【摘要】 目的研究孕中期空腹血糖(FPG)用于预测高龄产妇发生妊娠糖尿病(GMD)风险的应用价值。方法纳入河北北方学院附属第一医院2017年5月～2019年5月46例高龄产妇GDM患者作为观察组,另纳入同期46例健康正常高龄孕妇作为对照组。比较两组患者孕早期和孕中期FPG,三酰甘油(TG)、糖化血红蛋白(HbA1c)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及总胆固醇(TC)水平。采用Logistic多因素分析法分析GDM的独立影响因素。记录单一指标与联合检测在预测GDM风险中的价值。结果观察组患者HbA1c,孕中期与孕早期FPG,TG及TC水平均高于对照组孕妇,差异均有统计学意义(t=3.038～9.378,均P<0.05)。Logistic多因素分析结果显示孕中期FPG,HbA1c及TC与高龄孕妇发生GDM相关(P<0.05)。受试者工作曲线(ROC)分析显示HbA1c(AUC=0.725,95%CI=0.623～0.827,P=0.000),FPG(AUC=0.623,95%CI=0.508～0.738,P=0.042)及TC(AUC=0.716,95%CI=0.613～0.819,P=0.000)对预测GDM具有一定应用价值。HbA1c,FPG及TC联合预测GDM准确性高(AUC=0.870,95%CI=0.790～0.949,P=0.000)。结论孕中期FPG监测辅助HbAlc与TC,有助于预测GDM风险,指导临床,可为临床干预提供依据。更多还原

【Abstract】 Objective To study the value of fasting plasma glucose(FPG) in the second trimester to forecastthe gestational diabetes mellitus(GDM) in elderly parturient. Methods From May 2017 to May 2019, 46 elderly women with GDM were included as the observation group, and 46 healthy elderly women as the control group. FPG, TG, HbA1 c, LDL-C, HDL-C and TC were compared between the two groups. The independent influencing factors of GDM were analyzed by logistic multi factor analysis. Recorded the value of single indicator and jointed detection in predicting GDM risk. Results The levels of HbA1 c, FPG, TG and TC in the observation group were significantly higher than those in the control group(t=3.038～9.378,all P< 0.05). The results of logistic multivariate analysis showed that FPG, HbA1 c and TC in the second trimester were correlated with GDM(P < 0.05). The ROC analysis showed that HbA1 c(AUC = 0.725, 95% Cl = 0.623～0.827, P= 0.000), FPG(AUC = 0.623, 95% Cl = 0.508～0.738, P = 0.042) and TC(AUC = 0.716, 95% Cl = 0.613～0.819, P = 0.000) had certain application value to predict GDM. The combined prediction of HbA1 c, FPG and TC was of high accuracy(AUC = 0.870, 95% Cl = 0.790～0.949, P = 0.000). Conclusion FPG monitoring assisted HbAlc and TC in the second trimester is helpful to predict the risk of GDM, guide the clinical practice and provide basis for clinical intervention.更多还原