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目的:探讨妊娠期糖尿病(GDM)采用糖化血红蛋白(HbAlc)联合糖化白蛋白(GA)、一步筛选法进行早期诊断的临床价值。方法:将195例孕妇按照一步筛选法诊断结果分为糖耐量受损组(IGT组)53例,GDM组60例,正常妊娠组(对照组)82例,比较三组的空腹血糖(FPG)、GA、HbAlc水平。结果:三组HbAlc、GA、2 h FPG结果比较差异有统计学意义(F=6.381,P=0.037;F=6.182,P=0.001;F=5.935,P=0.046),IGT组、GDM组HbAlc、GA、2 h FPG结果高于对照组,GDM组高于IGT组,差异有统计学意义(P<0.05或P<0.01);GA组、HbAlc+GA组灵敏度、特异度、准确性高于HbAlc组,HbAlc+GA组高于GA组,差异有统计学意义(P<0.05或P<0.01),HbAlc+GA组阳性预测值、阴性预测值高于HbAlc组、GA组,差异有统计学意义(P<0.05)。结论:HbAlc联合GA、一步筛选法早期诊断GDM具有准确性高,简单、实用等特点,临床有重要参考价值。
Objective: To investigate the clinical value of gestational diabetes mellitus (GDM) using HbAlc combined with glycated albumin (GA) and one-step screening for early diagnosis. Methods: One hundred and fifty-five pregnant women were divided into IGT group (IGT group), GDM group (60 cases) and normal pregnancy group (82 cases). The fasting blood glucose (FPG) , GA, HbAlc levels. Results: There were significant differences in HbAlc, GA and 2 h FPG between the three groups (F = 6.381, P = 0.037; F = 6.182, P = 0.001; F = 5.935, P = 0.046) (P <0.05 or P <0.01). The sensitivity, specificity and accuracy of GA and HbAlc + GA group were higher than those of control group, GDM group and IGT group HbAlc group and HbAlc + GA group were higher than GA group, the difference was statistically significant (P <0.05 or P <0.01). The positive predictive value and negative predictive value of HbAlc + GA group were higher than those of HbAlc group and GA group Significance (P <0.05). Conclusion: HbAlc combined with GA, one-step screening early diagnosis of GDM has the characteristics of high accuracy, simple, practical and so on. It has important clinical value.