IADPSG诊断标准用于妊娠期糖尿病诊断的探讨  

Study of diagnostic criteria for gestational diabetes mellitus

作　　者：芦雅苹[1] 王加[1] 陆琳琳[1] 陈伟萍[1] 李艳芳[1] 

机构地区：[1]江门市中心医院产科,广东江门529000

出　　处：《中国实验诊断学》2012年第6期1041-1043,共3页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨妊娠期糖尿病应用国际糖尿病与妊娠研究组(IADPSG)诊断标准的合理性。方法对50g糖筛查阳性孕妇进行葡萄糖耐量实验,分别根据第7版妇产科教科书及IADPSG诊断标准诊断妊娠期糖尿病并分组,取同期非妊娠期糖尿病孕妇作为对照组,比较各组间妊娠结局。结果教科书诊断标准诊断阳性率9.7%,IADPSG诊断标准诊断阳性率12.3%。,按IADPSG诊断标准属于漏诊组的剖宫产率、子痫前期、羊水过多发生率均高于对照组,新生儿窒息、新生儿低血糖、巨大儿、大于胎龄儿发生率均高于对照组,按IADPSG诊断标准属于过度诊断组,剖宫产率、子痫前期、羊水过多、胎膜早破、早产发生率与对照组比较均无明显差异,巨大儿、大于胎龄儿发生率、新生儿高胆红素血症、新生儿转儿科率与对照组比较亦无明显差异。结论与教科书诊断标准相比,IADPSG诊断标准意味着孕期需要干预的妊娠期糖尿病孕妇增加,其围产期并发症明显增加,在我国采用IADPSG诊断标准是合理的。Objective To study the diagnostic criteria for gestational diabetes mellitus. Methods Pregnant women received 50 g glucose screen test（GST） between 24 to 28 gestational weeks. Positive subjects received a 78 g oral glucose tolerance test（OGTT）. The diagnosis of GDM were according to two diagnostic criteria： Yue Jie and IADPSG （The International Association of Diabetes and Pregnancy Study Groups）. Negative screeners were selected as control group. The outcomes of the mother and the neonate of these groups were compared. Results The incidence of GDM was 9.7% and 12.3% by these two diagnostic criteria. In groups diagnosed by IADPSG criteria but not diagnosed by the other one, the maternal complications including cesarean section, preeclampsia, polyhydramnios and neonatal complications including asphyxia, low blood glucose, macrosomia, large for gestational age were significant differences compared with control group. And in groups not diagnosed by IADPSG criteria but diagnosed by the other one, the maternal complications including cesarean section, preeclampsia, polyhydramnios, preterm ruptured of membrane, preterm birth and neonatal complications including macrosomia , larger for gestational age, hyperbilirubinemia, ICU nursing were no significant differences compared with control group. Conclusion IADPSG criteria which means more perinatal complications could increase the management of GDM. IADPSG criteria is more reasonable in our country.

关 键 词：糖尿病 妊娠 诊断 葡萄糖耐量试验 

分 类 号：R714.25[医药卫生—妇产科学]