妊娠期糖尿病患者糖化血红蛋白测定的临床意义

目的:检测妊娠期糖尿病(gestational diabetes mellitus,GDM)患者的糖化血红蛋白(glycosylated hemoglobin A,HbA1C)水平,分析HbA1C在GDM血糖监测及预测新生儿不良结局中的意义。方法:根据HbA1C水平将149例GDM患者分为低HbA1C(LH)组(HbA1C≤5.6%)和高HbA1C(HH)组(HbA1C>5.6%)。分别检测两组的血压、血糖、血脂,记录分娩后新生儿的情况,比较两组各指标的差异并进行HbA1C与各指标的相关性分析。结果:HH组的体重(W)、体重指数(BMI)、空腹血糖(FBG)、HbA1C明显高于低LH组(P<0.05);HbA1C与BMI、W、新生儿体重、FBG呈正相关(r分别为0.840、0.804、0.357、0.241,P<0.05);HH组新生儿发生低血糖、巨大儿的情况较LH组明显增加,比值比分别为3.63、4.84。结论:HbA1C在GDM患者血糖监测及预测新生儿低血糖和巨大儿的发生中有重要作用。

Clinical significance of glycosylated hemoglobin detection for patients with gestational diabetes mellitus

Objective:To detect the levels of glycosylated hemoglobin(HbA1c) in patients with gestational diabetes mellitus(GDM),and analyze the significance of HbA1c for blood glucose monitoring of patients with GDM and predicting adverse outcome of neonates.Methods:According to the levels of HbA1C,149 GDM patients were divided into low HbA1C(LH) group(HbA1C≤5.6%) and high HbA1C(HH) group(HbA1C>5.6%).The blood pressures,blood glucose levels,and blood lipids in the two groups were detected;neonatal situations in the two groups after birth were recorded;the indexes in the two groups were compared,and a correlation analysis between HbA1C and each index was conducted.Results:Body weight,body mass index(BMI),fasting blood glucose,and HbA1C level in HH group were statistically significantly lower than those in LH group(P<0.05);there was a positive correlation between HbA1C and BMI,body weight,neonatal weight,and fasting blood glucose,respectively(γ=0.840,0.804,0.357,0.241,P<0.05);the incidences of hypoglycemia and macrosomia in HH group were statistically significantly higher than those in LH group,the odds ratio were 3.63 and 4.84,respectively.Conclusion:HbA1C plays an important role in blood glucose monitoring of GDM patients and predicting the occurrences of neonatal hypoglycemia and macrosomia.