妊娠早期糖化血红蛋白联合体重指数筛查妊娠期糖尿病的意义

目的探讨在妊娠早期糖化血红蛋白联合体重指数在临床筛查妊娠期糖尿病和糖耐量受损中的应用价值。方法回顾性分析1300例孕妇产前检查,孕8-14周筛查糖化血红蛋白及体重指数,孕24-28周筛查GCT及OGTT的结果对照。结果①产前检查1300例孕妇中4例在孕8-14周空腹血糖异常确诊妊娠期糖尿病,余均行,24-28周的50g葡萄糖筛查试验(GCT),异常者252人;行口服葡萄糖耐量试验(OGTT),确诊妊娠期糖尿病36人,糖耐量异常51例。②产前检查1300例孕妇在8-14周均行糖化血红蛋白(HbA1c)及体重指数计算。以HbA1c≥5.5%为临界点异常者335人。HbA1c≥6.0%为临界点异常者为124人。以BMI≥24,异常者366人;BMI≥26,异常者132人。在孕早期采用HbA1c≥5.5%且BMI≥24的筛查方法,它的敏感性及特异性接近GCT筛查方法。结论糖化血红蛋白联合体重指数在孕早期作为筛查妊娠期糖尿病指标具有重要意义,临床前景应用广泛。

Glycosylated hemoglobin combined body mass index in early pregnancy screening for gestational diabetes mellitus

Objective：To study in early pregnancy the combined glycated hemoglobin,body mass index in the clinical screening in gestational diabetes mellitus and impaired glucose tolerance in the application.Methods：Retrospective analysis of 1300 pregnant women,prenatal care,pregnancy 8-14 weeks of screening glycated hemoglobin and body mass index,24-28 weeks of pregnancy and the OGTT screening results GCT control.Results：① Prenatal 1300 pregnant women in 4 cases diagnosed 8-14 weeks of fasting glucose gestational diabetes,others in 24 to 28 weeks 50 grams of glucose screening test（GCT）,abnormal 252;line oral glucose tolerance test（OGTT）,36 were diagnosed with gestational diabetes,impaired glucose tolerance in 51 cases.② 1300 pregnant women,prenatal care were performed in 8-14 weeks,glycosylated hemoglobin（HbA1c） AND body mass index calculations.With HbA1c ≥ 5.5% as the critical point of 335 abnormal.HbA1c ≥ 6.0% as the critical point for the 124 abnormal.To body mass index over 24,abnormal 366;more than 26,abnormal 132.In early pregnancy with HbA1c ≥ 5.5% and BMI ≥ 24 of the screening method,which is close to the sensitivity and specificity of screening GCT.Conclusion：The combined body mass index,glycosylated hemoglobin as a screening in early pregnancy is important indicators of gestational diabetes,the clinical prospects for wide application.