论文部分内容阅读
目的探讨广东地区50g葡萄糖负荷试验(GCT)筛查妊娠期糖尿病(GDM)的阈值、孕妇年龄对GDM发生的影响以及广东地区GDM的检出率。方法采用回顾性研究,对本院2005年1月至2007年12月全部孕妇实施50g葡萄糖负荷试验,异常者再行75g口服葡萄糖耐量(OGTT)实验,依据美国糖尿病资料小组(NDDG)的诊断标准诊断妊娠期糖尿病和糖耐量受损(IGT)。结果12000例孕妇GCT1h平均血糖水平为(7.37±1.75)mmol/L;以7.80mmol/L为切点,GCT血糖异常率为35.3%;IGT的检出率为6.9%,GDM的检出率为5.4%。GCT1h血糖≥11.1mmol/L者中,GDM的发生率为74.7%(195/261),其中36.8%(96/261)根据空腹血糖水平可以作出诊断。24岁以下孕妇GDM的发生率为0.83%,显著低于年龄≥24岁的孕妇,GCT的异常率和IGT及GDM的发生率随年龄的增加呈上升趋势。196例GCT1h血糖<7.8mmol/L存在高危因素的孕妇复行GCT和OGTT后,诊断为IGT和GDM的患者分别为23、17例,分别占总检出率的2.8%(23/824)和2.6%(17/648)。结论广东地区GCT筛查GDM以7.80mmol/L为切点是合理的,但1次GCT1h血糖正常的高危孕妇,复行GCT及OGTT是有必要的;GCT≥11.1mmol/L,仍有部分孕妇必须通过OGTT才能确诊;孕妇年龄与GDM发生密切相关,应加强高龄孕妇血糖的监测及GDM管理。
Objective To investigate the threshold of screening gestational diabetes mellitus (GDM), the influence of pregnant women age on GDM and the detection rate of GDM in Guangdong by 50g Glucose Load Test (GCT) in Guangdong Province. Methods A retrospective study was conducted on all pregnant women carrying 50g glucose load test from January 2005 to December 2007 in our hospital and 75g oral glucose tolerance test (OGTT). According to the diagnostic criteria of the American Diabetes Data Group (NDDG) Diagnosis of gestational diabetes and impaired glucose tolerance (IGT). Results The mean blood glucose level of GCT1h was (7.37 ± 1.75) mmol / L in 12 000 pregnant women. The abnormal rate of GCT was 35.3% at 7.80 mmol / L, the detection rate of IGT was 6.9%, the detection rate of GDM was 5.4%. The incidence of GDM was 74.7% (195/261) in GCT1h blood glucose ≥11.1mmol / L, of which 36.8% (96/261) could be diagnosed based on fasting blood glucose level. The incidence of GDM in pregnant women under 24 years old was 0.83%, which was significantly lower than that of pregnant women ≥24 years old. The abnormal rates of GCT and the incidence of IGT and GDM increased with the increase of age. After the GCT and OGTT of 196 pregnant women with high risk of GCT1h blood glucose <7.8mmol / L, the diagnosis of IGT and GDM were 23,17 cases, accounting for 2.8% (23/824) of the total detection rate and 2.6% (17/648). Conclusion It is reasonable to use GCD screening of 7.80mmol / L as the cut-off point in GCT screening in Guangdong Province. However, GCT1h GCT and OGTT are necessary for high-risk pregnant women with GCT1h normal blood glucose. There are still some pregnant women with GCT≥11.1mmol / Must be diagnosed by OGTT; pregnant women age and GDM are closely related to the elderly should be strengthened monitoring of blood glucose and GDM management.