糖化血红蛋白在诊断妊娠期糖尿病中的作用及意义
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[摘要] 目的：探讨糖化血红蛋白(HbA1c)在诊断妊娠期糖尿病(GDM)中的作用及意义。方法：2010年2月～2011年2月，分别检测68例GDM孕妇和100例正常孕妇HbA1c、口服糖负荷实验(OGCT)和空腹血糖(FPG)水平。结果：GDM组FPG、OGCT、HbA1c水平均明显高于对照组(P<0.05)。GDM组FPG、OGCT、HbA1c的阳性率均明显高于对照组(P<0.05)，其中以HbA1c的阳性率最高，为85.3%。HbA1c>6.0%的GDM孕妇羊水过多、胎膜早破和新生儿窒息发生率明显高于HbA1c≤6.0%的孕妇(P<0.05)。结论：HbA1c水平在GDM患者中明显升高，诊断GDM具有较高的阳性率，对HbA1c水平的监测有利于降低母婴并发症发生率，为糖尿病的血糖水平监测提供了新的方法。
[关键词] 糖化血红蛋白；妊娠期糖尿病；诊断；空腹血糖
[中图分类号] R446.1 [文献标识码] C[文章编号] 1674-4721(2011)07(c)-115-02
The function and significance of glycosylated hemoglobin in diagnosis of gestational diabetesmellitus
LAN Yan, LI Lifang
Department of Obstetrics and Gynecology, the People's Hospital in Hechi City, Guangxi Zhuang Nationality Autonomous Region, Hechi 547000, China
[Abstract] Objective: To discuss the function and significance of HbA1c in diagnosis of gestational diabetesmellitus(GDM). Methods: 68 cases of GDM patients and 100 cases of normal pregnant women were detected with HbA1c, OGCT and FPG. Results: The levels of HbA1c, OGCT and FPG in GDM group were significantly higher than those in control group(P<0.05). The positive rates of HbA1c, OGCT and FPG in GDM group were significantly higher than those in control group(P<0.05). The incidences of maternal polyhydramnios, premature rupture of membranes and neonatal asphyxia in HbA1c>6.0% group were significantly higher than those in HbA1c≤6.0% group(P<0.05). Conclusion: The levels of HbA1c were significantly increased in GDM patients and have higher positive rates, which is good for lowing incidence of maternal complications and can provide a new method for monitoring Diabetes blood glucose.
[Key words] Glycosylated hemoglobin; Gestational diabetesmellitus; Giagnosis; Fasting blood glucose
妊娠期糖尿病(GDM)是指在妊娠期间首次发生或识别的不同程度的糖耐量异常，是妊娠期常见的并发症之一，约占妊娠妇女的2%～8%，且发生率逐年升高。GDM与巨大儿、胎儿畸形等病理性妊娠及胎婴儿并发症等方面存在密切关系，故早期诊断及有效处理是降低母婴并发症的关键[1]。常规空腹血糖(FPG)检查容易造成GDM漏诊而延误治疗，而口服糖负荷实验(OGCT)，操作繁琐，花费时间长，重复性差，给患者带来痛苦和不便[2]。糖化血红蛋白(HbA1c)是反映糖尿病孕妇长期血糖水平的精确指标，现已广泛应用于临床诊断与治疗[3]。2010年2月～2011年2月本院对68例GDM患者血中HbA1c水平进行检测，探讨其在GDM中的作用及意义。
1 资料与方法
1.1 一般资料
2010年2月～2011年2月来本院行产前门诊检查及住院分娩的患GDM孕妇68例，年龄20～35岁，平均(27.6±8.7)岁，孕周(26 ......
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