妊娠糖尿病患者糖化血红蛋白监测的临床意义

Analysis of the clinical significance of glycated hemoglobin,glycated serum protein detection in patients with gestational diabetes mellitus

目的研究糖化血红蛋白(HbA1c)及糖化血清蛋白(GSP)对妊娠糖尿病(GDM)的早期诊断价值,探讨对妊娠糖尿病患者进行糖化血红蛋白监测的临床意义。方法 163例妊娠糖尿病患者设为GDM组,57例健康孕妇为对照组,比较空腹血糖(FPG)、HbA1c及GSP对妊娠糖尿病的诊断价值,并对妊娠糖尿病组不同HbA1c控制水平的妊娠并发症进行比较。结果空腹血糖、糖化血红蛋、糖化血清蛋白血清水平及异常率在两组均有统计学差异(P<0.05);以OGTT为GDM的诊断标准FPG、HbA1c对GDM诊断方法学评价,灵敏度、正确诊断指数及符合率以GSP、HbA1c较好;HbA1c≥6.0%组GDM患者妊高症、羊水过多、新生儿窒息、新生儿低血糖、新生儿黄疸发生率均高于HbA1c<6.0%组,差异有统计学意义(P<0.05)。结论 GSP、HbA1c对妊娠糖尿病的早期诊断有重要的临床应用价值,对妊娠糖尿病患者HbA1c监测有重要的临床意义。

Objective To study the glycosylated hemoglobin （HbA1c） and glycosylated serum protein （GSP） on gestational diabetes mellitus （GDM） in early diagnosis and discuss the clinical significance of glycated hemoglobin monitoring of patients with gestational diabetes mellitus.Methods 163 patients with gestational diabetes mellitus were group GDM and 57 healthy pregnant women were control group.The fasting blood glucose （FPG）,HbA1c and GSP in diagnosis of gestational diabetes mellitus,and the complications of pregnancy in gestational diabetes mellitus were observed.Results The fasting blood glucose,glycosylated hemoglobin,serum levels of glycosylated serum protein and abnormal rate in the two groups were statistically different （P〈0.05）.According to OGTT,the sensitivity,and correct diagnosis index and the coincidence rate with GSP and HbA1c was good.The incidences of neonatal jaundic hypertension,polyhydramnios,neonatal asphyxia and neonatal hypoglycemia of HbA1c ≥ 6% group were higher than those in HbA1c〈6.0% group （P〈0.05）.Conclusion GSP,HbA1c on gestational diabetes early diagnosis has important clinical application value.