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目的 了解北京地区正常妊娠 (NG)、妊娠糖耐量受损 (GIGT)、妊娠糖尿病 (GDM )孕妇的糖耐量水平。 方法 5家医院联合前瞻性对 94 8名孕妇在孕 2 4～ 32周间先行 5 0 g糖筛查试验 ,不管其值高低均于 3d后行口服葡萄糖耐量试验 (OGTT)。 结果 OGTT按美国国家糖尿病资料组 (NDDG)标准判断正常组 5 34名 ,取其 4次血糖值的第 97 5百分位数为 5 2 8、9 75、6 6 1和6 78mmol/L。OGTT中 1项异常或 2h血糖值在 6 6 7～ 9 11mmol/L之间为GIGT组 372名 ,第97 5百分位数血糖值为 6 0 6、11 89、9 6 1、和 8 0 0mmol/L。GDM组 4 2例 ,其中 33例根据OGTT 4项值中≥ 2项异常确诊 ,其血糖值为 8 0 0、16 89、14 4 4和 11 6 7mmol/L。 结论 正常孕妇OGTT第 97 5百分位数的血糖值低于国内外报道。目前应用的NDDG诊断标准是否过高导致假阴性 ,有待进一步调查研究
Objective To understand the level of glucose tolerance in pregnant women with normal pregnancy (NG), gestational impaired glucose tolerance (GIGT) and gestational diabetes mellitus (GDM) in Beijing. Methods A total of 94 8 pregnant women in 5 hospitals were prospectively enrolled in this study. 50 g of sugar screening test was carried out during 24 to 32 weeks of pregnancy. OGTT was performed after 3 days regardless of the value. Results OGTT judged 5 34 normal subjects according to the National Diabetes Data Group (NDDG) criteria. The 97th percentile of four blood glucose values was 528, 9 75, 6 6 1 and 6 78 mmol / L. One of the abnormal OGTT or 2h blood glucose values was 372 in the GIGT group between 6 6 7 and 9 11 mmol / L, the 97th percentile blood glucose values were 6 0 6, 11 89, 9 6 1, and 80 0mmol / L. GDM group 42 cases, of which 33 cases were diagnosed according to OGTT 4 items in 2 abnormalities, the blood glucose values of 80, 16 89, 14 4 4 and 11 6 7mmol / L. Conclusion The blood glucose level of the 97th percentile of OGTT in normal pregnant women is lower than that of domestic and foreign reports. Whether the current application of NDDG diagnostic criteria is too high lead to false negatives, pending further investigation