标题：广东惠州地区7 105例妊娠期糖尿病筛查分析及适宜诊断标准探讨

      作者：彭林平，陈利强，王凤鸣，万婷，罗浩元    惠州市第一人民医院内分泌科，广东 惠州 516000

      卷次： 2019年30卷17期

      【摘要】 目的 了解惠州地区妊娠期糖尿病(GDM)的发病情况，探讨口服葡萄糖耐量试验(OGTT)各时间点空腹血清血糖(FPG)，1 h血清葡萄糖(1 hPG)和 2 h血清葡萄糖(2 hPG)诊断GDM的差异。方法 收集 2015年 1月至2018年6月于惠州市第一人民医院进行常规产检的妊娠24~28周孕妇的GDM筛查结果，对符合要求的7 105例OGTT结果进行分析。采用ROC曲线评价OGTT各时间点、任意一点和任意两点血糖异常诊断GDM的差异。结果 惠州地区GDM发病率为 23.6% (1 677/7 105)，高龄孕妇(年龄≥35岁)的发病率高达 36.16%(435/1203)，明显高于35岁以下孕妇的21.04% (1 242/5 902)，差异有显著统计学意义(P<0.01)；以OGTT任意一点异常诊断GDM时FPG的曲线面积(AUC)大于任意两点异常诊断GDM时的AUC (Z=2.15，P<0.05)，以任意两点异常诊断GDM时 1 hPG (Z=17.32，P<0.01)和 2 hPG (Z=14.45，P<0.01)的AUC大于任意一点异常诊断GDM时二者的AUC，差异均有统计学意义。结论 目前惠州地区GDM发病率较高，OGTT各时间点血糖水平异常诊断GDM存在一定的差异，单项FPG异常与1 hPG或2 hPG合并OGTT其他任意一项异常诊断GDM可能更具有优势。
      【关键词】 惠州地区；妊娠期糖尿病；口服葡萄糖耐量实验；筛查；诊断标准
      【中图分类号】 R714.256 【文献标识码】 A 【文章编号】 1003—6350（2019）17—2236—04

Screening analysis of 7 105 cases of gestational diabetes mellitus in Huizhou area of Guangdong Province anddiscussion of appropriate diagnostic criteria.
PENG Lin-ping, CHEN Li-qiang, WANG Feng-ming, WAN Ting, LUOHao-yuan. Department of Endocrinology and Metabolism, the First People's Hospital of Huizhou, Huizhou 516000,Guangdong, CHINA
【Abstract】 Objective To investigate the incidence of gestational diabetes mellitus (GDM) and explore the dif-ference of diagnosis of GDM in oral glucose tolerance test (OGTT) at different time points in Huizhou region of Guang-dong Province. Methods The GDM screening results of pregnant women at 24-28 weeks of gestation who underwentroutine obstetric examination in First People's Hospital of Huizhou from January 2015 to June 2018 were collected, andthe OGTT results of 7 105 cases who met the requirements were analyzed. ROC curve was used to evaluate the value ofabnormal blood glucose at any point and any two points of OGTT in the diagnosis of GDM. Results The incidence ofGDM in Huizhou was 23.60% (435/1 203). The incidence of GDM in pregnant women aged ≥35 years was 36.16%(435/1 203), significantly higher than 21.04% (1 242/5 902) in pregnant women aged <35 years (P<0.01). The area un-der the curve (AUC) of FPG in diagnosis of GDM by OGTT at any one point was significantly greater than that at anytwo points (Z=2.15, P<0.05), and the AUC of 1 hPG (Z=17.32, P<0.01) and 2 hPG (Z=14.45, P<0.01) in diagnosis ofGDM by OGTT at any two points was significantly greater than that at any one point. Conclusion The incidence ofGDM was relaticely high in Huizhou region. More importantly, there are some differences in the diagnosis of GDM byabnormal blood glucose levels at different time points of OGTT, and single FPG abnormality and 1 hPG or 2 hPG com-bined with any other one abnormalities of OGTT is more advantageous in diagnosing GDM.
      【Key words】 Huizhou region; Gestational diabetes mellitus; Oral glucose tolerance test (OGTT); Screening; Di-agnostic criteria