糖化血红蛋白与果糖胺在妊娠糖代谢异常诊断中的临床应用

Clinical application of the diagnosis of glycated hemoglobin and fructosamine in pregnancy sugar metabolic abnormalities

关键词:  妊娠期糖尿病  妊娠期糖耐量受损  果糖胺  血糖化血红蛋白

Key words:  gestational diabetes  pregnancy impaired glucose tolerance  fructosamine  blood sugar change hemoglobin

摘要:

目的　探讨糖化血红蛋白与果糖胺诊断妊娠糖代谢异常的临床价值。　方法　检测并比较观察组280例，其中正常妊娠妇女222例（正常妊娠组），妊娠期糖耐量受损(gestational impaired glucose tolerance,GIGT)患者20例（GIGT组），妊娠期糖尿病(gestational diabetes mellitus,GDM)患者38例（GDM 组）及对照组60例孕妇的空腹血糖（FBG）、果糖胺（FRU）和糖化血红蛋白（HbAlc）水平。GDM 组和GIGT组孕妇进行口服葡萄糖耐量试验(OGTT)检测FBG和FRU水平并分析比较。　结果　GDM 组FBG和HbAlc水平分别为(8.50±0.92)mmol/L和(8.95±0.69)%显著高于GIGT组(5.50±0.68)mmol/L和(5.95±0.58)%、正常妊娠组(4.62±0.90)mmol/L和(5.15±0.22)%及对照组(5.29±0.87) mmol/L和(5.03±0.24)%，差异均有显著性意义（P<0.01）。GDM 组和GIGT组FRU水平明显高于正常妊娠组和对照组；正常妊娠组FRU水平明显低于对照组，差异均有显著性意义（P<0.05）。GDM 组和GIGT组孕妇进行OGTT检测FRU时,糖耐量各检测时间点(空腹、1、2、3 h)FRU 结果比较恒定,差异无显著性意义(P>0.05) 。直线相关分析：GDM 组FBG与FRU和HbAlc均呈正相关（P<0.01）,相关系数分别为r=0.59, r=0.75, 差异均有显著性意义（P<0.01）。　结论〖HTK〗　FBG与FRU和HbAlc联合检测，将更有助于妊娠糖代谢异常患者的诊断及疗效监测。

Abstract:

Object　To explore the clinical value of the diagnosis of glycated hemoglobin and fructosamine in pregnancy sugar metabolic abnormalities.　Methods　Testing and comparing the levels of FBG ,FRU and HbAlc in the observation group 280 examples, including 222 cases of normal pregnant women (Norman pregnancy group), GIGT (gestational impaired glucose tolerance) patients 20 cases (GIGT group), GDM (gestational diabetes mellitus) patients 38 cases (GDM group) and control group of 60 cases of pregnant women. Analyzing and comparing the levels of FBG and FRU in GDM group and GIGT pregnant group by an oral glucose tolerance test.　Results　GDM group had a significantly higher level of FBG and HbAlc than GIGT group and normal pregnancy group and control group (P<0.01). GDM (8.50±0.92) mmol/L, (8.95±0.69)% vs GIGT (5.50±0.68)mmol/L, (5.95±0.58)%. GDM(8.50±0.92) mmol/L, (8.95±0.69)% vs normal pregnancy group (4.62±0.90) mmol/L and (5.15±0.22)%; GDM (8.50±0.92) mmol/L, (8.95±0.69)% vs (5.29±0.87) mmol/L, (5.03±0.24)%. The levels of FRU in GIGT and GDM group is obviously higher than that in normal pregnancy group and control group. The level of FRU in normal pregnancy group was significantly lower than that in the control group, the differences were statistically significant(P<0.05). When GDM group and GIGT pregnant women group underwent OGTT testing FRU, the result of the testing time point of sugar tolerance was constant,the difference has no statistically significant(P>0.05). Linear correlation coefficient r=0.59, respectively, r=0.75, the differences were statistically significant（P<0.01）. 　Conclusion　FBG, FRU and HbAlc joint detection will be a better help for the diagnosis and curative effect monitoring of pregnancy sugar metabolic abnormalities patients.