目的:通过对几种检验方法的研究,总结出能早期筛查出妊娠期糖尿病的可靠检测指标,并初步了解濮阳地区妊娠期糖尿病(GDM)的发病率及分布特点。方法:对2008年1月～2010年7月来妇产科门诊行产前检查的孕妇510例进行了筛选,筛选出高危组150例(24～28周孕妇,年龄>30岁,肥胖或有巨大胎儿生产史,难以解释的死胎史,妊高征患者等)。无高危组(24～28周无高危人群的孕妇)150例。对她们进行了产前GDM的筛选。筛查方法先行空腹血糖、血脂、测定,发现空腹血糖值在5.5mmol/L以上且伴有血脂增高者,进行50g葡萄糖激发试验(GCT),再有异常者进一步做75g葡萄糖耐量试验(OGTT)及空腹胰岛素、2小时胰岛素、糖化血红蛋白(Hb)、尿微量蛋白(AIb)、尿糖测定。结果:①空腹血糖在5.5mmol/L以上79例,占总人数26.3%,血糖在5.5mmol/L以上且伴有血脂增高者51例,占总人数17%,GCT异常者38例占总人数12.6%,OGTT异常者14例占总人数9.3%,空腹及2小时胰岛素异常者16例占总人数5.3%,随机尿微量白蛋白增高者1例占总人数0.33%、尿糖增高者3例占总人数1.0%,发现GDM患者10例占总人数3.3%,这10例当中都伴有空腹血糖在5.5mmol/L以上、血脂、GCT、OGTT异常及空腹胰岛素、2小时胰岛素持续增高。②通过以上数据显示对24～28周孕妇进行妊娠期糖尿病(GDM)的筛查,可靠的检测方法是:血糖5.5mmol/L以上且伴有血脂增高者进行50g葡萄糖激发试验(GCT),再有异常者进一步做75g葡萄糖耐量试验(OG-TT)、及空腹及2小时胰岛素测定。③濮阳地区GDM的发病率为3.3%,高危组孕妇明显高于对照组,城市高于乡镇,且随着孕妇年龄的增长而增高,脑力劳动者明显高于体力劳动者。结论:应对育龄妇女加强孕前GDM的宣传力度,加强孕期保健,使她们对糖尿病的防治有深刻的认识,选择合适正确的检验方法,以便及早进行妊娠期糖尿病筛查,有效地降低围产期患病率,减少妊娠期糖尿病及并发症的发生;尤其对于有高危因素的人群更予以重视,建议在高危人群中进行普查GDM。 OBJECTIVE: Through the study of several test methods, the reliable detection index of early detection of gestational diabetes mellitus can be concluded, and the prevalence and distribution of gestational diabetes mellitus (GDM) in Puyang area can be preliminarily understood. Methods: From January 2008 to July 2010, 510 pregnant women of prenatal examination in obstetrics and gynecology clinic were screened out, 150 cases of high risk group (24-24 weeks pregnant women, age> 30 years old, obese or have Huge fetus production history, unexplained history of stillbirth, PIH patients, etc.). No high-risk group (24 to 28 weeks pregnant women without high-risk groups) 150 cases. They were prenatal GDM screening. Screening method fasting blood glucose, blood lipids, determination and found that fasting blood glucose values ​​above 5.5mmol / L and associated with elevated blood lipids, 50g glucose challenge test (GCT), and further abnormal 75g glucose tolerance test (OGTT) And fasting insulin, 2 hours of insulin, glycosylated hemoglobin (Hb), urinary microalbumin (AIb), ​​urine glucose determination. Results: ①The fasting blood glucose was above 5.5mmol / L in 79 cases, accounting for 26.3% of the total. Blood glucose was above 5.5mmol / L, with 51 cases of hyperlipidemia, accounting for 17% of the total. 12.6%, 14 cases of abnormal OGTT accounted for 9.3% of the total, fasting and 2 hours of insulin abnormalities in 16 cases accounted for 5.3% of the total, random urine microalbumin increased in 1 case accounted for 0.33% of the total number, increased urine sugar in 3 cases Accounting for 1.0% of the total. 10 cases of GDM patients were found, accounting for 3.3% of the total. Among these 10 cases, fasting blood glucose was above 5.5mmol / L, dyslipidemia, GCT, OGTT abnormalities and fasting insulin and 2 hours of insulin were continuously increased. ② The above data show that gestational diabetes mellitus (GDM) screening of 24-28 weeks pregnant women, reliable detection methods are: blood glucose 5.5mmol / L or more with hyperlipidemia were 50g glucose challenge test (GCT), and then Patients with abnormalities were further subjected to 75 g glucose tolerance test (OG-TT), and fasting and 2-hour insulin measurements. ③ The prevalence of GDM in Puyang was 3.3%. The pregnant women in high-risk group were significantly higher than those in control group. The urban area was higher than that of township, and increased with the increase of pregnant women’s age. The mental workers were significantly higher than manual workers. CONCLUSIONS: Women of childbearing age should step up publicity of pre-pregnancy GDM and strengthen their care during pregnancy so that they have a profound understanding of the prevention and treatment of diabetes. The appropriate and appropriate test methods should be selected in order to screen gestational diabetes as soon as possible and effectively reduce perinatal Reduce the incidence of gestational diabetes mellitus and complications; especially for people with high risk factors pay more attention, it is recommended to carry out census GDM in high-risk groups.