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1、IADPSG糖尿病诊断新标准的临床应用价值张丽娟I,蒋玉蓉2(1.湖南省妇幼保健院产科,长沙410008;2.屮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)o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
2、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(PV0.05),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(PV0.05),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
3、大儿的发生率高于正常对照组,比较有显著性差杲(PV0.05)。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TheClinicalapplicationvalueofIADPSGdiabetesdiagnosisnewstandardJIANGYurong,ZHANGLijuan(Materrrnlandchildrenhealthcarehospitalofhunanprovinccchangs
4、ha410008)【abstract]objectivc:tostudythegestationaldiabetesdifferentdiagnoSticstandardfortheinfluenceofthepregnancyoutcome-Methods:8046casesofpregnantwomeninglucosetolerancetest(OGTT).Accordingtotheuseofseventheditionoftheobstetricsandgynecology^standardsandTADPS
5、Gtwodiagnosisstandardofpregnantwomeningestationaldiabetesdiagnosis,wi11useTADPSGstandarddiagnosisforGDMandtheseventheditionoftheobstetricsandgynecology"standarddidnotdiagnosedwithGDMandG1GTpregnantwomenforrandominterventiongroupandtheinterventiongroup,theinterve
6、ntiongroupgestationaldiabetesaccordingtointerveneandmanagement,theother180casesofnormalpregnantwomen(controlgroup),thethreegroupsoffemalesoncomparedthepregnancyoutcome.Results:all8046casesofpregnantwomenaccordingtotheseventheditionoftheobstetricsandgynecology^st
7、andarddiagnosisGDMpatientswithGTGTandatotalof368cases,thedetectionrateis4.57%,accordingtothe8046casesofpregnantwomenTADPSGstandarddiagnosisGDMpatientsatotalof655patients,forTADPSGgroup,thedetectionratewas8.14%.GDMinterventiongroupofgestationalhypertensiondisease
8、,polyhydramnios,prematureruptureofmembranc,theincidenccofmacrosomiainlessthanGDMnoninterventiongroup,themoresignificantdifference(P<0・05),GDMinterventiongroupofcesare