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目的比较空腹血浆血糖(FPG)、糖化血红蛋白(HbA1c)、2型糖尿病(T2DM)危险评分表(DRS)、T2DM发病概率预测模型(DPM)筛查无症状2型糖尿病患者的效果。方法使用2010年浙江省参与中国慢性病监测的横断面调查资料,利用受试者特征工作曲线(ROC)对上述4种方法筛查无症状T2DM的灵敏度、特异度、ROC曲线下面积(AUROC)进行分析,并对筛查成本进行比较。结果 FPG筛查无症状T2DM的灵敏度、特异度、AUROC和平均发现每例糖尿病的筛查成本分别为79.11%、90.46%、0.904和295元;HbA1c为75.32%、84.40%、0.862和891元;DRS为77.85%、91.45%、0.897和804元;DPM为82.28%、79.95%、0.876和789元。结论 FPG筛查无症状T2DM筛查效果最好,筛查成本最低,且易于操作,是适合社区日常开展糖尿病筛查的方法。
Objective To compare the effects of fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), type 2 diabetes mellitus (T2DM) risk score (DRS) and T2DM morbidity prediction model (DPM) in asymptomatic type 2 diabetic patients. Methods The cross-sectional survey of chronic disease surveillance in China was conducted in Zhejiang Province in 2010, and the sensitivity, specificity and area under the ROC curve (AUROC) of the four screening methods for asymptomatic T2DM by the above four methods were evaluated by using receiver operating characteristic curve (ROC) Analysis, and screening costs compared. Results The sensitivity, specificity, AUROC, and AUROC of screening for asymptomatic T2DM in FPG screening were 79.11%, 90.46%, 0.904 and 295 yuan respectively on average; the screening costs of HbA1c were 75.32%, 84.40%, 0.862 and 891 yuan respectively; DRS was 77.85%, 91.45%, 0.897 and 804 yuan respectively; DPM was 82.28%, 79.95%, 0.876 and 789 yuan respectively. Conclusion Asymptomatic T2DM screening for FPG screening is the best, screening the lowest cost, and easy to operate, is suitable for community diabetes screening routine method.