考普指数用于鉴别糖尿病性巨大儿价值探讨

Application of Kaup Index on identifying macrosomia born to gestational diabetic mothers

目的探讨考普指数作为糖尿病性巨大儿评估标准的必要性。方法 2003年1月至2012年2月间于中国医科大学附属盛京医院住院孕妇分娩的巨大儿598例(糖尿病性巨大儿244例,健康巨大儿354例),回顾性分析其的出生体重(BW)、身高(BL),计算考普指数[Kaup index,KI;KI=BW(kg)/BL(cm)2×104],对两组结果进行t检验。应用ROC曲线获得糖尿病性巨大儿考普指数临界值。结果糖尿病性巨大儿考普指数大于健康巨大儿,糖尿病性巨大儿考普指数和健康巨大儿相比差异有统计学意义(P<0.05),ROC曲线获得糖尿病性巨大儿考普指数临界值为15.07。结论考普指数比出生体重更能反映妊娠期糖尿病产妇能量代谢对胎儿的影响,对鉴别糖尿病性巨大儿可能更具有临床价值。

Objective To evaluate the necessity of making Kaup Index as a criterion to assess diabetic macrosomia, we compare Kaup Index between diabetic macrosomia and normal macrosomia, and ascertain the cutoff value of Kaup Index for diabetic macrosomia. Methods This is a retrospective study of 598 macrosomia （ including 244 diabetic macrosomia and 354 normal maerosomia）. Their birth weight, birth length were collected and Kaup index[ KI = BW（kg）/BL（cm） 2 × 10^4 ] was calculated. Independent samples t test is applied. ROC curve is used to get Kaup Index cutoff value of dia-betic macrosomia. Result Kaup Index of diabetic macrosomia is higher than that of normal macrosomia. There＇s statistic significance of Kanp Index between macrosomia and normal ones （ P 〈 0. 05 ）. According to ROC curve, KI cutoff value is 15.07. Conclusion Kaup index could reflect adverse energy metabolism, compared with birth weight, of pregnant women with gestational diabetic mellitus, which maybe a better way to identify diabetic macrosomia.