标题：妊娠早期糖化血红蛋白检测联合体质量指数筛查妊娠期糖尿病的临床价值

      作者：王冬玲，黄燕萍，吴川平    连州市妇幼保健计划生育服务中心妇产科，广东 连州 513400

      卷次： 2020年31卷6期

      【摘要】 目的 探讨妊娠早期糖化血红蛋白(HbA1c)检测联合体质量指数(BMI)在妊娠期糖尿病筛查中的应用价值。方法 回顾性分析2017年1月至2018年12月在连州市妇幼保健计划生育服务中心妇产科进行建档、产前常规检查，并行分娩的1 100例单胎孕妇的临床资料，在孕8~14周进行HbA1c及BMI筛查。以孕24~28周进行75 g葡萄糖耐量试验(OGTT)结果作为诊断标准，观察筛查结果，将糖代谢异常的74例孕妇作为观察组，同时随机选取 74例正常孕妇作为对照组，比较两组孕妇的HbA1c及BMI水平。结果 观察组孕妇HbA1c及BMI分别为(9.28±0.85)%、(25.64±1.37) kg/m2，明显高于对照组的(4.52±0.76)%、(21.87±1.24) kg/m2，差异均有统计学意义(P<0.05)；以各种筛查方法综合比较分析，HbA1c≥5.5%且 BMI≥24的筛查方法诊断妊娠期糖尿病的敏感性为89.19%，特异性为89.91%。结论 妊娠期糖尿病孕妇的糖化血红蛋白水平及体质量指数显著高于正常孕妇，糖化血红蛋白及体质量指数检测在孕早期应用于妊娠期糖尿病的筛查具有较高的敏感性、特异性，对妊娠期糖尿病的筛查具有临床应用价值。
      【关键词】 妊娠期糖尿病；糖化血红蛋白；体质量指数；筛查；应用价值
      【中图分类号】 R714.256 【文献标识码】 A 【文章编号】 1003—6350（2020）06—0754—03

Clinical value of glycosylated hemoglobin combined with body mass index during early pregnancy in screeninggestational diabetes mellitus.
WANG Dong-ling, HUANG Yan-ping, WU Chuan-ping. Department of Obstetrics andGynecology, Lianzhou Maternal and Child Health and Family Planning Service Center, Lianzhou 513400, Guangdong,CHINA
【Abstract】 Objective To explore the value of HbA1c combined with body mass index (BMI) in the screening ofgestational diabetes mellitus. Methods The clinical data of 1 100 singleton pregnant women in Department of Gynaecol-ogy and Obstetrics, Lianzhou Maternal and Child Health and Family Planning Service Center from January 2017 to De-cember 2018 were analyzed, who were filed and checked before delivery, screened for HbA1c and BMI at 8~14 weeks ofgestation. Taking the results of 75 g glucose tolerance test (OGTT) at 24-28 weeks of gestation as the diagnostic standard,the screening results were analyzed. The pregnant women with abnormal glucose metabolism were divided into the obser-vation group (n=74), and the normal pregnant women were assigned as the control group (n=74). The HbA1c and BMI lev-els of the two groups were compared. Results The HbA1c and BMI of pregnant women in the observation group were(9.28±0.85)% and (25.64±1.37) kg/m2, which were significantly higher than (4.52±0.76)% and (21.87±1.24) kg/m2 in thecontrol group (P<0.05). Through the comprehensive comparative analysis of various screening methods, the sensitivityand specificity of HbA1c≥5.5% and BMI≥24 were 89.19% and 89.91%. Conclusion The glycosylated hemoglobinlevel and BMI of pregnant women with gestational diabetes were significantly higher than those of normal pregnantwomen, and the detection of glycosylated hemoglobin and BMI was applied to the screening of gestational diabetes inthe early stage of pregnancy, which had high sensitivity and specificity, and had clinical application value for the screen-ing of gestational diabetes.
      【Key words】 Gestational diabetes; Glycated hemoglobin (HbA1c); Body mass index (BMI); Screening; Applica-tion value·短篇论著·doi:10.3969/j.issn.1003-6350.2020.06.023