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目的分析并探讨孕中期女性进行葡萄糖糖耐量筛查试验以及胰岛素释放水平的临床特点,以及对妊娠期糖尿病(geseational diabetes mellitus,GDM)诊断的参考价值。方法选取2015年1月—2017年1月在本院接受常规产前检查的孕妇1 614例。所有孕妇均进行葡萄糖筛查试验,检测胰岛素释放水平。分析临床特点及与GDM的相关性。计量资料采取t检验,计数资料比较采取χ~2检验,P<0.05为差异有统计学意义。结果口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)异常孕妇301例,OGTT正常孕妇1 313例。OGTT异常孕妇年龄、BMI明显高于正常组(P<0.05)。其中,OGTT异常孕妇中,糖耐量减低(gestational impaired glucose tolerance,GIGT)孕妇217例,GDM孕妇84例。OGTT异常孕妇SI、胰岛素敏感指数(insulin sensitive index,ISI)明显高于OGTT正常组,且ΔPI/ΔPG和HOMA-β明显低于OGTT正常组,对比差异有统计学意义(P<0.05)。GDM组孕妇ISI明显高于GIGT组[(-3.77±0.23)、(-3.61±0.21)],HOMA-β明显低于GIGT组[(3.11±0.20)、(3.19±0.32)],对比差异均有统计学意义(均P<0.05)。0.5 h峰值点GDM占比20.74%,1 h峰值点GDM占比29.73%,2 h峰值点GDM占比41.82%,胰岛素释放随着峰值时间的延长,GDM发生率明显升高,对比差异有统计学意义(P<0.05)。结论孕中期女性进行葡萄糖糖耐量筛查试验以及胰岛素释放水平检测对GDM的早期检测有显著意义。
Objective To analyze and explore the second trimester women with glucose tolerance test and clinical characteristics of insulin release, as well as the reference value of gestational diabetes mellitus (GDM) diagnosis. Methods From January 2015 to January 2017, 1 614 pregnant women undergoing routine antenatal examination in our hospital were selected. All pregnant women underwent glucose screening tests to measure the level of insulin release. Analysis of clinical features and the correlation with GDM. Measurement data to t test, count data to compare χ ~ 2 test, P <0.05 for the difference was statistically significant. Results There were 301 pregnant women with oral glucose tolerance test (OGTT) and 1313 normal pregnant women with OGTT. The age of pregnant women with abnormal OGTT, BMI was significantly higher than the normal group (P <0.05). Among them, 217 pregnant women with gestational impaired glucose tolerance (GIGT) and 84 pregnant women with GDM were pregnant women with OGTT abnormalities. The SI and insulin sensitivity index (ISI) in pregnant women with OGTT abnormality were significantly higher than those in normal OGTT group, and ΔPI / ΔPG and HOMA-β were significantly lower than those in normal OGTT group (P <0.05). The ISI of GDM group was significantly higher than that of GIGT group [(-3.77 ± 0.23), (-3.61 ± 0.21)], HOMA-β was significantly lower than that of GIGT group [(3.11 ± 0.20), (3.19 ± 0.32) There was statistical significance (all P <0.05). GDM accounted for 20.74% at 0.5 h peak, 29.73% GDM at 1 h peak, 41.82% GDM at 2 h peak, and the incidence of GDM increased significantly with the increase of peak time with statistically significant difference Significance (P <0.05). Conclusion Pregnancy women with glucose tolerance test and insulin release test have a significant effect on the early detection of GDM.