健康妊娠妇女血糖指标参考区间的建立

目的:探讨非妊娠女性血糖指标参考区间用于评估健康妊娠妇女临床价值,并建立健康妊娠妇女血糖指标正常参考区间。方法:选取本院2016年1月-2018年12月产前检查产妇750例,按照孕期分为早孕组、中孕组和晚孕组各250例,另选本院体检的非妊娠妇女250例为对照组。检测各组空腹血糖水平。结果:K-S检验显示4组血糖测定值均呈正态分布(P>0.05)。空腹血糖水平早孕组、中孕组和晚孕组高于对照组(P<0.05),而中孕组和晚孕组无差异(P>0.05)但高于早孕组(P<0.05)。4组内不同年龄段血糖水平未见差异(P<0.05)。通过±1.96s计算参考值区间,对照组4.02~5.40mmol/L,早孕组3.91~5.83mmol/L,中孕组4.32~5.97mmol/L,晚孕组4.33~6.05mmol/L。结论:用非妊娠妇女的血糖指标参考区间值评估妊娠妇女的血糖值存在不合理性,临床应建立针对妊娠妇女的血糖指标正常参考区间,可为妊娠期糖尿病的早发现、早预防、早干预提供科学依据。

Establishment of reference interval for blood glucose indexes of pregnant women

Objective:To explore the clinical value of reference range of blood glucose index of women without pregnancy used for evaluating healthy pregnant women,and to establish the normal reference range of blood glucose index of healthy pregnant women.Methods:The total of 750 pregnant women were selected as subjects,and were divided in group A(250 women during the first trimester of pregnancy),in group B(250 women during the second trimester of pregnancy),and group C(250 women during the third trimester of pregnancy)from January 2016 to December 2018.Another 250 healthy women without pregnancy were selected in group D.Fasting blood glucose level of women in the four groups were measured.Results:K-S test showed that the blood glucose level of women in the four groups had showed normal distribution(P>0.05).Fasting blood glucose level of women in group A,B and C was significant higher than that of women in group D(P<0.05),and the fasting blood glucose level of women in group B and C was significant higher than that of women in group A(P<0.05),but the fasting blood glucose level of women in group B had no significant different to that of women in group C(P>0.05).There was no significant different in blood glucose level of women in the four groups among women with different age(P<0.05).After calculated based on x±1.96s,the reference range of blood glucose level of women in group D,A,B and C were 4.02-5.40mmol/L,3.91-5.83mmol/L,4.32-5.97mmol/L,and 4.33-6.05mmol/L,respectively.Conclusion:It is unreasonable to evaluate the blood glucose level of pregnant women based on the reference range of blood glucose index of women without pregnant.The normal reference range of blood glucose index of pregnant women should be established in clinical practice,which can provide scientific evidence for early detection,prevention and intervention of GDM.