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目的:寻找孕早中期对妊娠期糖尿病(GDM)高危人群敏感度和特异度均较高的合适的Fasting Blood Glucose(FBG)值。方法:妊娠12～16周的孕妇在建孕管卡时常规测定FBG,根据FBG值是否≥4.7 mmol/L分为高、低二组,观察和统计其妊娠经过、分娩经过、GIGT和GDM的发生率、剖宫产率、母儿并发症率,产后由内分泌科医生在该界值筛查出的高危人群的产后血糖随访中统计其DM患者的发生率。结果:以孕12～16周FBG值为4.7 mmol/L作为筛查GIGT和GDM高危的切点,高组敏感率为79.24%,低组敏感率为14.32%,差异有统计学意义(P<0.05);高组的特异度为67.92%,低组的特异度为2.30%,差异有统计学意义(P<0.05)。阳性漏诊率为11.1%,低于同类研究。结论:该方法简易、经济,满足了孕妇的心理和精神的需要,值得临床推广。
OBJECTIVE: To find a suitable Fasting Blood Glucose (FBG) value with high sensitivity and specificity in the first trimester of pregnancy and high risk of gestational diabetes mellitus (GDM). Methods: Pregnant women with gestational age from 12 to 16 weeks were divided into high and low FBG group according to whether the FBG value was ≥ 4.7 mmol / L, and their pregnancy, delivery, GIGT and GDM were observed and counted Incidence, cesarean section rate, maternal and child complications rate, postpartum endocrinology in the screening of high-risk population screening rate of postpartum blood glucose in patients with follow-up statistics of the incidence of DM. Results: The FBG value of 4.7 mmol / L at 12-16 weeks of gestation was used as a screening point for high-risk GIGT and GDM. The sensitivity of the high-group was 79.24% and that of the low-group was 14.32%, the difference was statistically significant (P < 0.05). The specificity of high group was 67.92%, while the specificity of low group was 2.30%, the difference was statistically significant (P <0.05). The rate of positive missed diagnosis was 11.1%, lower than similar studies. Conclusion: The method is simple and economical, which meets the psychological and spiritual needs of pregnant women and is worthy of clinical promotion.