妊娠期糖筛查异常与妊娠期糖尿病的关系

STUDY ON RELATIONS BETWEEN 50 GRAM ORAL GLUCOSE SCREENING TEST AND GESTATIONAL DIABETES MELLITUS

目的 :探讨妊娠期糖筛查异常与妊娠期糖尿病的关系及对母儿的影响。方法 :随机对 190例孕妇行 5 0 g葡萄糖筛查 ,异常者进一步行 75 g葡萄糖耐量试验 (OGTT) ,并随访其妊娠结局。结果 :口服 5 0 g葡萄糖后 1h血糖≥ 7.8m mol/ L 者 74例(38.95 % ) ,进一步行 OGTT试验 ,发现妊娠期糖尿病 (GDM) 10例 ,发生率为 5 .2 6 % ,妊娠期糖耐量降低 (GIGT) 2 4例 ,发生率为 12 .6 3% ,5 0 g葡萄糖筛查阳性率为 45 .94%。有不良孕产史、家族遗传史、孕期体重增长率 >2 5 %的孕妇为高发人群 ,妊高征、羊水过多、巨大儿、新生儿高胆红素血症发生率均明显增高。结论 :妊娠期可发生不同程度的糖耐量降低 ,在妊娠期行糖尿病筛查可以使妊娠期糖尿病得到及早诊断和及时处理 ,尤其是对有高危因素的孕产妇在妊娠晚期更应加强监测。

Objective:To study the relations between 50 gram oral glucose screening test and gestational diabetes mellitus(GDM) and outcome in pregnant women and fetus and newborns. Methods: 50-gram oral glucose challenge test (50g GCT) was performed, as a screening test of gestational diabetes on 190 pregnant women, and further a 75g oral glucose tolerance test (OGTT) was done on those women with glucose level ≥7.8 mmol/L. Results: In those women with glucose level ≥7.8 mmol/L, the results showed that 190 women had a glucose level ≥7.8 mmol/L 74(38.95%), among whom 24(12.63%)were identified as having gestational impaired glucose tolerance(GIGT), and 10(5.26%) had gestational diabetes mellitus(GDM) as diagnosed by 75g OGTT.Perinatal morbidity were higher in GIGT and GDM mothers and there was a positive correlation between glucose level of 50g GCT and the birth weight of newborns. Conclusion:It suggested that 50g GCT may be a preferable screening test for GDM since it is simple and cheap with high sensitivity and specificity.