论文部分内容阅读
目的观察孕24~28周孕妇行葡萄糖筛查试验(GCT)时空腹和服糖后血糖、胰岛素水平,了解胰岛素抵抗的程度,分析葡萄糖筛查试验在妊娠糖尿病的诊断价值。方法550例孕24~28周孕妇行葡萄糖筛查试验,其中58例孕妇同时采用免疫发光法检测了胰岛素释放水平。结果GCT正常孕妇的空腹血糖水平(4.36±0.33)mmol/L明显低于健康非妊娠育龄妇女(4.82±0.38 mmol/L)(P<0.05),GCT异常孕妇(4.53±0.35)mmol/L空腹血糖水平分别与GCT正常孕妇和健康非妊娠育龄妇女比较,均无显著性差异(P>0.05)。GCT异常孕妇112例,其中GDM13例,占总数2.4%,妊娠期合并糖耐量减低(GIGT)30例,占总数5.5%。GCT异常孕妇空腹和服糖后1 h胰岛素水平分别为8.1±3.5mIU/L、94.5±42.7 mIU/L,明显高于GCT正常孕妇5.4±1.6 mIU/L、36.3±20.2 mIU/L(P<0.05)。结论妊娠期妇女会呈现“加速饥饿状态,并以空腹时的相对性低血糖现象为临床特征。GCT筛查异常孕妇经过OGTT不能诊断为GDM和GIGT者的孕妇随孕周发展,仍有可能进一步发展为GDM。
Objective To observe the levels of blood glucose and insulin in pregnant women undergoing glucose screening test (GCT) between 24 and 28 weeks of gestation, and to understand the extent of insulin resistance. The diagnostic value of glucose screening test in gestational diabetes mellitus was analyzed. Methods A total of 550 pregnancies from 24 weeks to 28 weeks of gestation underwent glucose screening test, in which 58 pregnant women simultaneously tested for the release of insulin by immunoluminescence. Results The fasting plasma glucose (4.36 ± 0.33) mmol / L in normal pregnant women with GCT was significantly lower than that in healthy non-pregnant women (4.82 ± 0.38 mmol / L) (P <0.05) There was no significant difference in blood glucose level between GCT normal pregnant women and healthy non-pregnant women of childbearing age (P> 0.05). There were 112 cases of abnormal GCT in pregnant women, including 13 cases of GDM, accounting for 2.4% of the total, and 30 cases of GIGT during pregnancy, accounting for 5.5% of the total. The levels of insulin at 1 h after fasting and oral glucose deprivation in GCT pregnant women were 8.1 ± 3.5 mIU / L and 94.5 ± 42.7 mIU / L, respectively, which were significantly higher than those of normal pregnant women with GCT (5.4 ± 1.6 mIU / L, 36.3 ± 20.2 mIU / L, P <0.05 ). Conclusion Pregnant women will show ”accelerated hunger state" and their fasting relative hypoglycemia is a clinical feature.GCCT screening abnormal pregnant women who can not be diagnosed as GDM and GIGT by OGTT may still develop with gestational age Further development of GDM.