#蒋玉蓉尿病诊断新标准的诊断价值 张.doc

IADPSG 糖尿病诊断新标准的 临床应用价值 张丽娟1，蒋玉蓉2 （1.湖南省妇幼保健院产科，长沙 410008；2.中南大学湘雅二医院产科） 【摘要】 目的:探讨妊娠期糖尿病不同诊断标准对于妊娠结局的影响。方法:对8046例孕妇进行葡萄糖耐量试验(OGTT)。按照利用第7版《妇产科学》标准和IADPSG两种诊断标准对孕妇进行妊娠期糖尿病诊断，将采用IADPSG标准诊断为GDM而采用第7版《妇产科学》标准并未诊断为GDM及GIGT的孕妇随机为干预组（A组）和非干预组（B组），对干预组按妊娠期糖尿病进行干预与管理，另选180例正常孕妇为对照组（C组），对三组的母儿妊娠结局进行比较。结果:8046例孕妇根据第7版《妇产科学》标准诊断GDM及GIGT患者共368例，检出率为4.57%，8046例孕妇根据IADPSG标准诊断GDM患者共655例，为IADPSG组，检出率为8.14%。GDM干预组的妊娠期高血压疾病、羊水过多、胎膜早破、巨大儿的发生率低于GDM非干预组，比较有显著性差异(P＜0.05)，GDM干预组的剖宫产率、新生儿平均出生体重儿显著低于非干预组(P＜0.05)，GDM干预组母儿妊娠结局与正常孕妇组无明显差异，非干预组的妊娠期高血压疾病、巨大儿的发生率高于正常对照组，比较有显著性差异(P＜0.05)。结论:采用IADPSG诊断标准，可以使更多的GDM患者被诊断，对其进行膳食及生活方式的干预，可有效减少不良妊娠结局的发生。 【关键词】 糖尿病；妊娠；妊娠结局；葡萄糖耐量试验 The Clinical application value of IADPSG diabetes diagnosis new standard JIANG Yurong , ZHANG Lijuan (Maternal and children health care hospital of hunan province changsha 410008) 【 abstract 】 objective: to study the gestational diabetes different diagnostic standard for the influence of the pregnancy outcome. Methods: 8046 cases of pregnant women in glucose tolerance test (OGTT). According to the use of seventh edition of the obstetrics and gynecology standards and IADPSG two diagnosis standard of pregnant women in gestational diabetes diagnosis, will use IADPSG standard diagnosis for GDM and the seventh edition of the obstetrics and gynecology standard did not diagnosed with GDM and GIGT pregnant women for random intervention group and the intervention group, the intervention group gestational diabetes according to intervene and management, the other 180 cases of normal pregnant women (control group), the three groups of female son compared the pregnancy outcome. Results: all 8046 cases of pregnant women according to the seventh edition of the obstetrics and gynecology standard diagnosis GDM patients with GIGT and a total of 368 cases, the detection rate is 4.57%, according to the 8046 cases of pregnant women IADPSG standard diagnosis GDM patients a total of 655 patients, for IADPSG group, the detection rate was 8.14%. GDM