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目的:通过妊娠期糖尿病患者75 g葡萄糖耐量试验的结果,比较三种诊断标准诊断妊娠期糖尿病(GDM),探讨其在临床中的诊断价值。方法:对482例50 g糖筛阳性患者进行75 g葡萄糖耐量试验(OGTT),利用第7版《妇产科学》、ADA及NDDG诊断标准对其进行诊断分组,然后对三组进行分析比较。结果:利用第7版《妇产科学》标准,GDM的诊断率为47.30%;利用ADA诊断标准,GDM的诊断率为39.83%;利用NDDG诊断标准,GDM的诊断率为26.14%。第3组分别与第1组、第2组诊断率比较,差异均有统计学意义(P<0.05)。第3组分别与第1组、第2组比较,在孕妇年龄、孕前体重指数、孕期体重增长率、妊娠期高血压、剖宫产率、巨大儿发生率及新生儿平均出生体重方面差异均有统计学意义(P<0.05)。结论:①第7版《妇产科学》的GDM诊断标准和ADA诊断标准都适合在临床应用,ADA的诊断标准更适合临床应用。②NDDG诊断标准界值过高,临床应用时较易漏诊患者,不推荐临床使用。
OBJECTIVE: To compare the diagnostic criteria of gestational diabetes mellitus (GDM) with gestational diabetes mellitus (75-g glucose tolerance test) in patients with gestational diabetes mellitus, and to explore its diagnostic value in clinical practice. Methods: A total of 482 patients with 50 g glycosphosphate-positive glucose syndrome (OGTT) were enrolled in this study. OGTT was diagnosed by using the 7th edition of Obstetrics and Gynecology, ADA and NDDG diagnostic criteria, and then analyzed and compared among the three groups. Results: The diagnostic criteria of GDM was 47.30% using the 7th edition of Obstetrics and Gynecology standards. The diagnostic rate of GDM was 39.83% using ADA diagnostic criteria. The diagnostic rate of GDM was 26.14% using NDDG diagnostic criteria. There were significant differences between the third group and the first group and the second group (P <0.05). Group 3 were compared with Group 1 and Group 2 respectively in terms of the age of pregnant women, body mass index before pregnancy, body weight gain during pregnancy, gestational hypertension, cesarean section rate, incidence of macrosomia and average birth weight of newborns There was statistical significance (P <0.05). Conclusion: The 7th edition of Obstetrics and Gynecology GDM diagnostic criteria and ADA diagnostic criteria are suitable for clinical application, ADA diagnostic criteria more suitable for clinical applications. ② NDDG diagnostic criteria is too high threshold, clinical application easier to missed patients, not recommended for clinical use.