孕早期与孕中期糖化血红蛋白检测在妊娠期糖尿病中的应用价值  

Value of First and Second Trimester HbA_(1)c in Gestational Diabetes Mellitus

作　　者：陈曦妍 罗立权[1] 付宽[1] CHEN Xiyan;LUO Liquan;FU Kuan(Department of Clinical Laboratory,Leshan Shizhong District People's Hospital,Leshan 614000,China)

机构地区：[1]乐山市市中区人民医院医学检验科,四川乐山614000

出　　处：《中国医药指南》2023年第27期105-108,共4页Guide of China Medicine

基　　金：乐山市科技计划重点研究项目(20ZDYJ0060)。

摘　　要：目的研究孕早期与孕中期糖化血红蛋白(HbA_(1)c)检测在妊娠期糖尿病(GDM)中的应用价值。方法前瞻性纳入2021年4月至2022年3月我院检查的孕早期孕妇,孕早期与孕中期均行HbA_(1)c检测,根据孕中期75 g口服葡萄糖耐量试验(OGTT)结果将其分为GDM组与非GDM组。分析两组孕妇基本情况及孕早期、孕中期HbA_(1)c水平。结果研究共纳入66例孕妇,GDM组25例,非GDM组41例。GDM组年龄高于非GDM组,经产妇较非GDM组多,差异具有统计学意义(P<0.05)。两组在孕次、孕前体质量指数(BMI)、孕早期及中期血红蛋白(Hb)含量方面比较,差异无统计学意义(P>0.05)。GDM组与非GDM组比较,孕早期及孕中期HbA_(1)c水平差异无统计学意义(P>0.05)。GDM组孕早期与孕中期HbA_(1)c水平比较,差异无统计学意义(P>0.05)。非GDM组孕早期HbA_(1)c水平高于孕中期,差异具有统计学意义(P<0.05)。孕早期和孕中期HbA_(1)c水平差值在GDM组与非GDM组间比较,差异无统计学意义(P>0.05)。结论仅孕早期或孕中期HbA_(1)c水平无法独立预测或诊断GDM,孕中期HbA_(1)c水平较孕早期HbA_(1)c水平降低可能有效排除GDM,但尚需要更进一步的研究。Objective To explore the value of First and Second Trimester HbA_(1)c in gestational diabetes mellitus(GDM).Methods From April 2021 to March 2022,pregnant women in the first trimester examined in our hospital.They had HbA_(1)c tests in both first and second trimester.They were divided into GDM group and non GDM group according to the results of 75 g oral glucose tolerance test(OGTT)in the second trimester of pregnancy.The basic data and HbA_(1)c levels of the two groups were analyzed.Results A total of 66 pregnant women were included in the study,including 25 cases in GDM group and 41 cases in non GDM group.The age of GDM group was higher than that of non GDM group,and the number of multiparous women was more than that of non GDM group,the difference was statistically significant(P<0.05).There was no significant difference between the two groups in terms of gravidity,BMI before pregnancy,hemoglobin level in the first and second trimester of pregnancy(P>0.05).There was no significant difference in HbA_(1)c levels between GDM group and non GDM group in the first and second trimester of pregnancy(P>0.05).There was no significant difference in HbA_(1)c levels between the first and second trimester of pregnancy in GDM group(P>0.05).The HbA_(1)c level in the non GDM group in the first trimester of pregnancy was higher than that in the second trimester of pregnancy,and the difference was statistically significant(P<0.05).There was no significant difference in the difference of the first and second trimester HbA_(1)c levels between GDM group and non GDM group(P>0.05).Conclusion HbA_(1)c in the first or second trimester of pregnancy can not be used as evidence for independent prediction or diagnosis of GDM,but the decrease of HbA_(1)c level in the second trimester of pregnancy compared with that in the first trimester of pregnancy may have the effect of excluding GDM,and further research is needed in the future.

关 键 词：糖化血红蛋白 妊娠期糖尿病 孕早期 孕中期 

分 类 号：R714.25[医药卫生—妇产科学]