孕妇外周血糖化血红蛋白检测在妊娠期糖尿病诊断中的价值探讨

摘要

Objective Study the clinical value of maternal peripheral blood glucose hemoglobin (HbA1c)testing in the diagnosis of gestational diabetes mellitus (GDM).Methods From January 2014 to March 2015 in Chengdu women and children's Center Hospital GDM (GDM)and healthy pregnant women (control group)Blood HbA1c,FPG,1h (GLU),2hGLU and 3hGLU were testing,and the differences of the two groups were analyzed and the effects of HbA1c on the outcome of pregnancy were analyzed.Results GDM group testing of HbA1c,FPG,1hGlu,2hGlu and 3hGlu levels were significantly higher than those of the normal group,the difference is statistically significant or highly significant (P <0.05 or P <0.01);pregnancy induced hypertension in pregnant women with GDM (HbA1c>5.8%), cesarean section,polyhydramnios,premature rupture of membranes,macrosomia,premature fetus,neonatal asphyxia, neonatal hypoglycemia in the neonatal jaundice and other complications were significantly higher than those in healthy pregnant women (HbA1c≤ 5.8%),the difference has statistical significance (P <0.05).Conclusion The testing of HbA1c in peripheral blood of pregnant women is closely related to the outcome of pregnancy.It can help to understand the GLU control of GDM pregnant women and provide guidance for the early diagnosis of GDM,clinical delivery, screening and reduce the incidence of maternal complications.%目的：探讨孕妇外周血糖化血红蛋白（HbA1c）检测在妊娠期糖尿病（GDM）诊断中的临床应用价值。方法对2014年1月-2015年3月在成都市妇女儿童中心医院产科做产前检查的 GDM 孕妇（GDM 组）和健康妊娠孕妇（对照组）进行外周血 HbA1c、空腹血糖（FPG）、1h 血糖（GLU）、2h GLU 和3h GLU 检测，分析两组上述检测指标的差异和 HbA1c 水平变化对妊娠结局影响。结果GDM 组检测 HbA1c、FPG、1h GLU、2h GLU 和3h GLU 水平均明显高于正常组，差异有统计学意义或高度统计学意义（P ＜0．05或 P ＜0．01）；GDM 孕妇（HbA1c＞5．8％）发生妊高症、剖宫产、羊水过多、胎膜早破、巨大儿、胎儿早产、新生儿窒息、新生儿低血糖、新生儿黄疸等并发症明显高于健康妊娠孕妇（HbA1c≤5．8％），比较差异有统计学意义（P ＜0．05）。结论孕妇外周血 HbA1c 检测水平与妊娠结局密切相关，有助于了解 GDM 孕妇的 GLU 控制情况，对 GDM 的早期诊断、临床分娩、筛查及降低母婴并发症发生率方面提供指导性的实验室依据。