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目的 :探讨 ADA1997年提出以空腹血糖 (FBG)为基础进行糖尿病流行病学调查的可行性。方法 :以微量血糖筛查餐后 2小时血糖 (PBG)≥ 12 0 m g/ dl者 1889例进行标准 OGTT试验 ,按 1985年 WHO标准 ,分为糖尿病组、 IGT组和正常人组。结果 :普查 1889例中 ,糖尿病 2 6 8人 ,IGT44 6人 ,正常 1175人。FBG≥ 140 m g/ dl诊断糖尿病敏感性 38.43% ,特异性 73.79% ,漏诊率 6 1.5 6 % ,PBG≥ 2 0 0 mg/ dl诊断糖尿病敏感性 89.93% ,漏诊率 10 .0 7%。按 1997年 ADA标准诊断糖尿病 2 84例 ,新增糖尿病 2 1例 ,FBG≥ 12 6 mg/ dl诊断糖尿病敏感性 5 4.2 2 % ,特异性 72 .0 8% ,漏诊率 45 .77%。结论 :(1) ADA糖尿病诊断标准在保证 FBG诊断特异性无明显变化的条件下 ,提高了 FBG诊断敏感性 ,有一定的优越性。但难以胜任仅以 FBG为基础进行糖尿病流行病学调查。对 FBG在正常范围内的对象 ,如有糖尿病高危因素 ,仍应再次复查 PBG以免漏诊。 (2 )对糖尿病流行病学普查 ,为尽可能减低漏诊率 ,应采用 WHO建议以 PBG为基础的研究方法 ,可免查 FBG。
OBJECTIVE: To investigate the feasibility of an epidemiological survey of diabetes mellitus based on ADB’s 1997 report on ADB. Methods: A total of 1889 patients with blood glucose (PBG )≥12 0 m g / dl after 2-hour postprandial blood glucose screening were divided into diabetic group, IGT group and normal group according to the WHO standard of 1985. Results: In the 1889 cases of census, 2680 were diabetes, 6 were IGT44 and 1175 were normal. FBG ≥ 140 m g / dl diagnosis of diabetes sensitivity 38.43%, specificity 73.79%, missed diagnosis rate of 6 1.56%, PBG ≥ 200 mg / dl diagnosis of diabetes sensitivity 89.93%, missed diagnosis rate of 10.07%. According to the ADA criteria in 1997, 2 84 cases of diabetes were diagnosed, 2 cases of newly diagnosed diabetes were diagnosed, FBG≥12 6 mg / dl was diagnosed as diabetes with a sensitivity of 52.22%, specificity of 72.08% and misdiagnosis rate of 45.77%. Conclusion: (1) ADA diabetes diagnostic criteria in the FBG diagnostic specificity without significant changes in the conditions, improve the diagnostic sensitivity of FBG, there are some advantages. However, it is difficult to qualify for the epidemiological investigation of diabetes based on the FBG alone. PBG in the normal range of subjects, if the risk factors for diabetes, PBG should still be reviewed again so as to avoid misdiagnosis. (2) For epidemiological survey of diabetes, in order to minimize the rate of misdiagnosis, PBG-based research methods suggested by the WHO should be adopted to avoid FBG.