OGTT和糖化血红蛋白检测在妊娠期糖尿病筛查的应用价值对比分析

Comparison of different OGTT and HbA1c examination in gestational diabetes screening

目的探讨OGTT和糖化血红蛋白检测在筛查妊娠期糖尿病中的一次检测成功率以及筛检阳性率等。方法将研究对象进行分组,一组为妊娠期糖耐量正常(GNGT)组(300例),另一组为妊娠期糖尿病(GDM)组(60例);比较受试患者进行OGTT和HbA1c水平检测,收集两组受试者相关检测结果信息,讨论不同的检测方法对于筛查妊娠糖尿病的效力。结果本研究中OGTT检测GDM的一次检测成功率为16.67%,低于OGTT检测GNGT(24.33%);血红蛋白水平检测用于筛检GDM的一次检测成功率为86.67%,检测GNGT为84.33%,无明显差别;OGTT联合血红蛋白检测对于GDM的一次检测成功率为95.00%,对于GNGT为93.33%,也无明显差别。纵向联合检测分别与其它两种检测方法比较,OGTT联合血红蛋白检测的方法对于筛检GDM和排除GNGT一次检测成功率均显著高于其他两种方法。OGTT检测GDM的总筛查阳性率为20.00%,血红蛋白检测方式的总筛查阳性率为93.33%,而OGTT联合血红蛋白检测筛查阳性率最高,为96.67%;三种方法用于GNGT的筛查排除,阳性率分别为25.56%,95.67%和99.00%,也以OGTT联合血红蛋白检测方法的阳性率最高。且其中OGTT检测方法对于GNGT的检测更为敏感,阳性率高于对GMD的筛检阳性率。结论 Hb Alc(%)测定在是GDM筛查中的功用不容忽视,特别是与其他方法联合检测,一次检测成功率高,灵敏度和特异度也好,是快速准确简便的筛查方法,值得临床推广使用。

Objective To investigate the success rate by OGTT and HbA1c in the screening of gestational diabetes mellitus.Methods The subjects were divided into two groups： normal glucose tolerance group（n= 300） and gestational diabetes mellitus（GDM） group（n = 60）.OGTT HbA1c levels were compared,the information of related test results of two groups of subjects were collected to discuss the effectiveness of different detection methods for the screening of gestational diabetes mellitus,and discussed the effectiveness of different screening methods in screening for gestational diabetes mellitus.Results The success rate of GDM was 16.67% in OGTT and 24.33% in OGTT.The success rate of detection of GGDM was 86.67%,the detection rate of GNGT was 84.33% with no statistical difference; as used OGTT combined with hemoglobin for the detection of GDM,the success rate was 95.00%,93.33% for the GNGT,with no significant difference.Compared the three detection methods,OGTT combined with hemoglobin detection method for screening GDM and exclusion of GNGT obtained a success rate of significantly higher than the other two.The total screening positive rate of OGTT was 20.00%,the total screening positive rate of hemoglobin was 93.33%,while that of OGTT combined with hemoglobin detection was 96.67%.Three positive rates for screening of GNGT were 25.56%,95.67% and 99.00%,respectively.The positive rate of OGTT combined with hemoglobin test was also showed to be the highest.OGTT detection method for the detection of GNGT is more sensitive,with the positive rate a little higher.Conclusions HbA1c（%） determination is a useful method in the screening of GDM,especially in combination with other methods.The detection rate of HbA1c（%） is high.It is a quick,accurate and simple screening method and suggest for wider clinical screening.