糖化血红蛋白检测在妊娠期糖尿病诊断中的应用价值

马亚娟1，杜清丽2，杨彩萍1

（陕西省宝鸡市扶风县人民医院：1.检验科；2.妇产科，陕西 宝鸡，722200）

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摘要：

目的 探讨糖化血红蛋白（HbA1c）检测在妊娠期糖尿病（GDM）诊断中的价值。方法 选取我院2013年1月至2016年5月收治的妊娠期糖尿病孕妇30例（GDM组），糖耐量正常孕妇52例（NGT组）和糖耐量减低孕妇28例（GIGT组）为研究对象。比较三组的糖化血红蛋白（HbA1c）、空腹血糖（FPG）、口服糖负荷试验的1 h切点血糖（OGCT-1 h PG）。结果 GDM 组的 HbA1c、FPG、OGCT-1 h PG 水平和阳性率与NGT 组和GIGT组比较，差异具有统计学意义（P<0.05）；与NGT组比较，GIGT组的HbA1c 和OGCT-1 h PG 水平明显较高（P<0.05）；NGT组和GIGT组的HbA1c、FPG、OGCT-1 h PG阳性率比较，差异不具有统计学意义（P>0.05）。GDM组的HbA1c阳性率显著高于FPG阳性率（P<0.05），HbA1c阳性率高于OGCT-1 h PG阳性率，但差异无统计学意义（P>0.05）。结论 HbA1c 水平在GDM 患者中明显升高,对早期诊断GDM 具有重要意义。

关键词：妊娠期糖尿病；糖化血红蛋白；空腹血糖；口服糖负荷实验

中图分类号：R714文献标志码：A文章编号：2096-1413(2017)22-0129-02

Clinical value of glycosylated hemoglobin in the diagnosis of gestational diabetes mellitus
MA Ya-juan 1, DU Qing-li 2, YANG Cai-ping 1
(1. Department of Clinical Laboratory; 2. Department of Gynaecology and Obstetrics, People``s Hospital of Fufeng County, Baoji 722200, China)

ABSTRACT: Objective To explore the significance of glycosylated hemoglobin (HbA1c) screening test in the diagnosis of gestational diabetes mellitus (GDM). Methods From January 2013 to May 2016, 30 cases of pregnant women with gestational diabetes mellitus(GDM group), 52 cases of pregnant women with normal glucose tolerance(NGT group), and 28 cases of pregnant women with impaired glucose tolerance (GIGT group) were selected as the research objects. The glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), 1 h point cut blood sugar of oral glucose tolerance test (OGCT-1 h PG) were compared between the three groups. Results The levels and positive rate of HbA1c, FPG, OGCT-1 h PG in the GDM group were significantly higher than those of NGT group and GIGT group(P<0.05); compared with the NGT group, the levels of HbA1c and OGCT -1 h PG in the GIGT group increased significantly (P <0.05),; there were no significantly differences in the positive rates of HbA1c, FPG and OGCT-1 h PG between NGT group and GIGT group (P> 005). In the GDM group, the positive rate of HbA1c was significantly higher than that of the FPG(P<005), and the positive rate of HbA1c was higher than that of OGCT -1 h PG, but the difference was not statistically significant (P >005). Conclusion The level of HbA1c is obviously higher in GDM patients, which is important for early diagnosis of GDM.

KEYWORDS: gestational diabetes mellitus; glycosylated hemoglobin; fasting plasma glucose; oral glucose tolerance test

参考文献：
[1] 中华人民共和国卫生部医政司.全国临床检验操作规程(精)[M].3版.南京:东南大学出版社,2006.
[2] BOLZETTA F.Standards of medical care in diabetes -2010 [J].Diabetes Care,2010,33(Suppl 1):S11-S61.
[3] 关莉.糖化血红蛋白与糖耐量联合检测在妊娠期糖尿病诊断中的价值[J].标记免疫分析与临床,2014,21(3):355-356.
[4] 庞玲霞,王友沛,龚永生,等.妊娠期糖尿病患者糖化血红蛋白水平测定及意义[J].山东医药,2010,50(3):95-96.
[5] 吴捷,邹大进.2010 年美国糖尿病学会指南推行用糖化血红蛋白筛查和诊断糖尿病的背景[J].中国糖尿病杂志,2010,2(3):226-228.
[6] 曾雪芳.糖化血红蛋白在妊娠期糖尿病筛查中的临床价值研究[J]. 现代诊断与治疗,2014,25(6):1388-1389.
[7] GILLETT MJ.International expert committee report on the role of the A1c assay in the diagnosis of diabetes: diabetes care[J].Clin Biochemist Rev,2009,32(7):1327-1334
[8] SACKS DB,ARNOLD M,BAKRIS GL,et al.Executive summary: guidelines and recommendations for laboratory analysis in the diagnosisand management of diabetes mellitus[J].Diabetes Care,2011,34(6):e61-e99.