according to clinical comprehensive diagnosis. All subjects underwent fasting venous blood collection (detection of FBG, GHb), oral glucose tolerance test (detection of 2hrPPG), and morning urine retention (detection of GLU). Biochemical indicators were detected using the hexokinase method (FBG, 2hrPPG) and high-performance liquid chromatography (GHb), while GLU was detected using the glucose oxidase method. Using clinical comprehensive diagnosis as the gold standard, the diagnostic efficacy indicators of biochemical tests, routine urine tests alone and in combination were calculated and compared. Results: The levels of FBG, 2hrPPG, GLU and GHb in the diabetes group were significantly higher than those in the non-diabetes group, and the differences between the groups were statistically significant (P < 0.05). Using clinical comprehensive diagnosis as the gold standard, the combined detection of biochemical tests and routine urine tests detected 25 true positives, 2 false positives, 1 false negative, and 21 true negatives. The corresponding sensitivity was 96.15%, specificity was 95.45%, accuracy was 95.83%, positive predictive value was 96.15%, and negative predictive value was 95.45%, significantly higher than single detection (P < 0.05). Conclusion: The combination of biochemical test and routine urine test can significantly improve the sensitivity, specificity and diagnostic accuracy of diabetes screening, and its comprehensive diagnostic efficacy is better than any single test. It is recommended as an optimization strategy for clinical preliminary screening.