糖化血清清蛋白和血糖联合检测在妊娠糖尿病筛查中的应用

Combined detection of glycated albumin and blood glucose in screening of gestational diabetes mellitus

目的 分析糖化血清清蛋白（GA）和血糖联合检测在妊娠糖尿病（GDM）筛查中的应用价值.方法 筛选孕期为24～28周的孕妇行孕期检查,其中GDM 124例和正常妊娠对照组86例,空腹采血检测GA和空腹血糖（FBG）,然后口服759无水葡萄糖,观察GA和不同时间血糖水平对GDM筛查的应用价值.结果 GDM组的GA、FBG、餐后1、2、3h血糖结果与正常妊娠对照组比较,差异均有统计学意义（P＜0.05或0.01）;在诊断GDM的各项指标中,GA的灵敏度、特异度、总符合率及阳性预测值分别是86.50％、93.20％、91.32％、92.60％,在诊断GDM中较为理想;其次是餐后1h血糖,其灵敏度、特异度、总符合率及阳性预测值分别是79.34％、79.34％、85.70％、83.70％;如果GA合并FBG同时检测,其灵敏度、特异度、总符合率及阳性预测值分别是94.30％、86.27％、93.51％、94.60％.结论 FBG和GA联合检测,可以提高GDM的诊断率.

Objective To evaluate the application of combined detection of glycated albumin （GA） and blood glucose in screening of gestational diabetes mellitus （GDM）. Methods One hundred and twenty four pregnant women of 24-28 week gestation with GMD and 86 normal pregnant women were enrolled in the study. The fasting blood glucose （FBG） and GA were determined, then the blood glucose levels were measured at 1, 2 and 3h after intake of 75g glucose. Results There were significant differences in GA, FBG and blood glucose at 1, 2, 3h after glucose intake between GMD pregnant women and controls （P〈 0.05 or 0.01 ）. The sensitivity, specificity, accuracy and positive predictive value of GA in screening of GDM were 86.50%, 93.20%, 91.32% and 92.60%, respectively; and those of blood sugar lh after glucose intake were 79.34%, 79.34%, 85.70% and 83.70%, respectively. The sensitivity, specificity, accuracy rate and positive predictive value of the combination of GA with FBG were 94.30%, 86.27%, 93.51% and 94.60%, respectively. Conclusion Glucose tolerance testing combined with GA measurement improves the effectiveness in screening of GDM.