妊娠期糖尿病3种筛查方法的探讨

Evalution of three screening methods to detect diabetes in gestational women

目的:对孕妇糖尿病3种筛查方法进行对比分析,以简化传统的筛查方法,使之更加适应孕妇普查需要。方法:对孕妇作空腹静脉血糖、末梢血糖、血清糖化蛋白测定,并作50 g OGTT测静脉及末梢血糖。阳性者再作75 g OGTT。统计资料时将75 g OGTT异常及GDM者列为异常组,其他为正常组,两者进行对比分析。结果:筛查206例,50 g OGTT异常者30例,75 g OGTT异常者13例(GDM 2例占0.97%,G IGT 11例占5.39%),孕妇空腹时末梢血糖高于静脉血糖,服糖后无此现象。血清糖化蛋白检测GDM敏感度为92.31%,有61.65%孕妇在正常值之下。50 g OGTT静脉血糖异常者67例(37.72%),末梢血糖异常者153例(79.21%)。结论:测定孕妇血清糖化蛋白可作为孕妇糖尿病的初筛。更加适宜筛查的需要。异常者再作50 g OGTT比做50 g末梢血糖筛查更经济、合理,若阳性再做75 g OGTT以确诊。

Objective： To compare the efficacy of three screening methods to detect diabetes in gestational women and to popularize the effective diabetic screening methods in pregnancies so as to simplify the traditional screening methods. Methods： Fasting vein plasma glucose, peripheral plasma glucose and serum glucoprotein were measured in pregnancies. Vein and peripheral plasma glucose were measured again after 50 g oral glucose tolerance test （OGTT） and then did 75 g OGTT in the imparirod pregnancies. The results were compared in the normal and the impaired （including impaired 75 g OGTT and gestational diabetic mellitus （GDM） groups. Results： Among total 206 subjects were 30 for impaired 50 g OGTT and 13 for impaired 75 g OGTT （2 subjects GDM 0.97%, 11 subjects GIGT 5.39%）. The fasting vein plasma glucose level was higher than that of peripheral one, but they were equal after eating glucose. When detecting GDM, the sensitivity of using serum glucoprotein was 92.31%, 61.65% of subjects were under the normal level. There were 67 subjects （37.72%） with impaired vein plasma glucose and 153 subjects （79.21%） with impaired peripheral one in 50 g OGTT. Conclusion： Measuring serum glucoprotein can be served as the effective primary screening method for GDM women. It is more economical and reasonable for the impaired subjects to do 50 g OGTT than measuring 50 g peripheral glueose. After doing 75 g OGTT in the impaired 50 g OGTT subjects, GDM may be identified.