糖化血红蛋白联合空腹血糖在早期妊娠期糖尿病筛查中的应用价值.docxVIP

糖化血红蛋白联合空腹血糖在早期妊娠期糖尿病筛查中的应用价值 　　[摘要]目的探讨糖化血红蛋白（hba1c）联合空腹血糖（fpg）在早期妊娠期糖尿病（gdm）筛查中的应用价值。方法选取2017年1月～2018年7月我院妇产科确诊的64例gdm患者作为gdm组，另选取同期来我院行常规产检的64例健康孕妇作为对照组。两组均行hba1c及口服葡萄糖耐量试验（ogtt）检测。比较两组受试者fpg、hba1c和服糖后不同时间的ogtt水平;比较不同指标检测的曲线下面积（auc）、灵敏度、特异性及准确率。结果gdm组的fpg、hba1c及服糖后1、2hogtt水平均高于对照组，差异有统计学意义（p0.05）;fpg与hba1c联合检测诊断gdm的受试者工作特征（roc）auc高于二者单独检测，差异有统计学意义（p0.05）;fpg与hba1c联合检测诊断gdm的灵敏度、特异性及准确率均高于二者单独检测，差异有统计学意义（p0.05）。结论hba1c与fpg两项指标联合应用于诊断gdm具有更高的诊断效能，对gdm患者的早期筛查具有指导意义。 　　[关键词]妊娠期糖尿病;糖化血红蛋白;空腹血糖;口服葡萄糖耐量试验;筛查 　　[中图分类号]r714.25[文献标识码]a[文章编号]1674-4721（2020）2（b）-0184-03 　　[abstract]objectivetoexploretheapplicationvalueofglycatedhemoglobin（hba1c）combinedwithfastingbloodglucose（fpg）inthescreeningofearlygestationaldiabetesmellitus（gdm）.methodsatotalof64patientswithgdmdiagnosedintheobstetricsandgynecologydepartmentofourhospitalfromjanuary2017tojuly2018wereselectedasthegdmgroup，and64healthypregnantwomenwhounderwentroutinebirthexaminationinourhospitalduringthesameperiodwereselectedasthecontrolgroup.bothgroupsweretestedforhba1candoralglucosetolerancetest（ogtt）.fpg，hba1candogttwerecomparedbetweenthetwogroups.theareaundercurve（auc），sensitivity，specificityandaccuracyofdifferentindexeswerecompared.resultsthelevelsoffpg，hba1candogttinthegdmgroupat1and2hoursaftertakingglucosewerehigherthanthoseinthecontrolgroup，thedifferenceswerestatisticallysignificant（p0.05）.thereceiveroperatingcharacteristic（roc）aucofsubjectswithcombineddetectionoffpgandhba1cinthediagnosisofgdmwerehigherthanthoseofthetwoalone，thedifferenceswerestatisticallysignificant（p0.05）.thesensitivity，specificityandaccuracyofthecombineddetectionoffpgandhba1cinthediagnosisofgdmwerehigherthanthoseofthetwoalone，thedifferenceswerestatisticallysignificant（p0.05）.conclusionthecombineduseofhba1candfpginthediagnosisofgdmhashigherdiagnosticefficacy，andhasguidingsignificanceforearlyscreeningofpatientswithgdm. 　　[keywords]gestationaldiabetesmellitus;glycatedhemoglobin;fastingbloodglucose;oralglucosetolerancetest;screening