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目的探讨妊娠合并糖尿病(gestational diabetes mellitus,GDM)筛查的优势方法(一步到位法)和提高妊娠期低血糖对母儿危害的认识。方法选出2007年1月至2008年12月在辽宁省人民医院妇产科门诊产检的254例孕妇进行50g葡萄糖负荷试验(glucose challenge test,GCT)和具有妊娠合并糖尿病高危因素的84例孕妇进行75g葡萄糖耐量试验(oral glucose tolerance test,OGTT)进行比较。妊娠期糖耐量异常(impaired glucose tolerance,IGT)孕妇分别为48例和6例,GDM确诊人数分别为2例和14例。同时随机选出169例孕妇在孕早期(<12周)和孕中期(24～28周)抽取空腹血糖(fasting plasma glucose,FPG)进行比较,低血糖发生人数分别为5例和22例。结果OGTT方法的GDM确诊率明显高于GCT方法(P<0.01),妊娠中期低血糖发生率明显高于妊娠早期(P<0.01)。结论75g OGTT明显优于50g GCT方法,即一步到位法;同时应重视妊娠期低血糖,提高其对母儿影响的认识。
Objective To explore the advantages and disadvantages of gestational diabetes mellitus (GDM) screening (one-step approach) and to improve the risk of hypoglycemia in pregnant women. Methods A total of 254 pregnant women with obstetrics and gynecology outpatient clinics in Liaoning Provincial People’s Hospital from January 2007 to December 2008 were selected for glucose tolerance test (GCT) and 84 pregnant women with high risk of pregnancy complicated with diabetes 75g glucose tolerance test (oral glucose tolerance test, OGTT) for comparison. Pregnant women with gestational impotence glucose tolerance (IGT) were 48 and 6, respectively, and the number of diagnosed GDM was 2 and 14, respectively. A total of 169 pregnant women were randomly selected for fasting plasma glucose (FPG) during the first trimester (<12 weeks) and second trimester (24-28 weeks). The incidence of hypoglycemia was 5 and 22, respectively. Results The diagnosis rate of GDM in OGTT was significantly higher than that in GCT (P <0.01). The incidence of hypoglycemia in the second trimester was significantly higher than that in early pregnancy (P <0.01). Conclusion 75g OGTT is significantly better than 50g GCT method, that is, one-step method; at the same time should pay attention to pregnancy hypoglycemia, improve their understanding of the impact on the mother and child.