摘要
目的：了解武汉地区孕妇葡萄糖耐量试验（OGTT）筛查结果,为临床诊治提供依据。方法：回顾性分析湖北省妇幼保健院2016年10月-2017年9月间25 359例妊娠期24-28周妇女临床OGTT资料及妊娠期糖尿病（GDM）相关结果,同时随机选取其中120例OGTT筛查结果正常的孕妇做对照分析。结果：25 359例孕妇75g OGTT平均空腹血糖为（4.4±0.4）mmol/L,OGTT 1h血糖为（7.7±1.1）mmol/L,OGTT 2h血糖为（6.3±1.0）mmol/L。共检出妊娠糖尿病1 191例,检出率4.7%（1 191/25 359）;1 191例GDM中FPG≥5.1mmol/L、OGTT 1h≥10.0 mmol/L、OGTT 2h≥8.5 mmol/L占比分别为31.4%（374/1 191）、48.02%（572/1 191）、48.78%（581/1 191）,其中空腹血糖（FPG）值〈4.4 mmol/L占比33.3%（397/1 191）。根据仅一项异常诊断GDM,FPG、OGTT 1h、OGTT 2h占比分别是19.81%、26.95%、28.88%;根据两项异常诊断GDM,FPG＋OGTT1h、FPG＋OGTT 2h、OGTT 1h＋OGTT 2h占比分别是4.45%、3.27%、12.76%;根据三项异常（FPG＋OGTT1h＋OGTT 2h）诊断GDM占比3.86%。GDM中糖化血红蛋白（HbA1c）的均值为（5.40±0.72）%,与正常对照组无统计学差异。结论：GDM诊断尽可能用诊断一步法,不建议用空腹血糖〈4.4mmol/L排除GDM,妊娠期24-28周慎用HbA1c诊断GDM。
Objective：To analyze the results of oral glucose tolerance test（OGTT）screening for pregnant women in Wuhan,and to provide a basis for clinical diagnosis and treatment.Methods：A retrospective analysis was made on the clinical OGTT data and gestational diabetes mellitus（GDM）results of 25 359 cases of women in the 24-28 weeks of pregnancy in Hubei Maternal and Child Health Hospital from October 2016 to October 2017.120 cases of pregnant women with normal OGTT screening were randomly selected to make a control analysis.Results：The average fasting blood glucose of and that of 75 g OGTT was（4.4±0.4）mmol/L,blood glucose of OGTT 1 hwas（7.7±1.1）mmol/L,and that of OGTT 2 hwas（6.3±1.0）mmol/L in 25 359 pregnant women.Among them,1 191 cases of gestational diabetes were detected,and the detection rate was 4.7%（1 191/25 359）.In 1 191 cases of GDM,FPG ≥5.1 mmol/L,OGTT 1 h≥10.0 mmol/L,and OGTT 2 h ≥8.5 mmol/L,accounted for 31.4%（374/1 191）,48.02%（572/1 191）,and 48.78%（581/1 191）,respectively.Among them,the value of fasting blood glucose4.〈4 mmol/L was 33.3%（397/1 191）.According to only one abnormal item diagnosis of GDM,the ratio of FPG,OGTT 1 h and OGTT 2 hwas 19.81%,26.95% and 28.88%,respectively.The diagnostic rate FPG＋OGTT 1 h,FPG＋OGTT 2 h,and OGTT 1 h＋OGTT 2 hwas4.45%,3.27%,and 12.76%,respectively,based on the diagnosis of two items.Only 3.86%GDM was diagnozed based on three abnormalities（FPG＋OGTT 1 h＋ OGTT 2 h）.The mean value of glycated hemoglobin（HbA1c）in GDM was（5.40±0.72）% and it has no statistical difference from that of normal control.Conclusion：One step method is preferred to make diagnosis of GDM,fasting blood glucose〈4.4 mmol/L is not recommended to exclude the GDM,and in the 24-28 weeks of pregnancy,HbA1cis used with caution to diagnose GDM.
作者
石祖亮
田婷
杜树国
童桂林
王渊渊
严水情
SHI Zuliang;TIAN Ting;DU Shuguo;TONG Guilin;WANG Yuanyuan;YAN Shuiqing(Maternal and Child HealthCare Hospital in Hubei Province,Wuhan 430070,Chin)
出处
《武汉大学学报（医学版）》
CAS
2018年第5期797-800,共4页
Medical Journal of Wuhan University
