糖化血红蛋白与果糖胺水平检测在妊娠糖代谢异常诊断中的应用价值研究

Application value of glycosylated hemoglobin and fructosamine levels in the diagnosis of abnormal glucose metabolism in pregnancy

目的探究糖化血红蛋白(HbA1c)与果糖胺(FRU)水平检测在妊娠糖代谢异常诊断中的应用价值。方法选择2018年5月-2020年5月于抚州市职工医疗保险门诊部建档产前检查的妊娠糖尿病孕妇60例作为观察组,另选择同期行产前检查的健康孕妇60例作为对照组。采集2组孕妇清晨空腹静脉血送检,检测空腹血糖(FPG)、FRU、HbA1c水平。比较2组孕妇HbA1c、FPG和FRU检测结果,观察组HbA1c、FRU和FPG联合及单独检测阳性率。结果观察组HbA1c为(8.96±0.68)%、FPG为(8.51±0.96)mmol/L、FRU为(2.78±0.14)mmol/L,均高于对照组的(5.02±0.24)%、(5.23±0.85)mmol/L、(1.93±0.10)mmol/L,差异有统计学意义(P<0.05);观察组HbA1c阳性检出率为60.00%,FPG阳性检出率为16.67%,FRU阳性检出率为56.67%,HbA1c+FPG+FRU阳性检出率为95.00%,联合检测阳性率高于单独检测,差异有统计学意义(P<0.05)。结论联合检测的方式在妊娠糖代谢异常诊断中应用价值较高,依据其水平变化可对孕妇血糖情况展开判断,从而给予针对性干预,改善母婴结局。

Objective To explore the application value of glycosylated hemoglobin(HbA1c)and fructosamine(FRU)in the diagnosis of abnormal glucose metabolism in pregnancy. Methods 50 cases of pregnant women with gestational diabetes mellitus who were registered for prenatal examination in our hospital from May 2018 to December2019 were selected as the observation group, and 50 healthy pregnant women in the same period who underwent prenatal examination in our hospital were selected as the control group. Fasting blood glucose(FPG), fru and HbAlc levels were detected. The results of HbA1c, FPG and fru, and the positive rates of HbA1c, fru and FPG were compared between the tw o groups. Results The levels of HbA1c, FPG and fru in the observation group were(8.96±0.68)%,(8.51±0.96)mmol/L and(2.78±0.14)mmol/L in the observation group, which were higher than those in the control group [(5.02±0.24)%,(5.23±0.85)mmol/L,(1.93 ± 0.10)mmol/L,the difference was statistically significant(P<0.05);the positive detection rate of HbA1c, FPG and FRUru in the observation group was 72.00%, 20.00% and 68.00% respectively The positive detection rate of HbA1c + FRU was 94.00%, which was higher than 2.00%, 0,2.00% and 2.00% in the control group(P<0.05).Conclusion The combined detection of HbAlc and fru has high application value in the diagnosis of abnormal glucose metabolism in pregnancy. According to the changes of HbAlc level, we can judge the blood glucose of pregnant women and give targeted intervention to improve the maternal and infant outcomes.