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目的常规对产前检查的孕妇进行GCT(糖筛查试验)筛查妊娠期糖尿病(GDM),初步了解海南西部地区妊娠期糖耐量减退(GIGT)及GDM的患病率。分析适宜本地的GCT切点及筛查的高危因素。方法对2007年8月～2009年2月,在农垦那大医院普通产科门诊常规产检的孕妇385例,孕周在24～33周,用口服50g葡萄糖筛查。由血糖值≥7.8mmol/L者行葡萄糖耐量试验(OGTT)以明确诊断,血糖值≤7.8mmol/L伴高危因素者在34周再次重复GCT试验。结果GDM发生率为3.63%,GIGT发生率为4.93%,肥胖、DM(糖尿病)家族史、PCOS(多囊卵巢综合征)及反复霉菌性阴道炎,不良孕育史学与OGTT异常有相关性。取GCT切点为8.0mmol/L,敏感性为56.89%。结论发生GDM的最重要因素是肥胖;应将GCT列入产前检查的一个常规项目;选择GCT的切点为8.0mmol/L。
Objective To investigate the prevalence of gestational diabetes mellitus (GDM) by GCT (Pregnancy Test) in prenatal pregnant women and to understand the prevalence of impaired glucose tolerance (GIGT) and GDM in pregnant women in western part of Hainan. Analysis of appropriate local GCT cut points and screening of risk factors. Methods From August 2007 to February 2009, 385 pregnant women of routine obstetrics and gynecology clinics in Nongken University Hospital were enrolled. Pregnant women were enrolled in this study. The GCT test was repeated again at 34 weeks by the glucose tolerance test (OGTT) with a blood glucose level ≥ 7.8 mmol / L to confirm the diagnosis and the blood glucose level ≤ 7.8 mmol / L with the risk factors. Results The incidence of GDM was 3.63%. The incidence of GIGT was 4.93%. The obesity, DM family history, PCOS and repeated mycotic vaginitis were associated with abnormal histories of OGTT. GCT cut point was 8.0mmol / L, the sensitivity was 56.89%. Conclusions The most important factor in the development of GDM is obesity. GCT should be included in a routine program of prenatal care. The site of choice for GCT is 8.0 mmol / L.