合肥滨湖地区22881例妊娠期糖尿病筛查  

Screening of 22 881 Cases of Gestational Diabetes in Binhu District of Hefei

作　　者：李源玲 胡元生 LI Yuan-ling;HU Yuan-sheng(Department of Laboratory medicine,Binhu Hospital of Hefei City,Hefei 230601)

机构地区：[1]合肥市滨湖医院检验科,230601

出　　处：《临床输血与检验》2021年第6期774-778,共5页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的调查合肥滨湖地区妊娠期糖尿病(GDM)的发生率,了解各年龄段不同分型妊娠期糖尿病构成比,并比较OGTT试验中,任意一点血糖异常和任意两点血糖异常诊断GDM的效能差异。方法收集2016年1月~2019年9月在我院产检并符合纳入标准的22881名孕妇,于孕24~28周进行OGTT筛查并分析。比较不同ROC曲线下面积,分析以任意一点血糖异常和任意两点血糖异常诊断GDM的差异。结果依据IADPSD新标准,合肥滨湖地区GDM整体发生率为24.74%,随年龄增加,妊娠期糖尿病发生率显著升高,各组间发生率有统计学差异(P<0.01),≥35岁组,妊娠期糖尿病发生率高达40.05%,发生率最低组为<25岁组,为15.40%。各年龄段不同类型妊娠期糖尿病患者分布不全相同,χ^(2)_(趋势)为142.489,P<0.01,差异具有统计学意义。以任意一点血糖异常诊断妊娠期糖尿病时空腹血糖的AUC大于以任意两点血糖异常诊断时空腹的AUC(Z=5.502,P<0.0001),以任意两点血糖异常诊断妊娠期糖尿病时1 h和2 h的AUC大于以任意一点血糖异常诊断妊娠期糖尿病时的AUC(Z=35.440,31.180,P<0.0001)。结论合肥滨湖地区GDM发生率较高,OGTT试验中,空腹血糖异常合并1 h或2 h异常的敏感性和特异性高于单一1 h或2 h血糖异常时对GDM的诊断,且在高龄(≥35岁)孕妇中,以任意一点血糖异常诊断妊娠期糖尿病时空腹AUC与以任意两点血糖异常诊断时空腹AUC相比同样具有统计学差异(Z=2.064,P=0.039)。Objective To evaluate the incidence of gestational diabetes mellitus(GDM)in Binhu district of Hefei,we investigated the composition ratio within different types of GDM in each groups,and explored the difference of diagnosis of GDM in oral glucose tolerance test(OGTT)at different time points.Methods From January 2016 to September 2019,22881 pregnant women who underwent routine obstetric examination in Binhu Hospital of Hefei were screened,and OGTT test had been performed in their 24~28 weeks of gestation.In order to evaluate the value of abnormal blood glucose at any time point and any two time points for the diagnosis of GDM,the area under the different ROC curves had been compared.Results According to the new IADPSD standard,the overall incidence of GDM in Binhu area of Hefei was 24.74%.With the increasing age,the incidence of GDM increased significantly.There were statistically differences between groups.The incidence of GDM in women aged≥35 years was 40.05%,while the incidence was 15.40%in women aged<25 years.The distribution of patients with different types of GDM in each group obviously different.The area under the curves(AUC)of fasting blood glucose in diagnosis of GDM at any one point was significantly greater than that at any two points(Z=5.502,P<0.0001).The AUC of 1 h(Z=35.44,P<0.0001)and 2 h(Z=31.18,P<0.0001)in diagnosis of GDM at any two points was significantly greater than that any one point.Conclusion the incidence of GDM in Binhu district of Hefei is relatively high.The sensitivity and specificity of abnormal fasting blood glucose combined with 1 h or 2 h better than that of single 1h or 2h abnormal blood glucose.Same as above,among pregnant women aged≥35 years,the AUC of fasting blood glucose in diagnosis of GDM at any one point was also statistically different from that at any two point(Z=2.064,P=0.039)

关 键 词：妊娠期糖尿病 口服葡萄糖耐量试验 ROC曲线 

分 类 号：R714.2[医药卫生—妇产科学]