孕早期糖化血红蛋白联合空腹血糖检测预测妊娠期糖尿病的价值研究

The value of glycosylated hemoglobin combined with fasting blood glucose test in predicting gestational diabetes in early pregnancy

目的探究孕早期行糖化血红蛋白联合空腹血糖检测预测妊娠期糖尿病(GDM)的临床价值。方法选取98例妊娠期糖尿病患者设为试验组;另选取同期98例行产前检查的健康孕妇设为对照组。两组均于孕12周前行空腹血糖、糖化血红蛋白检测,于孕24周后行口服葡萄糖耐量试验(OGTT),对比两组检测方式预测妊娠期糖尿病的效果。结果试验组孕早期空腹血糖、糖化血红蛋白及孕中期OGTT空腹血糖、OGTT服糖后1 h、2 h检测值高于对照组,差异有统计学意义(P<0.05)。绘制ROC曲线分析:孕早期糖化血红蛋白检测敏感性为83.7%,特异性为99.0%,孕早期空腹血糖检测敏感性为57.2%,特异性为83.7%,联合检测预测敏感性为84.7%,特异性为100%,联合检测高于单一检测敏感性和特异性,差异有统计学意义(P<0.05)。预测准确率分析:孕早期糖化血红蛋白检测预测准确率为83.7%,孕早期空腹血糖检测预测准确率为45.9%,联合检测预测准确率为98.0%,联合检验预测准确率显著高于单一预测准确率,差异有统计学意义(P<0.05)。结论在孕早期进行糖化血红蛋白联合空腹血糖检测能更早地预测妊娠期糖尿病,对早期干预治疗及改善母婴结局具有重要意义。

Objective To explore the clinical value of glycosylated hemoglobin combined with fasting blood glucose detection in predicting gestational diabetes mellitus(GDM)in early pregnancy.Methods 98 patients with gestational diabetes were selected as experimental group.Another 98 healthy pregnant women who underwent prenatal examination during the same period were selected as the control group.Fasting blood glucose and glycosylated hemoglobin were tested 12 weeks before gestation,and oral glucose tolerance test(OGTT)was performed 24 weeks after gestation.The prediction effect of gestational diabetes between the two groups was compared.Results Fasting blood glucose and glycosylated hemoglobin in the first trimester of trial group and OGTT fasting blood glucose and OGTT 1 h and 2 h after sugar administration in the second trimester were higher than those in the control group,and the differences were statistically significant(P<0.05).ROC curve analysis:The sensitivity and specificity of glycosylated hemoglobin detection in early pregnancy were 83.7%and 99.0%,the sensitivity and specificity of fasting blood glucose detection in early pregnancy were 57.2%and 83.7%,and the prediction sensitivity and specificity of combined test were 84.7%and 100%,which were higher than those of single test,and the difference was statistically significant(P<0.05).Prediction accuracy analysis:The prediction accuracy of glycosylated hemoglobin detection in early pregnancy was 83.7%,fasting blood glucose detection in early pregnancy was 45.9%,and the prediction accuracy of combined test was 98.0%.The prediction accuracy of combined test was significantly higher than that of single test,and the difference was statistically significant(P<0.05).Conclusion Detection of glycosylated hemoglobin combined with fasting blood glucose in early pregnancy can predict gestational diabetes earlier,which is of great significance for early intervention and improvement of maternal and infant outcomes.