妊娠期糖尿病患者临床诊断时应用血脂及糖耐量试验等生化检验的价值分析  

The Value Analysis of the Application of Biochemical Tests Such as Blood Lipid and Glucose Tolerance Test in the Clinical Diagnosis of Gestational Diabetes

作　　者：陈庆 吴志辉[1] 马梅[1] CHEN Qing;WU Zhihui;MA Mei(Fujian Provincial Maternity and Child Health Hospital,Fuzhou,Fujian Province,350001 China)

机构地区：[1]福建省妇幼保健院,福建福州350001

出　　处：《糖尿病新世界》2021年第21期57-60,共4页Diabetes New World Magazine

摘　　要：目的探讨在妊娠期糖尿病(GDM)患者临床诊断时应用血脂和糖耐量试验等生化指标的临床价值。方法选取2020年1—12月于该院建档产检的266例孕妇为研究对象,按照糖耐量试验结果将其分为GDM组(研究组)和正常孕妇组(对照组),两组病例数分别为136例和130名,依次检测所有受检者的血脂水平,对比两组受检者检测结果,分析GDM发生的危险因素;另外记录两组受检者的妊娠结局,以OGTT为诊断标准,比较血脂指标诊断与OGTT诊断结果之间的一致性。结果研究组三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、口服葡萄糖耐量试验(OGTT)0、1、2 h后结果均高于对照组,差异有统计学意义(P<0.05),并且经Logistic回归方程分析显示,TG、TC及LDL-C均是GDM发生的危险因素。研究组巨大儿发生率为14.71%、早产儿发生率为20.59%、胎膜早破发生率为11.76%、胎儿窘迫发生率为8.82%和新生儿黄疸发生率为17.65%均高于对照组的1.54%、3.08%、1.54%、0.00%和4.62%,差异有统计学意义(P<0.05)。OGTT试验诊断阳性率为51.13%、阴性率为48.87%;血脂指标诊断阳性率为50.38%、阴性率为49.62%,两组对比Kappa=0.970,一致性良好。结论血脂对GDM的临床诊断具有重要意义,与OGTT诊断GDM的一致性较高,可以为改善GDM患者的分娩结局提高可靠的参考依据,具有较高的临床应用价值。Objective To explore the clinical value of using blood lipids and glucose tolerance test in the clinical diagnosis of patients with gestational diabetes mellitus(GDM). Methods The 266 pregnant women who were filed in the hospital from January to December 2020 were selected as the research objects. According to the results of the glucose tolerance test, they were divided into GDM group(research group) and normal pregnant women group(control group). The number of cases in the two groups was 136 and 130, study. Detected the blood lipid levels of all subjects in turn, compared the test results of the two groups of subjects, and analyzed the risk factors of GDM. In addition, the pregnancy outcomes of the two groups of subjects were recorded, and OGTT was used as the diagnostic standard to compare the consistency between the diagnosis of blood lipid indexes and the diagnosis of OGTT. Results The results of triacylglycerol(TG), total cholesterol(TC), low-density lipoprotein(LDL-C) and oral glucose tolerance test(OGTT) at 0, 1 and 2 h in the study group were higher than those in the control group. The difference was statistically significant(P<0.05). Logistic regression equation analysis showed that TG, TC and LDL-C were risk factors for the occurrence of GDM. The incidence of macrosomia 14.71%, prematurity20.59%, premature rupture of membranes 11.76%, fetal distress 8.82% and neonatal jaundice 17.65% in study group were higher than those in control group 1.54%, 3.08%, 1.54%, 0.00% and 4.62%. The difference was statistically significant(P<0.05). The positive rate and negative rate of OGTT test were 51.13% and 48.87% respectively. The positive rate of blood lipid index was 50.38% and the negative rate was 49.62%. The Kappa of the two groups was 0.970, indicating good consistency. Conclusion Blood lipids are of great significance to the clinical diagnosis of GDM. It has a high consistency with OGTT in the diagnosis of GDM. It can provide a reliable reference for improving the delivery outcome of GDM patients and has high c

关 键 词：妊娠期糖尿病 血脂 糖尿量试验 妊娠结局 一致性 

分 类 号：R587.1[医药卫生—内分泌]