妊娠早期空腹血糖测定结果回顾性分析

目的 探讨妊娠早期空腹血糖（FPG）测定水平与妊娠中期75g葡萄糖口服糖耐量试验（OGTT）结果 的关系。方法 选取2012年8月至2013年4月在孕12周时来该院建立孕册行空腹血糖检测，并于24～28周行75g葡萄糖OGTT试验的孕妇1107例，对其临床资料进行回顾性分析。以国际妊娠合并糖尿病研究组（IADPSG）2010年提出的新诊断标准按OGTT结果 将孕妇分为4组。A组为OGTT结果 正常组，B组为OGTT结果 有1项异常，C组为OGTT结果 有2项异常，D组为OGTT结果 有3项异常。比较4组孕妇空腹血糖结果 的差异。结果 A、B、C、D组的孕早期空腹血糖均值呈递增变化，A组孕早期FPG≥5．1mmol／L的孕妇有65例占5．9％（65／1107），OGTT异常组有7例孕妇早期FPG≤4mmol／L。结论 孕早期空腹血糖升高是预警信号，提示孕中期发生妊娠糖尿病（GDM）的可能性增大。但将孕早期FPG≥5．1mmol／L作为GDM的诊断标准尚存疑问。处于任何一个空腹血糖区间，均有可能发生糖耐量异常，设立1个空腹血糖值而排除GDM的方法 不准确。

Analyze of early pregnancy fasting blood glucose

Objective To explore the correlation between fasting blood glucose levels and 75g oral glucose tolerance test （OGTT） results of Second trimester in early pregnancy Methods From 2012 August to 2013 April, 1 107 pregnant women who establish pregnancy books in our hospital during 12 weeks and underwent the 75 g oral glucose tolerance test for routine GDM screening in 24-28 weeks. Acording to a new diagnostic criteria that the International Association or Diabetes and pregnancy study （IADPSG） proposed in 2010, these pregnant women were divided into four groups. In group A,OGTT results was normal. B group,OGTT results had one abnormal;group C, OGTT results had two abnormal,group D,the OGTT results had three different. The fasting blood glucose result of different groups was compared. Results First trimester fasting blood glucose value of A,B,C,D group increased,In group A,FPG ≥ 5.1 mmol/L cases accounted for 5. 9% （65/1 107）. There are 7 cases of pregnant women early FPG 44 mmol/L in OGTT abnormal group. Conclusion The rising of fasting blood glucose in early pregnancy is the warning signal,It is suggested that the possibility of gestational pregnancy diabetes mellitus （GDM）should increase in middle period. The FPG ≥5.1 mmol/L early pregnancy as the surviving GDM diagnosis standard is not applicable. The establishment of a fasting blood glucose level is not desirable to exclude GDM.