口服葡萄糖筛查妊娠糖尿病的界值探讨  

Study for the criteria of screening tests for gestational diabetes mellitus

作　　者：韩红敬[1] 刘向蕊[2] 王山米[1] 

机构地区：[1]北京大学人民医院产科,北京100044 [2]郑州市第五人民医院

出　　处：《中国优生优育（1990-2002上半年）》2002年第2期56-58,共3页Journal of Improving Birth Outcome and Child Development of China

摘　　要：目的 探讨50 g葡萄糖筛查界值及糖筛值在7.2-7.8 mmol/L之间的临床意义。 方法 对北京大学人民医院1999年产科门诊的所有孕妇1 157例进行50 g葡萄糖筛查,血糖值≥7.2 mmol/L者进行75 g葡萄糖耐量试验(OGTT),对诊断妊娠糖尿病(GDM)及妊娠糖耐量损害(GIGT)者进行治疗和管理,登记其临床资料。 结果 24.2%(280/1 157)的孕妇糖筛值≥7.2 mmol/L,其中糖筛值7.2-7.8 mmol/L者84例,72例进行了OGTT试验,11.1%(8/72)诊断为GDM,18.1%(13/72)诊断为GIGT;糖筛界值定于≥7.2 mmol/L,GDM发生率和漏诊断率分别为5.3%(61/1 157)和3.2%(2/63),GIGT发生率和漏诊率分别为3.4%(39/1 157)和0;糖筛界值定于≥7.8 mmol/L,GDM发生率和漏诊率分别为4.9%(53/1 157)和15.9%(10/63),GIGT发生率和漏诊率分别为2.2%(26/1 157)和33.3%(13/39);比较糖筛值为7.2-7.8 mmol/L时OGTT正常组与OGTT异常组的妊娠结局,OGTT正常组巨大儿及手术产率略高,但差异无显著性。 结论 诊断妊娠糖尿病,50 g葡萄糖筛查界值应定在≥7.2 mmol/L为宜,以避免漏诊。Objective To study the clinical significance of 50 g, 1-hour glucose screening test value between 7.2-7.8 mmol/L during pregnancy. Methods A 50 g, 1-hour glucose screening test was given to all pregnant women (1 157 cases) between 24-30 weeks of gestation in 1999. Those women with plasma glucose valuese'7.2 mmol/L were given a 75 gm, 3-hour oral glucose tolerance test. Results 280 of 1 157 cases (24.2 %) were identified as their plasma glucose values e'7.2 mmol/L. 84 cases had 50 g glucose test values between 7. 2-7. 8 mmol/L. 11.1% (8/72) were diagnosed with gestational diabetes mellitus (GDM), 18.1% (13/72) were GIGT. If the thresholds for further testing wase'7. 2 mmol/L of plasma glucose,the prevalence of GDM and missed rate were 5. 3 % (61/1 157), 3.2% (2/63); GIGT 3. 4 % (39/1 157), 0. 1f the thresholds wase'7. 8 mmol/L of plasma glucose, the prevalence of GDM and missed rate was 4. 9 % (53/1 157) , 15. 9 % (10/63); GIGT 2. 2 % (26/1 157), 33. 3 % (13/39).The macrosomia rate and operation delivery rate of those 50 g glucose test value between 7. 2-7. 8 mmol/L while OGTT was normal were higher than those of abnormal, but there were no statistical differences. Conclusion When a 50 g glucose screening test value is e'7. 2 mmol/L, further testing is required.

关 键 词：葡萄糖 妊娠糖尿病 葡萄糖耐量试验 妊娠糖耐量损害 GDM 

分 类 号：R714.25[医药卫生—妇产科学]