妊娠期糖代谢异常患者糖化血红蛋白检测的临床价值

目的探讨妊娠期糖尿病患者糖化血红蛋白(glycosylatedhemoglobinAlc,HbAlc)检测的临床意义。方法对正常妊娠组318例、妊娠期糖耐量异常组69例及妊娠期糖尿病组105例分别进行空腹血糖(FPG)、口服葡萄糖耐量实验(OGCT)和HbAlc测定,通过ROC曲线评价FPG、OGCT和HbAlc在GDM筛查中的应用价值;并根据HbAlc水平高低分组进行并发症的统计及相关性分析。结果 FPG、OGCT和HbAlc诊断GDMROC曲线下面积(AUC%)分别为84%、92%和91%,HbAlc在GDM筛查中的诊断效率明显高于FPG;相对于OGCT而言,HbAlc的敏感性较高且具有测定快速、简便、准确、取血量少,不易受其它因素的影响的优点。并且妊娠期糖代谢异常患者的并发症随HbAlc的增高而增多。结论 HbAlc在妊娠期糖代谢异常的筛查诊断及并发症的监测方面有一定的意义。

Objective To investigate the clinical value of glycosylated hemoglobin（HbAlc）in gestational diabetesmellitus.Methods The fasting blood sugar,75g glucose tolerance test and HbA1c were measured in 318 cases with normal gestation women,60 with impaired glucose tolerance and 105 with gestational diabetesmellitus.The evaluation of significance of FPG,OGCT and HbAlc in GDM Screening were evaluated using the receiver-operating characteristic（ROC）curves.All subjects were divided into some groups according to the levels of HbA1c,to investigate the relationship between the complication and the levels of HbAlc.Results The area under the curve（AUC）of FPG,OGCT and HbAlc are 84%,92% and 91% respectively.The incidence of complication of gestational diabetesmellitus group increased when the level of HbA1c was high.Conculsion The determination of HbAlc is important in the screening,diagnosing and assessing the prognoses of the gestational diabetesmellitus and complication of gestational diabetesmellitus