Objective To explore the effects of the low pigmented anemia on glycated hemoglobin of pregnant women with normal glucose metabolism.Methods The study retrospectively selected the 10-28 weeks pregnant women of 647 cases(292 cases with Hb≥110 g/L and 355 cases with Hb<110 g/L)with normal fasting blood glucose at the Qingpu Branch of Zhongshan Hospital, Fudan University, between January and June 2017.According to their MCH and MCV,patients were divided into two groups.There are observation group which including 89 cases with MCH<27 pg and MCV<82 fl and 196 cases with MCH<27 pg and MCV≥82 fl as(low pigment group)and 362 cases with MCH≥27 pg and MCV≥82 fl as control group which including 70 cases with Hb≥110 g/L and 292 cases with Hb <110 g/L.RBC parameters, fasting plasma glucose and glycosylated hemoglobin of all cases were detected on the Hitachi 7600 automatic biochemical analyzer and HLC-723G8 automatic glycosylated hemoglobin analyzer.The t test, chi-square test and Bonferroni test were used for statistical analysis.Results Statistical analysis showed the fasting blood glucose of the pregnant women without anemia(Hb≥110 g/L)and the pregnant women with anemia (Hb<110 g/L)were(4.68 ±0.36)mmol/L and(4.632 ±0.33)mmol/L respectively, and there is no statistical difference between them with t=-1.860,P=0.063.The and glycosylated hemoglobin levels of the pregnant women with Hb≥110 g/L and the pregnant women with Hb <110 g/L were(4.851 ±0.32)%and(4.872 ±0.35)%respectively,and there is no statistical difference between them with t=0.780,P=0.436.The fasting blood glucose of the cases with MCH <27 pg and MCV<82 fl,the cases with MCH<27 pg and MCV≥82 fl and the cases with MCH≥27 pg and MCV≥82 fl were(4.609 ±0.319)mmol/L, (4.586 ±0.381)mmol/L,(4.661 ±0.344)mmol/L respectively, and there was no statistical difference among them with F=1.105,P=0.332;the glycated hemoglobin levels of the three groups were(5.097 ± 0.409)%,(5.084 ±0.375)% and(4.835 ±0.321)% respectively, the glycated hemoglobin of the cases with MCH<27 pg were statistically higher than that of the cases with MCH≥27 pg with F=18.479,P<0.000 1 and absolute difference was 0.26%.Conclusion Low pigment anemia with MCH <27 pg has a significant effect on glycated hemoglobin levels in pregnant women,which can cause the increase of glycated hemoglobin in pregnant women.%目的 探讨低色素性贫血对正常的妊娠期妇女糖化血红蛋白(HbA1c)的影响.方法 回顾性分析2017年1至6月来复旦大学附属中山医院青浦分院建立生育档案的10~28周、空腹血糖(GLU)水平均正常的妊娠期妇女647例(其中血红蛋白Hb≥110 g/L 292例,血红蛋白Hb<110 g/L 355例),根据平均红细胞血红蛋白量(MCH)和平均红细胞体积(MCV)将选取的647例妊娠期妇女分为两组.观察组(低色素组)285例,其中小细胞低色素性贫血(MCH<27 pg,MCV<82 fl)89例、正细胞低色素性贫血(MCH<27 pg,MCV≥82 fl)196例;对照组为正细胞正色素组(MCH≥27 pg,MCV≥82 fl)362例,其中正细胞正色素贫血70例、正细胞正色素非贫血292例.采用全自动生化分析仪和全自动糖化血红蛋白分析仪检测两组实验对象的血常规、空腹血糖和糖化血红蛋白,并将结果进行比较和统计学分析.计数资料以例数和百分比描述,组间分析采用卡方检验.两两之间比较采用独立样本t检验;三组或三组以上的比较采用的方差分析,两两比较采用Bonferroni 检验,若方差齐性采用方差分析,若方差不齐采用秩和检验.结果 经统计学分析,无贫血(Hb≥110 g/L)孕妇组与贫血(Hb<110 g/L)孕妇组的空腹血糖水平分别为(4.683 ±0.36)mmol/L、(4.632 ±0.33) mmol/L(t=-1.860,P=0.063);糖化血红蛋白(HbA1c)水平分别为(4.851 ±0.32)%与(4.872 ± 0.35)%(t=0.780,P=0.436),两组之间糖化血红蛋白水平比较差异无统计学意义;小细胞低色素性贫血、正细胞低色素性贫血、正细胞正色素性贫血三组的空腹血糖的水平分别为(4.609 ±0.319) mmol/L、(4.586 ±0.381)mmol/L、(4.661 ±0.344)mmol/L,两两之间空腹血糖水平比较差异无统计学意义(F=1.105,P=0.332),糖化血红蛋白水平分别为(5.097 ±0.409)%、(5.084 ±0.375)%和(4.835 ±0.321)%,低色素两组患者的糖化血红蛋白显著高于正细胞正色素组,绝对值升高约0.26%,差异有统计学意义(F=18.479,P<0.0001).结论 低色素性贫血对妊娠期妇女糖化血红蛋白水平有显著的影响,可引起妊娠期妇女糖化血红蛋白的升高.
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