75g葡萄糖耐量试验四时点检测与三时点检测的临床意义  

The Clinical Significance of Four-piont and Three-point 75g Glucose Tolerance Test

作　　者：彭其才[1] 范建辉[1] 侯红瑛[1] 滕奔琦[1] 

机构地区：[1]中山大学附属第三医院产科,广东广州510630

出　　处：《中国现代医生》2010年第20期159-160,共2页China Modern Doctor

摘　　要：目的探讨75g葡萄糖耐量试验三时点检测对诊断妊娠期糖尿病的意义。方法选择2009年1～10月在我院常规产检并行50g葡萄糖筛查(50gGCT)的孕妇682例,对筛查结果阳性者219例再行四时点75g葡萄糖耐量试验(75g OGTT),并将四时点数据截取为三时点再对比分析。结果四时点75g OGTT诊断GDM31例,发病率4.5%(31/682),诊断GIGT47例,发病率6.9%(47/682)。三时点75g OGTT诊断GDM22例,发病率3.2%(22/682),诊断GIGT39例,发病率5.7%(39/682)。三时点75g OGTT漏诊GDM9例,漏诊率高达29%(9/31),漏诊GIGT17例,漏诊率高达6.2%(17/47)。结论三时点75g OGTT检测诊断GDM和GIGT漏诊率高,不宜作为诊断妊娠期糖尿病常规检测,因此临床建议诊断妊娠期糖代谢异常应以四时点75g OGTT作为常规检测。Objective To study the clinical significance of four-piont and three-point 75 g glucose tolerance test in the diagnosis of gestational diabetes. Methods From January 2009 to October 2009 in our hospital prenatal check and routinely 50 g GCT of 682 cases of pregnant women, 219 cases of positive screening results further four-point 75 g oral glucose tolerance test. Cut-off the four-point OGTT data and become the three-point OGTT data, and then analyze the data of the two groups. Results Four-point 75g OGTT diagnosis GDM 31 cases,the incidence rate 4.5%（31/682）,diagnosis GIGT 47 cases,the incidence rate 6.9%（47/682）. Three-point 75g OGTT diagnosis GDM 22 cases, the incidence rate 3.2% （22/682）, diagnosis GIGT 39 cases, the incidence rate 5.7% （39/682）. Three-point 75g OGTT missed GDM 9 cases, misdiagnosis rate as high as 29% （9/31）, missed GIGT 17 cases and missed diagnosis rate 36.2%（17/47）. Conclusion Three Points 75g OGTT missed diagnosis of GDM and GIGT high, not as a routine diagnostic detection of gestational diabetes mellituso During pregnancy,only four-points 75g OGTT should be routine testing of diagnosis abnormal glucose metabolism.

关 键 词：葡萄糖筛查 糖耐量试验 妊娠期糖尿病 糖耐量减低 

分 类 号：R587.1[医药卫生—内分泌]