妊娠期妇女HbA1c水平测定及其在妊娠期糖尿病的早期筛查及诊断应用  

HbA1c level detection in normal pregnant women and its application in early screening and diagnosis of gestational diabetes mellitus

作　　者：王泓[1] 王霞[1] 崔亚利[1] 戴维[1] 李莹莹[1] 蒋冬梅[1] 张晓东[1] 刘剑龙 

机构地区：[1]四川大学华西第二医院检验科,成都610041

出　　处：《重庆医学》2016年第13期1770-1772,共3页Chongqing medicine

基　　金：四川省卫生厅课题资助项目(120262)

摘　　要：目的检测正常妊娠期妇女早、中、晚期糖化血红蛋白(HbA1c)水平,评价HbA1c在妊娠期糖尿病早期筛查诊断中的应用。方法用BIO-RAID D-10HbA1c分析仪测定正常妊娠期妇女、妊娠期糖尿病患者、非妊娠健康妇女HbA1c水平,西门子ADVIA 2400全自动生化分析仪测定空腹血糖(FPG)及口服75g葡萄糖后1、2h血糖水平用以诊断妊娠期糖尿病。结果正常妊娠期妇女早、中、晚期HbA1c分别为(5.21±0.35)%、(5.18±0.39)%、(5.53±0.34)%。早、中孕组HbA1c水平比较差异无统计学意义(P>0.05),晚孕组HbA1c明显高于早、中孕组(P<0.01),但与非妊娠健康对照组妇女HbA1c(5.47±0.32)%比较,差异无统计学意义(P>0.05);以HbA1c5.60%作为高危孕妇早期筛查的有效切点,其敏感性为96.90%,特异性为58.14%。结论妊娠早期即开展HbA1c测定可在早期有效发现妊娠妇女糖耐量受损,对妊娠期糖尿病提前诊断、治疗监测及预防母婴并发症的发生均具重要临床意义。Objective The detect the HbAlc level in early,middle and late pregnant normal women and to evaluate its application in early screening and diagnosis of gestational diabetes mellitus（GDM）. Methods The HbAlc level was determined by using the BIO-RAID D-10 glycosylated hemoglobin analyzer,and the Siemens ADVIA 2400 automatic biochemical analyzer was used to determine the fasting blood glucose （FPG） level and the glucose levels at 1,2 h after oral 75 g glucose for diagnosing GDM. Results The HbAlc levels in the early,middle and late normal pregnant women were （5.21 ± 0.35） %, （5.18 ± 0.39） % and （5.53 ± 0.34）% respectively, the difference between the early pregnancy group and the middle pregnancy group was not statistically signifi- cant （P〉0. 05） ,but the HbAlc level in the late pregnancy group was significantly higher than that in the middle pregnancy group, and the difference between them was statistical significance（P〈0. 01）, but compared with the non-pregnancy healthy control women, the difference had no statistical significance （P〉0.05） ;with HbAlc 5.60 % as the effective cut-point for early screening of high risk pregnant women,its sensitivity was 96.90% and the specificity was 58.14%. Conclusion Conducting the HbAlc detec- tion in early pregnancy can effectively find the glucose tolerance impairment in pregnancy women and has an important clinical application significance in early diagnosis of GDM,its treatment and monitoring,and prevention of maternal and child complications.

关 键 词：血红蛋白A 糖基化 葡糖耐量试验 糖尿病 妊娠 

分 类 号：R714.256[医药卫生—妇产科学]