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目的:探讨糖化血红蛋白(HbA1c)在妊娠期糖尿病(GDM)筛查中的应用价值。方法:2011年1月~2012年10月,在我院门诊就诊的孕妇245例,其中符合GDM诊断标准的24例为GDM组,其余221例为非GDM组。分别对2组进行空腹血糖(FBG)、口服葡萄糖耐量试验(OGTT)及HbA1c进行检测。比较3种检测方法的检测结果,并对检测结果进行评价。结果:GDM组FBG、OGTT及HbA1c均明显高于非GDM组,差异有统计学意义(P<0.05),在3种项目检测中,HbA1c的灵敏度、特异性和阳性预测值最高,分别为90.0%、80.2%、82.3%,提示HbA1c在诊断GDM的3种检查中效果最好。结论:HbA1c水平在GDM患者中明显升高,诊断GDM具有较高的阳性率,早期干预治疗可减少母婴发病率及死亡率。HbA1c为糖尿病的血糖水平监测提供了新的方法,是临床上筛查、诊断、监测妊娠期糖尿病的简单、可靠的方法。
Objective: To investigate the value of glycosylated hemoglobin (HbA1c) in the screening of gestational diabetes mellitus (GDM). Methods: From January 2011 to October 2012, 245 pregnant women were enrolled in our clinic. Among them, 24 cases were diagnosed as GDM by GDM, and 221 cases were non-GDM. Fasting blood glucose (FBG), oral glucose tolerance test (OGTT) and HbA1c were detected in two groups respectively. The test results of three test methods were compared and the test results were evaluated. Results: The FBG, OGTT and HbA1c of GDM group were significantly higher than those of non-GDM group (P <0.05), and the sensitivity, specificity and positive predictive value of HbA1c were the highest %, 80.2% and 82.3%, respectively, suggesting that HbA1c is the best one of the three tests for the diagnosis of GDM. Conclusion: The level of HbA1c in GDM patients was significantly higher, the diagnosis of GDM has a higher positive rate, early intervention can reduce maternal morbidity and mortality. HbA1c provides a new method for the monitoring of blood glucose levels in diabetes and is a simple and reliable method for clinical screening, diagnosis and monitoring of gestational diabetes.