【摘要】 目的探讨妊娠期糖尿病的50g葡萄糖筛查(50gGCT)和75g葡萄糖耐量试验(75gOGTT)诊断标准及确诊时间对妊娠结局的影响。方法回顾性分析北京大学人民医院137例妊娠期糖尿病患者的临床资料和50gGCT及75gOGTT的结果。结果50gGCT以7.2mmol/L为界值,则GDM的漏诊率约5.19%;75gOGTT平均空腹血糖为(4.95±1.20)mmol/L,1h血糖为(11.08±1.76)mmol/L,2h血糖为(9.46±2.65)mmol/L,3h血糖为(6.39±2.32)mmol/L,75gOGTT不检测3h血糖,将漏诊21例GDM,约16.3%;超过36周确诊,新生儿体重明显超重。结论GDM孕妇75gOGTT诊断可考虑降低空腹血糖标准,而提高服糖后1h、2h血糖标准;75gOGTT不宜省略OGTT3h血糖的检测。妊娠期糖尿病宜早筛查、早诊断从而早治疗利于改善母儿预后。更多还原

【Abstract】 [Objective] To explore the effects of diagnostic criteria and time of 50g GCT and 75g GOTT in patients with gastational diabetes mellitus (GDM) on pregnancy outcome. [Methods] Clinical data and results of 50g GCT and 75g GOTT of 137 patients with GDM of People’s Hospital of Peking University were retrospected. [Results] The missed diagnostic rate was about 5.19% if the cut-off value of 50g GCT was 7.2 mmol/L; the average fasting plasma glucose (FPG) of 75g GOTT was (4.95±1.20) mmol/L, 1h postprandial plasma glucose (1hPG) was (11.08±1.76) mmol/L, 2 h postprandial plasma glucose (2hPG) was (9.46±2.65) mmol/L, 3 h postprandial plasma glucose (3hPG) was (6.39±2.32) mmol/L; 21 cases of GDM, about 16.3%, would be missed diagnosed if 3hPG of 75g OGTT was not tested; obvious overweight of neonate would be diagnosed after gestational 36 weeks. [Conclusion] FPG value of 75g GOTT in patients with GDM is considered to be decreased, while 1hPG and 2hPG values increase. 3hPG of 75g OGTT should no be omitted. GDM should be early screened and diagnosed so that the patient could be treated early and the prognosis would be improved.更多还原