摘要
目的观察孕24—28周产前检查妇女口服75g无水葡萄糖耐量试验（0GTT）结果，分析应用2004年美国糖尿病协会（ADA）、2010国际妊娠合并糖尿病研究组织（IADPSG）、2005年第6版妇产科学教材推荐的3种妊娠糖尿病诊断时的诊断率。方法2864例入选者来自2011年4至11月期间就诊于北京大学第一医院产科门诊全部孕24～28周产前检查妇女。口服75g无水葡萄糖进行OGTF实验，分别于空腹，服用葡萄糖后1h和2h采集静脉血。静脉血以柠檬酸一氟化钠抗凝。血清葡萄糖测定采用具有溯源性的葡萄糖氧化酶法进行测定。未观察服用葡萄糖后3h血糖，本研究只读取空腹、OGT？1h、2h3点血浆葡萄糖水平，根据2004版ADA、2010年IADPSG和第6版妇产科学教材标准计算诊断率，同一标准不同年龄间诊断率的比较采用行×列表卡方检验，同一年龄组不同标准间诊断率的比较采用配对卡方检验。结果采用IADPSG标准，GDM诊断率高达20．6％，较2004版ADA和第6版妇产科学教材标准诊断率分别升高307％和199％。如将IADPSG标准的血糖异常个数改为≥2个，阳性例数下降到227人，GDM诊断率骤然下降到7．93％，与2004版ADA标准诊断阳性率（6．8％）相似。结论更严格的IADPSG标准使得GDM诊断率显著升高，IADPSG推荐的新标准与2004版ADA老标准间GDM诊断率的巨大差异主要源于诊断标准中超过血糖阈值的个数从2个变成1个所致。
Objective Women with gestational diabetes mellitus （GDM） are at risk to develop Type 2 diabetes mellitus （DM2）. The aim of this study is to compare the effect of three diagnostic criteria on the prevalence of GDM. Methods 2864 pregnant women receiving obstetric care at 24 to 28 weeks of gestation at Peking University First Hospital, underwent the 75 g oral glucose tolerance test for routine GDM screening. The pregnancies were evaluated bythe American Diabetes Association （ ADA 2004） Guideline, the new criteria which was proposed by the International Association of Diabetes and Pregnancy Study Groups （IADPSG 2010） based on the HAPO study, not by the criteria of American College of Obstetricians and Chinese Obstetrics and Gynecology （6th edition 2005 ）. Venous plasma glucose was measured by the IDMS- traceable glucose oxidase method. Results The mean age of the women was 30 years. 590 women were diagnosed with GDM using the IADPSG criteria. According to the IADPSG standard, GDM diagnostic rate reached 20. 6%. The diagnostic rate of new criteria was increased by 307% and 199% compared with the Chinese Obstetrics and Gynaecology （6th edition） and the old ADA standard, respectively. If increasing the number of abnormal glucose values in the IADPS standard to 2 or more, the number of positive cases dropped to 227 people. The diagnostic rate of GDM plummeted to 7.93% , similar with that of the old ADA diagnostic criteria （6. 8% ）. Conclusions The diagnosis rate of GDM was significantly higher using the IADPSG criteria, due to more stringent glucose abnormality recommended by the IADPSG.
出处
《中华检验医学杂志》
CAS
CSCD
北大核心
2012年第6期517-520,共4页
Chinese Journal of Laboratory Medicine
基金
首都发展基金资助（2009-1012）
关键词
糖尿病
妊娠
葡糖耐量试验
妊娠中期
流行病学研究
Diabetes, gestational
Glucose tolerance test
Pregnancy trimester, second
Epidemiologic studies
