论文部分内容阅读
目的探讨全血糖化血红蛋白(HbA1c)检测在筛查和诊断妊娠期糖尿病(GDM)中的价值。方法检测孕妇(24~28周)的空腹血糖(FPG),对空腹血糖受损(IFG,空腹血浆葡萄糖4.4~5.3mmol/L)的孕妇抽取葡萄糖负荷后2 h血糖(2 hPG)和HbA1c,以2 hPG≥8.6 mmol/L为标准,评价HbA1c诊断GDM的敏感性和特异性。结果降低诊断截断点,HbA1c诊断妊娠期糖尿病的检出率高,敏感性优于2 hPG;提高诊断截断点,HbA1c诊断妊娠期糖尿病的检出率低,特异性优于2 hPG。结论在某种程度上,HbA1c可以取代2 hPG成为筛查诊断糖尿病的手段之一,它具有检测方便、准确、稳定等特点,联合检测FPG和HbA1c可以大大提升对糖尿病的漏诊率。
Objective To investigate the value of detecting hemoglobin A1c (HbA1c) in the screening and diagnosis of gestational diabetes mellitus (GDM). Methods Fasting plasma glucose (FPG) was measured in pregnant women (24-28 weeks). Blood glucose (2 hPG) and HbA1c were measured at 2 h after glucose load in pregnant women with impaired fasting glucose (IFG, fasting plasma glucose 4.4-5.3 mmol / With 2 hPG≥8.6 mmol / L as the standard, the sensitivity and specificity of HbA1c in the diagnosis of GDM were evaluated. Results HbA1c had a higher detection rate of gestational diabetes mellitus and a higher sensitivity than 2 hPG. HbA1c had a lower detection rate of gestational diabetes mellitus with better specificity than 2 hPG at diagnosis cutoff points. Conclusion To some extent, HbA1c can replace 2 hPG as a screening method for the diagnosis of diabetes mellitus, which has the characteristics of convenient, accurate and stable detection. Combined detection of FPG and HbA1c can greatly improve the rate of missed diagnosis of diabetes.