糖化血红蛋白在妊娠期糖尿病孕妇中的检测价值

Value of glycosylated hemoglobin in gestational diabetes mellitus screening

目的：研究糖化血红蛋白在妊娠期糖尿病（ GDM）孕妇中的检测价值。方法选取2013年8月至2014年8月在南方医科大学第五附属医院产检或待产的120例孕妇作为研究对象,按照纳入标准进入GDM组60例,采用随机数字表法随机选取正常孕妇60例为对照组,分别检测糖化血红蛋白（HbA1c）、空腹血糖并进行50g葡萄糖筛查试验（GCT）和口服75g葡萄糖耐量试验（OGTT）。使用受试者工作特征（ROC）曲线将 GCT和 HbA1c水平作为 GDM 的筛查指标进行统计学分析。结果GDM组HbA1c和GCT水平均高于正常孕妇组,两组间HbA1c差异有统计学意义（t=19.052,P〈0.001）；两组间GCT差异亦有统计学意义（t=22.631,P〈0.001）。 ROC曲线分析GCT取7.9mmol/L,灵敏度为65.1%～69.2%,特异度61.9%～63.5%；HbA1c取5.8%,灵敏度为85.2%～87.6%,特异度79.4%～80.3%。结论在GDM诊断中,HbA1c敏感性较GCT强,故更适合对GDM筛查。

Objective To explore the clinical value of glycosylated hemoglobin （ HbA1c） in screening gestational diabetes mellitus （ GDM） . Methods From August 2013 to August 2014 totally 120 pregnant women undergoing prenatal examination in Fifth Affiliated Hospital of Southern Medical University were selected in the study. Sixty cases in GDM group recruited according to criteria and another 60 normal pregnant women in control group were studied to detect HbA1c level, GCT and OGTF. ROC curve of GCT and HbA1c was used for statistical analysis of GDM. Results The values of GCT and HbA1c in GDM group were higher than the control group, and the differences were significant （t value was 19. 052 and 22. 631, respectively, both P〈0. 001）. ROC curve analysis showed that when GCT level was 7. 9mmol/L, the sensitivity and specificity were 65. 1% -69. 2% and 61. 9% -63. 5%, respectively, and that when HbA1c value was 5. 8%, the sensitivity and specificity were 85. 2% -87. 6% and 79. 4% -80. 3%, respectively. Conclusion HbA1c is more sensitive than GCT in diagnosis of GDM, and it is more suitable for GDM screening.