糖化血红蛋白联合空腹血糖检测用于筛查妊娠期糖尿病的可能性研究

Study on the Possibility of Using Glycosylated Hemoglobin Combined with Fasting Blood Glucose Testing to Screen for Gestational Diabetes

目的研究糖化血红蛋白(HbA1c)联合空腹血糖检测用于妊娠期糖尿病的筛查。方法选取2020年1月-2021年5月在该院进行产检并在该院分娩的孕妇进行研究,选取82例已经确诊为妊娠期糖尿病的孕妇,将其设为研究组,选取82名血糖正常的孕妇,将其设为对照组。两组孕妇分别检测HbA1c与空腹血糖及口服75 g葡萄糖耐量试验(OGTT),对比两组HbA1c、空腹血糖、糖耐量试验及糖耐量试验检测一次性成功率、不同妊娠结局。结果研究组的HbA1c、空腹血糖与1 h糖耐量试验、2 h糖耐量试验均高于对照组;研究组与对照组空腹血糖及糖耐量试验检测一次性成功率均低于HbA1c检测一次性成功率,差异有统计学意义(P<0.05),研究组空腹血糖一次性成功率低于对照组,差异有统计学意义(P<0.05),两组糖耐量试验检测一次性成功率比较,差异无统计学意义(P>0.05);研究组剖宫产24.39%、母体并发症10.98%、新生儿并发症发生率9.76%均高于对照组,差异有统计学意义(P<0.05)。与此同时,妊娠期糖尿病患者糖化血红蛋白水平越高,其发生并发症的风险就越高。结论妊娠期糖尿病筛查在临床上应用糖化血红蛋白与空腹血糖联合检测效果较好,可以为临床确诊提供重要的参考依据,继而改善母婴结局。

Objective To study glycosylated hemoglobin(HbA1c)combined with fasting blood glucose test for screening gestational diabetes mellitus.Methods Selected pregnant women who have undergone prenatal check-ups in the hospital from January 2020 to May 2021 and gave birth in the hospital for research,selected 82 pregnant women who have been diagnosed with gestational diabetes and set them as the study group,and slected 82 pregnant women with normal blood glucose as the control group.Two groups of pregnant women tested HbA1c and fasting blood glucose and oral 75 g glucose tolerance test(OGTT)respectively,compared the two groups of HbA1c,fasting blood glucose,glucose tolerance test and glucose tolerance test one-time success rate and different pregnancy outcomes.Results The HbA1c,fasting blood glucose,1 h glucose tolerance test and 2 h glucose tolerance test in the study group were higher than those in the control group;the one-time success rate of fasting glucose and glucose tolerance test in study group and control group was lower than that in HbA1c test,the difference was statistically significant(P<0.05),the one-time success rate of fasting glucose in study group was lower than that in control group,the difference was statistically significant(P<0.05),and there was no statistically significant difference in one-time success rate of glucose tolerance test(P>0.05).The incidence of cesarean section 24.39%,maternal complications 10.98%and neonatal complications 9.76%in the study group were higher than those in the control group,the difference was statistically significant(P<0.05).Meanwhile,the higher the level of HbA1c in gestational diabetes,the higher the risk of complications.Conclusion GDM screening is effective in the clinical application of glycosylated hemoglobin and fasting blood glucose,it can provide important reference for clinical diagnosis and improve maternal and infant outcomes.