糖化血红蛋白在妊娠糖尿病诊断中的作用

Glycosylated Hemoglobin Test in Diagnosis of Gestational Diabetes Mellitus

目的:探讨糖化血红蛋白(HbAlc)在妊娠糖尿病(GDM)诊断中的作用。方法:120例GDM患者分为正常妊娠组、糖耐量异常组及GDM组,各40例,采用全自动生化仪进行空腹血糖(FPG)、口服50g葡萄糖筛查试验(GCT)、糖化血红蛋白(HbAlc)测定。结果:正常妊娠组和糖耐量异常组FPG及GCT差异无统计学意义(P>0.05),与糖耐量异常组比,GDM组FPG、GCT、HbAlc明显增高,差异有显著性(P<0.01);HbAlc阳性率在正常妊娠组、糖耐量异常组和GDM组中分别为2.5%、25%和80%,差异有统计学意义(P<0.05)。HbAlc在GDM诊断中的敏感性、特异性、可靠性、阳性预测分别为80%、95%、90%、95%。结论:HbAlc用于诊断和监测妊娠糖尿病,具有较好的敏感性和特异性,且快速、简便、实用、取血量少,建议临床进一步推广。

Objective： To explore the diagnostic value of glycosylated hemoglobin test in gestational diabetes mellitus. Methods： One hundred and twenty patients with GDM were divided into normal pregnancy women group, impaired glucose tolerance group and gestational diabetes mellitus group, each with forty patients. The fasting blood sugar, oral glucose 50 g screen and HbAlc were measured by automated biochemical instrument. Results： There was no difference in the levels of FPG group GCT between normal pregnancy group and impaired glucose tolerance group （P〉0.05）. Compared with those in impaired glucose tolerance group, the levels of FPG, GCT, HbAlc in GDM group were significantly increased with significant difference （P〈0.01）. The positive rate of HbAlc in normal pregnancy women group, impaired glucose tolerance group and gestational diabetes mellitus group were 2.5%, 25% and 80%, respectively, which were significantly different （P〈0.05）. The screening sensitivity, specificity, reliability, positive prediction of HbAlc was 80%, 95%, 90%, 95%, respectively. Conclusions： The HbAlc test is effective in diagnosis and monitoring of gestational diabetes mellitus, which is rapid, simple, practical, little sample of less blood, less susceptible to other factors.