自动化测定血清指标对妊娠糖尿病诊断的临床价值分析  

Clinical value of automatic detection of serum HbA1c,GSP and hs CRP in the diagnosis of gestational diabetes mellitus

作　　者：宋辉 何攀[1] 高守曦[1] 朱晓艳[1] 颜源[1] Song Hui;He Pan;Gao Shouxi;Zhu Xiaoyan;Yan Yuan(The Laboratory Medicine of Sichuan provincial maternity and child health care hospital,Sichuan,610045,China)

机构地区：[1]四川省妇幼保健院检验科,四川610045

出　　处：《现代科学仪器》2021年第3期152-155,共4页Modern Scientific Instruments

摘　　要：目的:探究糖化血红蛋白(HbA1c)、糖化血清蛋白(GSP)和超敏C反应蛋白(hs-CRP)的表达水平,在妊娠期糖尿病(GDM)的诊断及其与妊娠结局方面的临床应用价值。方法:选取本院在2019年1月~12月确诊并接受治疗的77例单胎GDM孕妇(实验组),以及75例同期在本院做产前检查健康单胎孕妇(对照组)作为研究对象。检测两组孕妇HbA1c、GSP、hs-CRP和空腹血糖(FPG)指标,分析两组孕妇HbA1c、GSP、hs-CRP和FPG表达水平差异以及对母婴妊娠结局的影响,采用受试者工作特征曲线(ROC)及曲线下面积(AUC)评价上述三指标表达水平及联合应用对GDM的诊断效能。结果:GDM组孕妇检测HbA1c、GSP、hs-CRP和FPG表达水平高于对照组,组间比较差异有统计学意义P<0.05)。GDM组孕妇发生妊高症、剖宫产、胎膜早破、巨大儿、早产等并发症的发生率明显高于对照组,比较差异有统计学意义(p<0.05)。HbA1C联合GSP、hs-CRP应用对GDM诊断的AUC为0.913、敏感性为90.91%、阳性预测值为81.40%,均高于三项指标单独应用。结论:HbA1c、GSP和hs-CRP可作为诊断GDM及评估妊娠结局的主要指标,其表达水平改变与不良妊娠结局密切相关,三指标联检可提高GDM诊断敏感度,在GMD的病情诊断、评估妊娠结局等方面有较高的临床应用价值。objective:To explore the expression levels of glycosylated hemoglobin(HbA1c),glycosylated serum protein(GSP)and hypersensitive C reactive protein(hs-CRP)in the diagnosis of gestational diabetes mellitus(gestational diabetes)and its clinical application with pregnancy outcome.Methods:Select in January~December 2019 Choose our hospital and treated to be diagnosed 77 single GDM pregnant women(experimental group),and 75 healthy single pregnant women(control group)who were examined in our hospital at the same time.To test the HbA1c、GSP、hs-CRP and Fasting Plasma glucose(FPG)indexes of pregnant women in the two groups,to analyze the difference of HbA1c、GSP、hs-CRP and FPG expression levels between the two groups and the effect on the outcome of maternal and infant pregnancy,The working characteristic curve(ROC)and the area under the curve(AUC)were used to evaluate the expression level of the above three indexes and the diagnostic efficacy of the combined application on the GDM.Results:The HbA1c、GSP、hs-CRP and FPG expression levels of pregnant women in GDM group were higher than those in the control group,Differences between groups were statistically significant(P<0.05).GDM group of pregnant women with pregnancy induced hypertension,cesarean section,premature rupture of membranes,macrosomia,premature delivery and other complications were significantly higher than the control group,Differences between groups were statistically significant(P<0.05).GDM diagnosis HbA1C combined GSP、hs-CRP application AUC was 0.913,sensitivity was 90.91%,positive predictive value was 81.40%,All above three indexes were applied separately.Conclusion:HbA1c,GSP and hs-CRP can be used as the main indicators for the diagnosis of GDM and the evaluation of pregnancy outcome,and the changes in their expression levels are closely related to adverse pregnancy outcome.Combined examination of the three indicators can improve the diagnostic sensitivity of GDM,and has a high clinical application value in the diagnosis of GMD and the evaluation

关 键 词：妊娠期糖尿病 糖化血红蛋白 糖化血清蛋白 超敏C反应蛋白 

分 类 号：R71[医药卫生—妇产科学]