HbA1c在筛查妊娠糖尿病患者产后糖尿病复发诊断中的意义及对新生儿的影响  

Significance of HbA1c Screening in the Diagnosis of Postpartum Recurrence of Gestational Dia-betes Mellitus and Its Impact on Newborns

作　　者：侯爱琴[1] 王宝兰[1] 李引第 

机构地区：[1]延安大学附属医院产科,陕西延安716000

出　　处：《医学临床研究》2014年第8期1503-1505,共3页Journal of Clinical Research

摘　　要：【目的】探讨糖化血红蛋白（HbA1c）筛查对妊娠糖尿病（GDM）患者产后6个月糖尿病复发的诊断和检出效果及干预治疗对新生儿体质量和血糖的影响。【方法】以231例GDM 患者和240例正常孕妇为研究对象，检测和比较两组产后第6周新生儿体质量、空腹血糖（FBG）、口服葡萄糖耐受试验（OGT T）和HbA1c水平并统计DM 复发率。【结果】FBG、OGT T和HbA1c三项指标GDM 患者产后第6周复发糖尿病检出人数分别为7（3．0％）、8（3．5％）和14（6．1％）；HbA1c≥43 mmol/mol检测的敏感性为100％、特异性为92．6％；HbA1c≥48 mmol/mol检测的敏感性为73．6％、特异性为98．5％；GDM组患者产出新生儿血糖和体重与正常新生儿相比无明显差异（P＞0．05）。【结论】HbA1c≥48 mmol/mol更适合作为GDM 产后糖尿病的早期诊断。[Objective]To explore the efficacy of hemoglobin A 1c（HbA1c） screening in the diagnosis and detection of 6-month-postpartum recurrence of gestational diabetes mellitus （GDM ） and the influence of interventional therapy on body weight and blood glucose of newborns .[Methods] Totally 231 GDM patients and 240 healthy pregnant women were enrolled in the study .Body weight ,fasting blood glucose（FBG） ,oral glucose tolerance test（OGTT） and HbA1 level of newborns at 6 weeks after delivery were measured and compared .The recurrence rate of diabetes mellitus was calculated .[Results] The recurrent case number of GDM patients detected by FBG ,OGTT and HbA1c at 6 weeks after delivery were 7（3% ） ,8（3 .5% ） and 14（6 .1% ） ,respectively .The sensitivity and specificity of HbA1c≥43mmol/mol for the detection of diabetes mellitus were 100% and 92 .6% ,respectively .The sensitivity and specificity of HbA1c≥48mmol/mol for the detection of diabetes mellitus were 73 .6% and 98 .5% ,respectively . There was no significant difference in blood glucose and body weight between newborns of GDM patients and normal newborns（ P〉0 .05） .[Conclusion] HbA1c≥48mmol/mol is more suitable for the early diagnosis of GDM postpartum diabetes mellitus .

关 键 词：糖尿病  妊娠/诊断 血红蛋白A 糖基化 普查 产后期 复发 婴儿  新生 葡糖耐量试验 早期诊断 

分 类 号：R587.1[医药卫生—内分泌]