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目的探讨在妊娠早期糖化血红蛋白联合体重指数在临床筛查妊娠期糖尿病和糖耐量受损中的应用价值。方法回顾性分析1300例孕妇产前检查,孕8-14周筛查糖化血红蛋白及体重指数,孕24-28周筛查GCT及OGTT的结果对照。结果①产前检查1300例孕妇中4例在孕8-14周空腹血糖异常确诊妊娠期糖尿病,余均行,24-28周的50g葡萄糖筛查试验(GCT),异常者252人;行口服葡萄糖耐量试验(OGTT),确诊妊娠期糖尿病36人,糖耐量异常51例。②产前检查1300例孕妇在8-14周均行糖化血红蛋白(HbA1c)及体重指数计算。以HbA1c≥5.5%为临界点异常者335人。HbA1c≥6.0%为临界点异常者为124人。以BMI≥24,异常者366人;BMI≥26,异常者132人。在孕早期采用HbA1c≥5.5%且BMI≥24的筛查方法,它的敏感性及特异性接近GCT筛查方法。结论糖化血红蛋白联合体重指数在孕早期作为筛查妊娠期糖尿病指标具有重要意义,临床前景应用广泛。
Objective To explore the clinical value of glycated hemoglobin combined with body mass index in the first trimester of pregnancy in the screening of gestational diabetes mellitus and impaired glucose tolerance. Methods A retrospective analysis of 1300 pregnant women prenatal examination, 8-14 weeks pregnant screening for HbA1c and body mass index, gestational 24-28 weeks screening GCT and OGTT results of the control. Results ① Prenatal examination of 1300 pregnant women in 4 pregnant women in 8-14 weeks pregnant with abnormal fasting blood glucose diagnosis of gestational diabetes mellitus, more than line, 24-28 weeks of 50g glucose screening test (GCT), 252 were abnormal; oral Glucose tolerance test (OGTT), diagnosed 36 gestational diabetes mellitus, impaired glucose tolerance in 51 cases. ② Prenatal examination of 1,300 pregnant women in the 8-14 week average HbA1c and body mass index calculation. HbA1c ≥ 5.5% as the critical point of abnormal 335. HbA1c ≥ 6.0% of the critical point was 124 abnormal persons. To BMI ≥ 24, abnormal 366; BMI ≥ 26, abnormal 132. In early pregnancy using HbA1c ≥ 5.5% and BMI ≥ 24 screening method, its sensitivity and specificity close to GCT screening methods. Conclusion HbA1c combined with body mass index is important in the first trimester as a screening index for gestational diabetes mellitus, and its clinical application is extensive.