早孕期HbA1c检测在诊断妊娠期糖尿病中的价值

The value of HbA1c in the diagnosis of gestational diabetes during early pregnancy

目的探讨早孕期糖化血红蛋白(Hb A1c)在诊断妊娠糖尿病中的价值。方法选取2015年6月～2017年10月于我院妇产科进行孕检的孕妇,其中明确诊断妊娠期糖尿病的98例孕妇作为实验组,同期进行正常孕检的100例孕妇作为对照组。两组患者均行空腹血糖(FPG)、糖耐量试验(OGTT)2 h血糖以及Hb A1c检测。分析两组孕妇FPG、2 h血糖及Hb A1c指标的差别,并比较其阳性率、诊断灵敏度和特异度。结果实验组FPG、2 h血糖、Hb A1c指标及阳性率均高于对照组(P<0.05);FPG检测灵敏度为77.5%、特异度为89.3%,2 h血糖的检测灵敏度为87.8%、特异度为98.0%,Hb A1c的检测灵敏度为85.7%、特异度为95.2%。结论临床上在孕妇孕早期进行Hb A1c检测对妊娠期糖尿病诊断具有一定的诊断价值,可作为早期对妊娠期糖尿病筛查的一项重要指标,临床上值得推广。

Objective To investigate the value of HbA1c in the diagnosis of gestational diabetes during early pregnancy.Methods Pregnant women who had undergone a pregnancy test in our department from June 2015 to October 2017 were selected.Among them,98 cases of pregnant women diagnosed with gestational diabetes were chosen as the experimental group,while 100 cases of pregnant women undergoing normal pregnancy tests were chosen as the control group.Fasting plasma glucose(FPG),glucose tolerance test(OGTT)2 h blood glucose,and HbA1c were detected in both groups.The differences in FPG,2 h blood glucose,and HbA1c were analyzed between the two groups of pregnant women,and the positive rate,diagnostic sensitivity,and specificity were compared.Results The FPG,2 h blood glucose,HbA1c and positive rate of the experimental group were higher than those of the control group(P<0.05).The FPG detection sensitivity was 77.5%,specificity was 89.3%,2 h blood glucose detection sensitivity was 87.8%,specificity was 98.0%,HbA1c detection sensitivity was 85.7%,specificity was 95.2%.Conclusion The clinical detection of glycated hemoglobin in early pregnancy has a certain diagnostic value for the diagnosis of gestational diabetes.It can be used as an important indicator for the early screening of gestational diabetes,and it is worthy of promotion in clinical practice.