糖化血红蛋白在妊娠期糖尿病筛查中的价值

The value of HbA1c in the screening of gestational diabetes mellitus

目的探讨糖化血红蛋白（HbA1c）在妊娠期糖尿病（GDM）诊断中的价值。方法选取2014年1-11月在铜陵市妇幼保健院产前门诊做常规产前检查的孕妇411例,于孕24-28周进行口服葡萄糖耐量试验（OGTT）,同时测定HbA1c。根据OGTT结果将孕妇分成3组,即GDM组、糖耐量异常组和糖耐量正常组,比较3组之间OGTT结果及HbA1c水平,评估HbA1c在GDM筛选中的价值。结果 GDM组空腹血糖,餐后1h、餐后2h血糖和HbA1c水平均高于其他两组,差异有统计学意义（P〈0.05）。受试者工作特征曲线显示,HbA1c最佳诊断临界值为5.75%,此时灵敏度、特异度、阳性预测值、阴性预测值分别为83.4%、74.8%、67.7%、89.2%。结论 HbA1c在GDM筛查中有重要临床价值,可以降低GDM漏诊率。

Objective To investigate the diagnosis value of HbA1 cfor gestational diabetes mellitus（GDM）.Methods 411 pregnant women were recruited in the antenatal clinic of Tongling Maternal and Child Health Care Centre from January 2014 to November 2014.OGTT was processed during 24 to 28weeks of gestation,and HbA1 c was detected at the same time.According to the OGTT results,the pregnant women were divided into 3groups：GDM group,impaired glucose tolerance group and normal glucose tolerance group.To compare the differences of OGTT results and HbA1 clevels among 3groups,and to assess the value of HbA1 cin the screening of GDM.ResultsThe levels of fasting plasma glucose（FPG）,1hplasma glucose,2hplasma glucose and HbA1 cin GDM group were higher than the other two groups,and the differences were statistically significant（P〈0.05）.ROC curve showed that the optimal diagnostic cut off value of HbA1 cwas 5.75%,the sensitivity,specificity,positive predictive value and negative predictive value were 83.4%,74.8%,67.7%,and 89.2%,respectively.Conclusion HbA1 chas important clinical value in the screening of GDM,which can reduce the rate of missed diagnosis.