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目的 探讨50 g葡萄糖筛查界值及糖筛值在7.2-7.8 mmol/L之间的临床意义。 方法 对北京大学人民医院1999年产科门诊的所有孕妇1 157例进行50 g葡萄糖筛查,血糖值≥7.2 mmol/L者进行75 g葡萄糖耐量试验(OGTT),对诊断妊娠糖尿病(GDM)及妊娠糖耐量损害(GIGT)者进行治疗和管理,登记其临床资料。 结果 24.2%(280/1 157)的孕妇糖筛值≥7.2 mmol/L,其中糖筛值7.2-7.8 mmol/L者84例,72例进行了OGTT试验,11.1%(8/72)诊断为GDM,18.1%(13/72)诊断为GIGT;糖筛界值定于≥7.2 mmol/L,GDM发生率和漏诊断率分别为5.3%(61/1 157)和3.2%(2/63),GIGT发生率和漏诊率分别为3.4%(39/1 157)和0;糖筛界值定于≥7.8 mmol/L,GDM发生率和漏诊率分别为4.9%(53/1 157)和15.9%(10/63),GIGT发生率和漏诊率分别为2.2%(26/1 157)和33.3%(13/39);比较糖筛值为7.2-7.8 mmol/L时OGTT正常组与OGTT异常组的妊娠结局,OGTT正常组巨大儿及手术产率略高,但差异无显著性。 结论 诊断妊娠糖尿病,50 g葡萄糖筛查界值应定在≥7.2 mmol/L为宜,以避免漏诊。
Objective To investigate the clinical significance of the screening limit of 50 g glucose and the value of sugar screening in 7.2-7.8 mmol / L. Methods A total of 1 157 cases of obstetric outpatients in Peking University People ’s Hospital were enrolled in this study. A glucose - glucose tolerance test (OGTT) of 50 g glucose screening and blood glucose level ≥ 7.2 mmol / L was performed for diagnosing gestational diabetes mellitus (GDM) and pregnancy Patients with impaired glucose tolerance (GIGT) are treated and managed to register their clinical data. Results 24.2% (280/1 157) of the pregnant women had the sugar screening value of 7.2 mmol / L, of which 84 cases had the sugar screening value of 7.2-7.8 mmol / L, 72 cases had the OGTT test and 11.1% (8/72) GDM, and 18.1% (13/72) were diagnosed as GIGT. The value of sugar screening was ≥7.2 mmol / L, and the diagnostic rates of GDM and missed diagnosis were 5.3% (61/1 157) and 3.2% (2/63) , The incidence of GIGT and the rate of misdiagnosis were 3.4% (39/1 157) and 0 respectively; the threshold value of sugar screening was ≥7.8 mmol / L, the incidence of GDM and misdiagnosis were 4.9% (53/1 157) and 15.9 % (10/63). The incidence of GIGT and misdiagnosis were 2.2% (26/1 157) and 33.3% (13/39), respectively. Compared with normal OGTT group and OGTT group Group pregnancy outcome, OGTT normal group of giant children and surgical yield was slightly higher, but the difference was not significant. Conclusion Diagnosis of gestational diabetes mellitus, 50 g glucose screening should be set at ≥ 7.2 mmol / L is appropriate to avoid missed diagnosis.