CAJ | 학술논문

目的探讨目前适合我国卫生经济条件的妊娠期葡萄糖负荷试验(GCT)的筛查界值.方法资料来源于2006年4月1日至2006年9月30日在全国18个城市25家医院保健并进行首次50 g GCT的16 286例孕妇,对其GCT结果进行统计和分析.结果以NDDG标准诊断妊娠期糖尿病(GDM),50 g GCT的界值选取7.2 mmol/L时的敏感度和特异度分别为98.2%和59.0%,选取7.8 mmol/L时分别为96.0%和73.0%,选取8.3 mmol/L时分别为90.2%和81.5%;以ADA标准诊断GDM,选取GCT界值为7.2 mmol/L时敏感度为97.9%,特异度为60.4%;选取7.8 mmol/L时分别为96.2%和74.7%;而选取8.3 mmol/L则分别为87.0%和83.1%.以NDDG标准诊断妊娠期糖代谢异常(包括GDM及妊娠期糖耐量受损),选取7.2 mmol/L时敏感度和特异度分别为97.7%和61.4%,选取7.8 mmol/L时分别为95.4%和75.8%,选取8.3 mmol/L时分别为84.9%和84.1%.结论据我国目前的卫生经济情况,以7.8 mmol/L作为50 g GCT的界值是合理的.
목적 탐토목전괄합아국위생경제조건적임신기포도당부하시험(GCT)적사사계치.방법 자료래원우2006년4월1일지2006년9월30일재전국18개성시25가의원보건병진행수차50 g GCT적16 286례잉부,대기GCT결과진행통계화분석.결과 이NDDG표준진단임신기당뇨병(GDM),50 g GCT적계치선취7.2 mmol/L시적민감도화특이도분별위98.2%화59.0%,선취7.8 mmol/L시분별위96.0%화73.0%,선취8.3 mmol/L시분별위90.2%화81.5%;이ADA표준진단GDM,선취GCT계치위7.2 mmol/L시민감도위97.9%,특이도위60.4%;선취7.8 mmol/L시분별위96.2%화74.7%;이선취8.3 mmol/L칙분별위87.0%화83.1%.이NDDG표준진단임신기당대사이상(포괄GDM급임신기당내량수손),선취7.2 mmol/L시민감도화특이도분별위97.7%화61.4%,선취7.8 mmol/L시분별위95.4%화75.8%,선취8.3 mmol/L시분별위84.9%화84.1%.결론 거아국목전적위생경제정황,이7.8 mmol/L작위50 g GCT적계치시합리적.
Objective To explore the cut-off value of 50 g glueose challenge test (GCT) for gestational diabetes mellitus (GDM), which is suitable for Chinese women. Methods A multi-centered prospective population-based survey on 16 286 pregnant women, who received 50 g GCT for the first time between Apr. 1, 2006 and Sept. 30, 2006, was performed at 25 hospitls of 18 cities in China. Relative data were retrieved and analyzed. Results Based on the ADA criteria for diagnosis of GDM, the sensitivity and specificity of GCT were 97.9 % and 60. 4 %, 96. 2% and 74.7 %, and 87.0% and 83.1% at a cutoff value of 7. 2 mmol/L, 7.8 mmol/L and 8. 3 mmol/L, respectively. When NDDG criteria for GDM diagnosis was applied, the sensitivity and specificity of GCT were 98.2% and 59.0% respectively at a cut-off value of 7. 2 mmol/L, 96.0% and 73.0% at 7.8 mmol/L and 90. 2% and 81.5% at 8. 3 mmol/L. In diagnosing glucose metabolism disorders (GDM and GIGT), the sensitivity and specificity of GCT were 97. 7% and 61.4%, 95.4% and 75. 8%, and 84.9% and 84.1% at the cutoff value of 7.2 mmol/L, 7.8 mmol/L and 8. 3 mmol/L, respectively. Conclusions A cut-off value at 7. 8 mmol/L for GCT is appropriate for Chinese women.