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目的探讨妊娠期糖尿病患者糖化血红蛋白(glycosylatedhemoglobinAlc,HbAlc)检测的临床意义。方法对正常妊娠组318例、妊娠期糖耐量异常组69例及妊娠期糖尿病组105例分别进行空腹血糖(FPG)、口服葡萄糖耐量实验(OGCT)和HbAlc测定,通过ROC曲线评价FPG、OGCT和HbAlc在GDM筛查中的应用价值;并根据HbAlc水平高低分组进行并发症的统计及相关性分析。结果 FPG、OGCT和HbAlc诊断GDMROC曲线下面积(AUC%)分别为84%、92%和91%,HbAlc在GDM筛查中的诊断效率明显高于FPG;相对于OGCT而言,HbAlc的敏感性较高且具有测定快速、简便、准确、取血量少,不易受其它因素的影响的优点。并且妊娠期糖代谢异常患者的并发症随HbAlc的增高而增多。结论 HbAlc在妊娠期糖代谢异常的筛查诊断及并发症的监测方面有一定的意义。
Objective To investigate the clinical significance of glycosylated hemoglobin A1c (HbAlc) detection in gestational diabetes mellitus. Methods Fasting plasma glucose (FPG), oral glucose tolerance test (OGCT) and HbAlc were measured in 318 normal pregnant women, 69 pregnant women with gestational impaired glucose tolerance group and 105 pregnant women with gestational diabetes mellitus. FPG, OGCT and HbAlc in GDM screening of the value; and according to the level of HbAlc subgroups of complications and statistical analysis of the correlation. Results The area under the GDMROC curve (AUC%) was 84%, 92%, and 91% respectively for FPG, OGCT and HbAlc. The diagnostic efficiency of HbA1c in GDM screening was significantly higher than that of FPG. The sensitivity of HbA1c to OGCT High and has the advantages of rapid, simple, accurate, less blood loss, less susceptible to other factors. And complications of patients with abnormal glucose metabolism during pregnancy increased with the increase of HbAlc. Conclusion HbA1c has certain significance in the screening diagnosis and complication monitoring of abnormal glucose metabolism during pregnancy.