孕中期葡萄糖耐量试验在妊娠期糖尿病筛查中的临床应用

Clinical application of glucose tolerance test in pregnancy stage diabetes screening

目的探讨葡萄糖耐量试验(OGTT)3个时间点血糖值在诊断妊娠期糖尿病(GDM)、发现隐性糖尿病患者中的临床价值。方法收集2019年1月—2020年2月480例孕中期OGTT筛查结果,对其进行统计分析。结果480例OGTT筛查中3个时间点血糖值均正常412例,占比85.83%,列入对照组。统计出GDM孕妇68例,阳性率14.17%,设为GDM组。其中,3个时间点血糖值均异常10例,阳性率14.71%;仅空腹血糖异常22例,阳性率32.35%;空腹正常,餐后1 h血糖、2 h血糖单项或双项升高36例,阳性率52.94%。结论孕中期如不进行OGTT筛查,仅凭空腹血糖诊断GDM,容易出现严重漏诊。OGTT筛查中,餐后1 h血糖、餐后2 h血糖对筛查隐性GDM患者起着重要作用。

Objective To investigate the clinical value of glucose tolerance test(OGTT)at 3 time points in the diagnosis of gestational diabetes Mellitus(GDM)and the detection of latent diabetes.Methods The results of 480 mid-pregnancy OGTT screenings were collected from January 2019-February 2020,and they were statistically analyzed.Results 480 OGTT screening cases,and the blood glucose values were normal at 3 time points for 412 cases,accounting for 85.83%of the total.Sixty-eight pregnant women with GDM were counted and the positive rate was 14.17%,which was set as GDM group.Among them,10 cases had abnormal blood glucose values at three time points,accounting for 14.71%;Only 22 cases of fasting blood glucose abnormality were found,and the positive rate was 32.35%;Fasting was normal,blood sugar increased by 36 cases in one hour and two hours after meal,and the positive rate was 52.94%.The positive rate of GDM was different in three groups,and it lacks statistical significance since P<0.05.Conclusion If OGTT screening is not carried out in the middle pregnancy period,GDM can be diagnosed only by fasting blood glucose,and serious missed diagnosis is easy.In OGTT screening,blood glucose 1 hour after meal and 2 hours after meal play an important role in screening patients with latent GDM.