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ENGLISH ABSTRACT
中国2型糖尿病防治指南（2020年版）
中华医学会糖尿病学分会
作者及单位信息
·
DOI： 10.3760/cma.j.cn115791-20210221-00095
Guideline for the prevention and treatment of type 2 diabetes mellitus in China (2020 edition)
Chinese Diabetes Society
Zhu Dalong
Authors Info & Affiliations
Chinese Diabetes Society
Zhu Dalong
Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing 210008, China
·
DOI： 10.3760/cma.j.cn115791-20210221-00095
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摘要

随着国内外2型糖尿病的研究取得了重大进展，获得了更多关于糖尿病及其慢性并发症预防、诊断、监测及治疗的循证医学新证据。中华医学会糖尿病学分会特组织专家对原有指南进行修订，形成了《中国2型糖尿病防治指南（2020年版）》，旨在及时传递重要进展，指导临床。本指南共19章，内容涵盖中国糖尿病流行病学、糖尿病的诊断与分型、2型糖尿病的三级预防、糖尿病的筛查和评估、糖尿病的教育和管理、2型糖尿病综合控制目标和高血糖的治疗路径、医学营养、运动治疗和体重管理、高血糖的药物治疗、糖尿病相关技术、糖尿病急性和慢性并发症、低血糖、糖尿病的特殊情况、代谢综合征和糖尿病的中医药治疗等。本指南的颁布将有助于指导和帮助临床医师对2型糖尿病患者进行规范化综合管理，改善中国2型糖尿病患者的临床结局。

糖尿病，2型;指南
引用本文

中华医学会糖尿病学分会. 中国2型糖尿病防治指南（2020年版）[J]. 中华糖尿病杂志,2021,13(04)：315-409.

DOI:10.3760/cma.j.cn115791-20210221-00095

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目录
第一章 中国糖尿病流行病学 316
一、糖尿病的流行病学 316
二、我国糖尿病流行特点 317
三、我国糖尿病流行的影响因素 317
第二章 糖尿病的诊断与分型 318
一、糖尿病的诊断 318
二、糖尿病的分型 318
三、各种类型糖尿病的特点 319
第三章 2型糖尿病的三级预防 320
一、2型糖尿病防治中的三级预防目标 320
二、一级预防的策略 320
三、二级预防的策略 321
四、三级预防的策略 321
第四章 糖尿病的筛查和评估 322
一、筛查 322
二、评估 322
第五章 糖尿病的教育和管理 324
一、基本原则 324
二、教育和管理的目标 325
三、教育和管理的形式 325
四、教育管理的流程和框架 325
五、糖尿病自我管理教育和支持的实施 325
六、糖尿病教育的基本内容 325
七、糖尿病相关心理压力与应对 326
八、新技术在糖尿病教育管理中的应用 326
第六章 2型糖尿病综合控制目标和高血糖的治疗路径 326
一、2型糖尿病的综合控制目标 327
二、2型糖尿病高血糖控制的策略和治疗路径 328
第七章 2型糖尿病的医学营养治疗 329
一、医学营养治疗的目标 329
二、膳食营养因素 330
三、营养教育与管理 331
第八章 2型糖尿病的运动治疗 331
第九章 戒烟 332
一、吸烟的危害和戒烟的获益 332
二、戒烟的措施及注意事项 332
第十章 高血糖的药物治疗 332
一、口服降糖药物 332
二、胰岛素 335
三、胰高糖素样肽-1受体激动剂 337
第十一章 2型糖尿病患者的体重管理 338
一、体重管理策略 338
二、2型糖尿病患者的代谢手术 340
第十二章 糖尿病相关技术 341
一、血糖监测 341
二、胰岛素注射装置和注射技术 343
三、胰岛素泵 343
第十三章 糖尿病急性并发症 344
一、糖尿病酮症酸中毒 344
二、高渗性高血糖状态 346
第十四章 心血管疾病及危险因素管理 347
一、概述 347
二、筛查 347
三、心血管危险因素控制 347
第十五章 糖尿病慢性并发症 350
一、糖尿病肾病 350
二、糖尿病视网膜病变 352
三、糖尿病神经病变 354
四、糖尿病下肢动脉病变 356
五、糖尿病足病 358
第十六章 低血糖 360
一、低血糖的诊断标准 360
二、可引起低血糖的降糖药物 360
三、临床表现 361
四、低血糖分级 361
五、低血糖的可能诱因和预防对策 361
六、低血糖的治疗 361
第十七章 糖尿病的特殊情况 362
一、住院糖尿病患者的管理 362
二、围手术期糖尿病管理 364
三、妊娠期高血糖管理 365
四、儿童和青少年2型糖尿病 367
五、老年糖尿病 369
六、阻塞性睡眠呼吸暂停低通气综合征与高血糖 371
七、糖尿病与感染 373
八、糖尿病与口腔疾病 373
九、糖皮质激素与糖尿病 374
十、糖尿病伴抑郁焦虑障碍 375
十一、重性精神障碍 376
第十八章 代谢综合征 376
一、代谢综合征的诊断标准 377
二、代谢综合征的防治 377
第十九章 糖尿病的中医药治疗 377
一、糖尿病中医药治疗概述 377
二、糖尿病中医药治疗建议 377
三、中医药防治糖尿病的循证证据 378
四、其他疗法的循证证据 378
附录1 本指南常用名词术语英文缩略语释义 379
附录2 常用降糖药（不包括胰岛素） 380
附录3 常用胰岛素及其作用特点 381
附录4 常用降压药 381
附录5 常用调脂药 382
附录6 口服葡萄糖耐量试验（OGTT）方法 383
附录7 常用体质指标 383
附录8 常用实验室检查数据及换算 383
附录9 本指南证据等级说明 384
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附录
附录：
中医证候术语

1.气阴两虚证：以神疲乏力、气短懒言、咽干口燥、烦渴欲饮、午后颧红、小便短少、大便干结、舌体瘦薄、苔少而干、脉虚数等为常见症的证候（GB/T16751.2-1997-中医临床诊疗术语）。

2.血瘀证：以局部出现青紫肿块、疼痛拒按，或腹内徵块、刺痛不移、拒按，或出血紫暗成块、舌紫或有瘀点、脉弦涩等为常见症的证候（GB/T16751.2-1997-中医临床诊疗术语）。

3.肠道湿热证：以脘腹痞胀、呕恶纳呆、便溏不爽，或下痢脓血、里急后重，或呕吐、腹泻如注、发热口渴、舌红苔黄腻、脉滑数等为常见症的证候（GB/T16751.2-1997-中医临床诊疗术语）。

4.肝胃郁热证：以发热口渴、急躁易怒、胁痛口苦、胃脘灼痛、舌红苔黄、脉数有力等为常见症的证候（GB/T16751.2-1997-中医临床诊疗术语）。

5.气虚络阻证：以四肢麻、凉、痛，伴肌肤甲错，面色晦暗，倦怠乏力，神疲懒言，自汗等为常见症的证候。

6.目络瘀阻证：以视物模糊，目睛干涩，或视物变形，或眼前黑花飘舞，舌紫暗或有瘀斑等为常见症的证候（中华中医药学会糖尿病分会糖尿病视网膜病变中医诊疗标准，2011）。

附录1
本指南常用名词术语英文缩略语释义
英文缩写 中文全称 英文全称
ABI 踝肱指数 ankle brachial index
ACEI 血管紧张素转化酶抑制剂 angiotensin converting enzyme inhibitors
ADA 美国糖尿病学会 American Diabetes Association
AI 人工智能 artificial intelligence
ARB 血管紧张素Ⅱ受体拮抗剂 angiotensin Ⅱ receptor antagonist
ASCVD 动脉粥样硬化性心血管疾病 atherosclerotic cardiovascular disease
BMI 体重指数 body mass index
CAD 冠状动脉疾病 coronary artery disease
CGM 持续葡萄糖监测 continuous glucose monitoring
CKD 慢性肾脏病 chronic kidney disease
CKD-EPI 慢性肾脏病流行病学合作研究 chronic kidney disease epidemiology collaboration
CLI 严重肢体缺血 critical limb ischemia
CSII 持续皮下胰岛素输注 continuous subcutaneous insulin infusion
CVOT 心血管结局试验 Cardiovascular Outcomes Trials
DEND 发育迟缓癫痫和新生儿糖尿病 developmental retardation, epilepsy and neonatal diabetes mellitus
DFU 糖尿病足溃疡 diabetic foot ulcer
DKA 糖尿病酮症酸中毒 diabetic ketoacidosis
DME 糖尿病黄斑水肿 diabetic macular edema
DPP-4i 二肽基肽酶Ⅳ抑制剂 dipeptidyl peptidase Ⅳ inhibitor
DR 糖尿病视网膜病变 diabetic retinopathy
DSMES 糖尿病自我管理教育和支持 diabetes self-management education and support
DSPN 对称性多发性神经病变 diabetes distal symmetrical polyneuropathy
eGFR 估算的肾小球滤过率 estimated glomerular filtration rate
FDA 美国食品药品监督管理局 Food and Drug Administration
GA 糖化白蛋白 glycated albumin
GADA 谷氨酸脱羧酶抗体 glutamate decarboxylase antibody
GCK 葡萄糖激酶 glucokinase
GDM 妊娠期糖尿病 gestational diabetes mellitus
GLP-1RA 胰高糖素样肽-1受体激动剂 glucagon-like peptide-1 receptor agonist
HbA 1c 糖化血红蛋白 glycated hemoglobin A 1c
HDL-C 高密度脂蛋白胆固醇 high-density lipoprotein-cholesterol
HHS 高渗性高血糖状态 hyperglycemic hyperosmolar status
HNF 肝细胞核因子 hepatic nuclear factor
IA-2A 胰岛细胞抗原2抗体 islet cell antigen 2 antibody
ICA 胰岛细胞抗体 islet cell antibody
IFG 空腹血糖受损 impaired fasting glucose
IGT 糖耐量减低 impaired glucose tolerance
INS 胰岛素 insulin
LADA 成人隐匿性自身免疫性糖尿病 latent autoimmune diabetes in adults
LDL-C 低密度脂蛋白胆固醇 low-density lipoprotein-cholesterol
LEAD 下肢动脉粥样硬化性病变 lower extremity atherosclerotic disease
MACE 主要心血管不良事件 major adverse cardiovascular events
MIDD 突变母系遗传的糖尿病和耳聋 maternally inherited diabetes and deafness syndrome
MODY 青少年的成人起病型糖尿病 maturity onset diabetes of the young
NPDR 非增殖型糖尿病视网膜病变 non-proliferlative diabetic retinopathy
ODM 妊娠期显性糖尿病 overt diabetes mellitus
OGTT 口服葡萄糖耐量试验 oral glucose tolerance test
OSAHS 阻塞性睡眠呼吸暂停低通气综合征 obstructive sleep apnea hypopnea syndrome
PAD 周围动脉病变 peripheral artery disease
PCOS 多囊卵巢综合征 polycystic ovarian syndrome
PDR 增殖型糖尿病视网膜病变 proliferlative diabetic retinopathy
PGDM 孕前糖尿病 prepregnancy diabetes mellitus
PNDM 永久性新生儿糖尿病 permanent neonatal diabetes mellitus
SGLT2i 钠-葡萄糖共转运蛋白2抑制剂 sodium-glucose cotransporter 2 inhibitor
SMBG 自我血糖监测 self-monitoring of blood glucose
T1DM 1型糖尿病 type 1 diabetes mellitus
T2DM 2型糖尿病 type 2 diabetes mellitus
TAR 葡萄糖高于目标范围时间 time above range
TBR 葡萄糖低于目标范围时间 time below range
TG 甘油三酯 triglyceride
TIR 葡萄糖目标范围时间 time in range
TNDM 暂时性新生儿糖尿病 transient neonatal diabetes mellitus
TZD 噻唑烷二酮类 thiazolidinediones
UACR 尿白蛋白/肌酐比值 urinary albumin/creatinine ratio
WHO 世界卫生组织 World Health Organization
ZnT8A 锌转运体8抗体 Zinc transporter 8 antibody
展开表格
附录2
常用降糖药（不包括胰岛素）
通用名 英文名 每片（支）剂量（mg） 剂量范围（mg/d） 作用时间（h） 半衰期（h）
格列本脲 glibenclamide 2.5 2.5~20.0 16~24 10~16
格列吡嗪 glipizide 5 2.5~30.0 8~12 2~4
格列吡嗪控释片 glipizide-XL 5 5.0~20.0

6~12

（最大血药浓度）

2~5

（末次血药后）
格列齐特 gliclazide 80 80~320 10~20 6~12
格列齐特缓释片 gliclazide-MR 30 30~120 — 12~20
格列喹酮 gliquidone 30 30~180 8 1.5
格列美脲 glimepiride 1、2 1.0~8.0 24 5
消渴丸（含格列本脲） Xiaoke Pill 0.25 mg 格列本脲/粒 5~30粒（含1.25~7.50 mg格列本脲） 同格列本脲 同格列本脲
二甲双胍 metformin 250、500、850 500~2 000 5~6 1.5~1.8
二甲双胍缓释片 metformin-XR 500 500~2 000 8 6.2
阿卡波糖 acarbose 50、100 100~300 — —
伏格列波糖 voglibose 0.2 0.2~0.9 — —
米格列醇 miglitol 50 100~300 — —
瑞格列奈 repaglinide 0.5、1、2 1~16 4~6 1
那格列奈 nateglinide 120 120~360 1.3 —
米格列奈钙片 mitiglinide calcium 10 30~60

0.23~0.28

（峰浓度时间）

 1.2
罗格列酮 rosiglitazone 4 4~8 — 3~4
罗格列酮+二甲双胍 rosiglitazone/metformin 2/500 — — —
吡格列酮 pioglitazone 15 15~45 2（达峰时间） 3~7
西格列汀 sitagliptin 100 100 24 12.4
西格列汀+二甲双胍 sitagliptin/metformin 50/500、50/850 — — —
沙格列汀 saxagliptin 5 5 24 2.5
沙格列汀+二甲双胍缓释片 saxagliptin/metformin-XR 5/500、5/1 000、 2.5/1 000 — — —
维格列汀 vildagliptin 50 100 24 2
维格列汀+二甲双胍 vildagliptin/metformin 50/850、50/1 000 — — —
利格列汀 linagliptin 5 5 1.5（达峰时间） 12
利格列汀+二甲双胍 linagliptin/metformin 2.5/500、2.5/850、2.5/1 000 — — —
阿格列汀 alogliptin 25 25 1~2（达峰时间） 21
艾塞那肽 exenatide 0.3/1.2 ml、0.6/2.4 ml 0.01~0.02 10 2.4
利拉鲁肽 liraglutide 18/3 ml 0.6~1.8 24 13
贝那鲁肽 benaglutide 2.1 ml/4.2 mg 0.3~0.6 2 0.25
利司那肽 lixisenatide 0.15/3 ml、0.30/3 ml 0.01~0.02 1~2（达峰时间） 2~4
艾塞那肽周制剂 exenatide once-weekly 2/瓶 2 mg每周1次 2个高峰 a 2.4 h每次释放
度拉糖肽 dulaglutide 0.75/0.5 ml、 1.50/0.5 ml 0.75~1.50 mg每周1次 48（达峰时间） 108~112
洛塞那肽 loxenatide 0.1/0.5 ml、 0.2/0.5 ml 0.1~0.2 mg 每周1次 67~118（达峰时间） 104~121
达格列净 dapagliflozin 10 10 24 12.9
恩格列净 empagliflozin 10 10~25 1.3~3.0（达峰时间） 5.6~13.1
卡格列净 canagliozin 100/300 100~300 1~2（达峰时间） 10.6~13.1
展开表格
附录3
常用胰岛素及其作用特点
胰岛素制剂 起效时间（h） 峰值时间（h） 作用持续时间（h）
短效人胰岛素（RI） 0.25~1.00 2~4 5~8
门冬胰岛素 0.17~0.25 1~2 4~6
赖脯胰岛素 0.17~0.25 1.0~1.5 4~5
谷赖胰岛素 0.17~0.25 1~2 4~6
中效人胰岛素（NPH） 2.5~3.0 5~7 13~16
长效胰岛素（PZI） 3~4 8~10 20
甘精胰岛素U100 2~3 无峰 30
甘精胰岛素 U300 6 无峰 36
地特胰岛素 3~4 3~14 24
德谷胰岛素 1 无峰 42
预混人胰岛素（30R，70/30） 0.5 2~12 14~24
预混人胰岛素（40R） 0.5 2~8 24
预混人胰岛素（50R） 0.5 2~3 10~24
预混门冬胰岛素30 0.17~0.33 1~4 14~24
预混门冬胰岛素50 0.25 0.50~1.17 16~24
预混赖脯胰岛素25 0.25 0.50~1.17 16~24
预混赖脯胰岛素50 0.25 0.50~1.17 16~24
双胰岛素类似物（德谷门冬双胰岛素70/30） 0.17~0.25 1.2 超过24
展开表格
附录4
常用降压药
化学名 英文名 常用剂量（mg） 最大剂量（mg/d） 主要不良反应
卡托普利 catopril 12.5~50.0 Bid~Tid 450 咳嗽，血钾升高，血管性水肿
依那普利 enalapril 5~40 Qd 40 咳嗽，血钾升高，血管性水肿
西拉普利 cilazapril 2.5~5.0 Qd 10 咳嗽，血钾升高，血管性水肿
福辛普利 fosinopril 10~40 Qd 40 咳嗽，血钾升高，血管性水肿
培哚普利 perindopril 4~8 Qd 8 咳嗽，血钾升高，血管性水肿
雷米普利 ramipril 2.5~10.0 Qd 20 咳嗽，血钾升高，血管性水肿
赖诺普利 lisinopril 10~40 Qd 80 咳嗽，血钾升高，血管性水肿
贝那普利 benazepril 5~40 Qd 40 咳嗽，血钾升高，血管性水肿
咪哒普利 imidapril 2.5~10.0 Qd 10 咳嗽，血钾升高，血管性水肿
氯沙坦 losartan 50~100 Qd 100 血钾升高，血管性水肿（罕见）
缬沙坦 valsartan 80~160 Qd 320 血钾升高，血管性水肿（罕见）
厄贝沙坦 irbesartan 150~300 Qd 300 血钾升高，血管性水肿（罕见）
坎地沙坦 candesartan 8~16 Qd 32 血钾升高，血管性水肿（罕见）
替米沙坦 telmisartan 40~80 Qd 80 血钾升高，血管性水肿（罕见）
奥美沙坦 olmesartan 20~40 Qd 40 血钾升高，血管性水肿（罕见）
依普沙坦 eprosartan 400~800 Qd 800 血钾升高，血管性水肿（罕见）
硝苯地平 nifedipine 10~30 Tid 90 水肿，头痛，潮红
硝苯地平缓释片 nifedipine SR 10~20 Bid 水肿，头痛，潮红
硝苯地平控释片 nifedipine CR 30 Qd~Bid 水肿，头痛，潮红
苯磺酸氨氯地平 amlodipine besylate 2.5~10.0 Qd 10 水肿，头痛，潮红
非洛地平 felodipine 2.5~10.0 Qd 10 水肿，头痛，潮红
拉西地平 lacidipine 4~8 Qd 8 水肿，头痛，潮红
佩尔地平 perdipine 40 Bid 80 水肿，头痛，潮红
尼群地平 nitrendipine 10~20 Tid 60 水肿，头痛，潮红
尼莫地平 nimodipine 30~60 Tid 水肿，头痛，潮红
乐卡地平 lercanidipine 10~20 Qd 20 水肿，头痛，潮红
地尔硫卓缓释片 diltiazem SR 90 Bid 360 水肿，头痛，眩晕
维拉帕米缓释片 verapamil SR 120~240 Qd 480 房室传导阻滞，心功能抑制，便秘
美托洛尔缓释剂 metoprolol SR 47.5~95.0 Qd 190 支气管痉挛，心功能抑制
比索洛尔 bisoprolol 2.5~10.0 Qd 20 支气管痉挛，心功能抑制
阿替洛尔 atenolol 12.5~50.0 Qd 100 支气管痉挛，心功能抑制
普萘洛尔 propranolol 20~90 Tid 320 支气管痉挛，心功能抑制
拉贝洛尔 labetalol 200~600 Bid 1 200 体位性低血压，支气管痉挛
卡维地洛 carvedilol 12.5~50.0 Bid 100 体位性低血压，支气管痉挛
阿罗洛尔 arotinolol 10~15 Bid 30 体位性低血压，支气管痉挛
呋塞米 furosemide 20~40 Qd~Bid 80 血钾降低
氯噻酮 chlorthalidone 12.5~25.0 Qd 100 血钾减低，血钠减低，血尿酸升高
氢氯噻嗪 hydrochlorothiazide 12.5~25.0 Qd 50 血钾减低，血钠减低，血尿酸升高
吲哒帕胺 indapamide 1.25~2.50 Qd 2.5 血钾减低，血钠减低，血尿酸升高
吲哒帕胺缓释片 indapamide SR 1.5 Qd 1.5 血钾减低，血钠减低，血尿酸升高
阿米洛利 amiloride 5~10 Qd 10 血钾增高
氨苯蝶啶 triamterene 25~100 Qd 100 血钾增高
螺内酯 spironolactone 10~40 Qd~Bid 80 血钾增高
特拉唑嗪 terazosin 1~20 Qd~Bid 20 体位性低血压
多沙唑嗪 doxazosin 1~8 Qd~Bid 16 体位性低血压
哌唑嗪 prazosin 1~10 Bid~Tid 20 体位性低血压
展开表格
附录5
常用调脂药
化学名 英文名 常用剂量（mg） 主要不良反应
非诺贝特 fenofibrate 200 消化不良，胆石症，肝酶升高和肌病
吉非贝齐 gemfibrozil 1 200 消化不良，胆石症，肝酶升高和肌病
洛伐他汀 lovastatin 20 头痛、失眠、抑郁，腹泻、腹痛、恶心、消化不良，肝酶升高，肌病
辛伐他汀 simvastatin 20~40 头痛、失眠、抑郁，腹泻、腹痛、恶心、消化不良，肝酶升高，肌病
普伐他汀 pravastatin 40 头痛、失眠、抑郁，腹泻、腹痛、恶心、消化不良，肝酶升高，肌病
氟伐他汀 fluvastatin 40~80 头痛、失眠、抑郁，腹泻、腹痛、恶心、消化不良，肝酶升高，肌病
阿托伐他汀 atorvastatin 10~20 头痛、失眠、抑郁，腹泻、腹痛、恶心、消化不良，肝酶升高，肌病
瑞舒伐他汀 rosuvastatin 10 头痛、失眠、抑郁，腹泻、腹痛、恶心、消化不良，肝酶升高，肌病
匹伐他汀 pitavastatin 2 头痛、失眠、抑郁，腹泻、腹痛、恶心、消化不良，肝酶升高，肌病
烟酸缓释片 nicotinic acid 500~2 000 胃肠道反应，颜面潮红，高血糖，高尿酸（或痛风）
考来烯胺 cholestyramine 4 000~16 000 胃肠不适，便秘
考来替泊 colestipol 5 000~20 000 胃肠不适，便秘
考来维仑 colesevelam 3 800~4 500 胃肠不适，便秘
依折麦布 ezetimibe 10 头痛、恶心，偶见肝酶、肌酶升高
多廿烷醇 policosanol 5~20 偶见皮疹
展开表格
附录6
口服葡萄糖耐量试验（OGTT）方法

1.晨7~9时开始，受试者空腹（8~10 h）后口服溶于300 ml水内的无水葡萄糖粉75 g，如用1分子水葡萄糖则为82.5 g。儿童则予每千克体重1.75 g，总量不超过75 g。糖水在5 min之内服完。

2.从服糖第1口开始计时，于服糖前和服糖后2 h分别在前臂采血测血糖。

3.试验过程中，受试者不喝茶及咖啡，不吸烟，不做剧烈运动，但也无需绝对卧床。

4.血标本应尽早送检。

5.试验前3 d内，每日碳水化合物摄入量不少于150 g。

6.试验前停用可能影响OGTT的药物如避孕药、利尿剂或苯妥英钠等3~7 d。

附录7
常用体质指标

1.体重指数（BMI）=体重/身高 2（单位kg/m 2）。

2.腰围：肋骨下缘与髂嵴连线中点的腹部周径。

3.臀围：臀部最大周径。

4.腰臀比（WHR）：腰围/臀围。

附录8
常用实验室检查数据及换算
项目 新制单位参考值 旧制单位参考值 换算系数（新➝旧） 换算系数（旧➝新）
空腹血糖（FPG） 3.61~6.11 mmol/L 65~110 mg/dl 18 0.055 51
甘油三酯（TG） 0.56~1.70 mmol/L 50~150 mg/dl 88.57 0.011 29
总胆固醇（TC） 2.84~5.68 mmol/L 110~220 mg/dl 38.67 0.025 86
高密度脂蛋白胆固醇（HDL-C） 1.14~1.76 mmol/L 44~68 mg/dl 38.67 0.025 86
低密度脂蛋白胆固醇（LDL-C） 2.10~3.10 mmol/L 80~120 mg/dl 38.67 0.025 86
钾（K +） 3.5~5.5 mmol/L 3.5~5.5 mEq/L 1 1
钠（Na +） 135~145 mmol/L 135~145 mEq/L 1 1
氯（Cl -） 96~106 mmol/L 96~106 mEq/L 1 1
钙（Ca 2+） 2.12~2.75 mmol/L 8.5~11 mg/dl 4.008 0.249 5
磷（P） 0.97~1.62 mmol/L 3~5 mg/dl 3.097 0.322 9
尿素氮（BUN） 3.6~14.2 mmol/L 5~20 mg/dl 1.401 0.714
肌酐（Cr） 44~133 μmol/L 0.5~1.5 mg/dl 0.011 31 88.402
尿酸（UA） 150~420 μmol/L 2.5~7.0 mg/dl 0.013 1 59.49
二氧化碳结合力（CO 2CP） 22~28 mmol/L 50~62 vol% 2.226 0.449 2
收缩压（SBP） 90~140 mmHg 12.0~18.7 kPa 0.133 7.5
舒张压（DBP） 60~90 mmHg 8.0~12.0 kPa 0.133 7.5
总胆红素（T-Bil） 3.4~20.0 μmol/L 0.2~1.2 mg/dl 0.058 47 17.1
直接胆红素（D-Bil） 0~7 μmol/L 0~0.4 mg/dl 0.058 47 17.1
血清总蛋白（TP） 60~80 g/L 6.0~8.0 g/dl 0.1 10
血清白蛋白（ALB） 40~55 g/L 4.0~5.5 g/dl 0.1 10
血清球蛋白（GLO） 20~30 g/L 2.0~3.0 g/dl 0.1 10
丙氨酸氨基转移酶（ALT，GPT） 0~40 U/L <120 U（改良金氏法） — —
天冬氨酸氨基转移酶（AST，GOT） 0~40 U/L <120 U（改良金氏法） — —
碱性磷酸酶（ALP，AKP） 40~160 U/L — — —
胰岛素 27.9~83.6 pmol/L 4~12 μU/ml 0.144 6.965
C肽 0.3~1.3 nmol/L 0.9~3.9 ng/ml 3.000 0.333
展开表格
附录9
本指南证据等级说明

本指南根据证据质量、一致性、临床意义、普遍性和适用性等将推荐意见分为 A（优秀）、B（良好）和 C（满意）三级。其中A级推荐意见应来自Ⅰ级水平的证据，所有研究结论一致，临床意义大，证据研究的样本人群与目标人群吻合，因此，该推荐意见可直接应用于各医疗行为中；而B、C级推荐意见则在上述各方面存在一定问题，其适用性受到不同限制。

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朱大龙，南京大学医学院附属鼓楼医院内分泌科 210008，Email： nc.defudabe.ujngnoladuhz
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