糖化血红蛋白、空腹血糖与D—二聚体联合检测在妊娠期糖尿病筛查中的临床应用(1)
【摘要】 目的：探討糖化血红蛋白(HbA1c)、空腹血糖(FPG)与D-二聚体(D-Dimer)联合检测用于筛查妊娠期糖尿病(GDM)的可能性。方法：选取2017年1-12月在本院进行定期产前检查发现的首诊GDM患者192例为观察组，并同期选取本院健康妊娠女性192例为对照组。比较两组HbA1c、FPG、D-Dimer水平，采用受试者工作特征曲线(ROC)确定HbA1c预测GDM的诊断界点，分析HbA1c、FPG与D-Dimer联合筛查GDM的可能性。结果：观察组HbA1c和FPG水平均高于对照组，比较差异均有统计学意义(P<0.01)；但两组D-Dimer水平比较差异无统计学意义(P>0.05)；HbA1c、FPG和D-Dimer筛查GDM的ROC曲线下面积分别为0.767、0.803、0.500；当HbA1c的诊断界点为5.25%时，其灵敏度为72.9%、特异度为66.7%，为HbA1c的最佳阈值。观察组中HbA1c≥5.25%者140例，灵敏度为72.9%；FPG≥5.1 mmol/L者60例，灵敏度仅为31.3%；HbA1c≥5.25%和/或FPG≥5.1 mmol/L者152例，灵敏度为79.2%。结论：HbA1c与FPG联合检测更有利于GDM患者早期诊断，D-Dimer的检测对于GDM患者早期诊断无相关性意义。
, http://www.100md.com
【关键词】 糖化血红蛋白； 空腹血糖； D-二聚体； 妊娠期糖尿病
Clinical Application of Combined Detection of Glycosylated Hemoglobin，Fasting Blood Glucose and D-Dimer in Screening of Gestational Diabetes Mellitus/QIU Cailing，CHEN Xiangyun，XUAN Chun，et al.
//Medical Innovation of China，2018，15(13)：049-052
【Abstract】 Objective：To explore the possibility of combined detection of glycosylated hemoglobin(HbA1c)，fasting blood Glucose(FPG) and D-Dimer in screening of gestational diabetes mellitus(GDM).Method：A total of 192 pregnant women of first diagnosed GDM in our hospital from January to December 2017 were selected as observation group，and 192 healthy pregnant women in same period were selected as control group.The levels of HbA1c，FPG and D-Dimer in two groups were compared.The diagnostic boundary of HbA1c was determined by the subjects’ work characteristic curve(ROC)，and the possibility of HbA1c，FPG and D-Dimer to screen GDM was analyzed.Result：The levels of HbA1c and FPG in observation group were higher than those of control group，the differences were statistically significant(P<0.01). But the levels of D-Dimer was compared，the difference was not statistically significant(P>0.05).The area of ROC curves for screening GDM by HbA1c，FPG and D-Dimer was 0.767，0.803 and 0.500 respectively.When the diagnostic threshold of HbA1c was 5.25%，the sensitivity was 72.9% and specificity was 66.7%，which was the best threshold of HbA1c.In the observation group，140 patients with HbA1c≥5.25% had a sensitivity of 72.9%，60 patients with FPG>5.1 mmol/L had a sensitivity only of 31.3%，152 patients with HbA1c>5.25% and/or FPG>5.1 mmol/L had a sensitivity of 79.2%.Conclusion：The combined detection of HbA1c and FPG is more beneficial to the early diagnosis of GDM patients and the detection of D-Dimer has no correlation with the early diagnosis of GDM patients.
【Key words】 Glycosylated hemoglobin； Fasting blood glucose； D-Dimer； Gestational diabetes mellitus, http://www.100md.com(邱彩玲 陈祥云 宣春 吴莉莉 苏伟雄)
, http://www.100md.com
【关键词】 糖化血红蛋白； 空腹血糖； D-二聚体； 妊娠期糖尿病
Clinical Application of Combined Detection of Glycosylated Hemoglobin，Fasting Blood Glucose and D-Dimer in Screening of Gestational Diabetes Mellitus/QIU Cailing，CHEN Xiangyun，XUAN Chun，et al.
//Medical Innovation of China，2018，15(13)：049-052
【Abstract】 Objective：To explore the possibility of combined detection of glycosylated hemoglobin(HbA1c)，fasting blood Glucose(FPG) and D-Dimer in screening of gestational diabetes mellitus(GDM).Method：A total of 192 pregnant women of first diagnosed GDM in our hospital from January to December 2017 were selected as observation group，and 192 healthy pregnant women in same period were selected as control group.The levels of HbA1c，FPG and D-Dimer in two groups were compared.The diagnostic boundary of HbA1c was determined by the subjects’ work characteristic curve(ROC)，and the possibility of HbA1c，FPG and D-Dimer to screen GDM was analyzed.Result：The levels of HbA1c and FPG in observation group were higher than those of control group，the differences were statistically significant(P<0.01). But the levels of D-Dimer was compared，the difference was not statistically significant(P>0.05).The area of ROC curves for screening GDM by HbA1c，FPG and D-Dimer was 0.767，0.803 and 0.500 respectively.When the diagnostic threshold of HbA1c was 5.25%，the sensitivity was 72.9% and specificity was 66.7%，which was the best threshold of HbA1c.In the observation group，140 patients with HbA1c≥5.25% had a sensitivity of 72.9%，60 patients with FPG>5.1 mmol/L had a sensitivity only of 31.3%，152 patients with HbA1c>5.25% and/or FPG>5.1 mmol/L had a sensitivity of 79.2%.Conclusion：The combined detection of HbA1c and FPG is more beneficial to the early diagnosis of GDM patients and the detection of D-Dimer has no correlation with the early diagnosis of GDM patients.
【Key words】 Glycosylated hemoglobin； Fasting blood glucose； D-Dimer； Gestational diabetes mellitus, http://www.100md.com(邱彩玲 陈祥云 宣春 吴莉莉 苏伟雄)
参见：首页 > 医疗版 > 疾病专题 > 内分泌科 > 糖尿病