糖化血红蛋白与妊娠期糖尿病的关系研究  

Study on the relationship between glycosylated hemoglobin and gestational diabetes mellitus

作　　者：张爱华[1,2] 闫洪领[1,2] 李慧琼[1,2] 陈雄兵[1,2] 朱圣群[1,2] 陈接强[1,2] 

机构地区：[1]三峡大学第三临床医学院 [2]葛洲坝中心医院内分泌科,湖北宜昌443001

出　　处：《海南医学》2015年第21期3152-3154,共3页Hainan Medical Journal

摘　　要：目的探讨糖化血红蛋白(Hb A1c)与妊娠期糖尿病(GDM)的关系。方法选取在我院产检的140例孕妇,根据中华医学会推荐的GDM诊断标准将其分为正常组(n=60)、糖耐量减低(GIGT)组(n=42)和GDM组(n=38),比较不同组别空腹血糖(FPG)、服葡萄糖后1 h血糖(1 h PG)、Hb Alc及胰岛素抵抗指数(HOMA-IR)差异,并比较不同Hb Alc水平与妊娠期母婴并发症的关系。结果 GDM组孕妇的FPG、1 h PG、Hb Alc及HOMA-IR比正常组和GIGT组孕妇的明显升高,差异均有统计学意义(P<0.05);Hb A1c>6%组孕妇早产、胎膜早破、胎儿宫内窘迫发生率明显高于≤6%组孕妇,差异均有统计学意义(P<0.05);Spearman相关性分析显示Hb Alc水平与HOMA-IR呈正相关性(P<0.05)。结论 Hb A1c可作为筛查孕妇GDM、反映血糖水平的可靠指标,其水平与GDM母婴并发症的发生有关,与胰岛素抵抗有正相关性。Objective To investigate the relationship of hemoglobin A1c （HbA1c） with gestational diabetes mellitus （GDM）. Methods One hundred and forty pregnant women were divided into normal group （n=60）, gesta-tional impaired glucose tolerance （GIGT） group （n=42）, GDM group （n=38） according to GDM diagnostic criteria rec-ommended by Chinese Medical Association. The fasting plasma glucose （FPG）, 1-h plasma glucose （1 hPG）, HbAlc and insulin resistance index （HOMA-IR） were compared between different groups. The relationship of HbAlc levels with maternal complications was studied. Results FPG, 1 hPG, HbAlc and HOMA-IR in GDM group were significant-ly higher than those in the normal group and GIGT group （P〈0.05）. The rate of preterm, premature rupture of mem-branes, intrauterine distress in HbA1c〉6%group were significantly higher than HbA1c≤6%group, and the differences were of statistically significance （P〈0.05）. Spearman correlation analysis showed that HbAlc was positively correlated with HOMA-IR （P〈0.05）. Conclusion HbA1c is a reliable indicator in GDM screening and reflecting blood glucose levels, which related with maternal complications of GDM, and is of a positive correlation with insulin resistance.

关 键 词：妊娠期糖尿病 糖化血红蛋白 胰岛素抵抗 

分 类 号：R714.256[医药卫生—妇产科学]