妊娠期糖尿病孕妇空腹血糖与妊娠结局相关性分析

Analysis of Pregnant Outcome and Fasting Blood Glucose of Pregnant Women with Gestationl Diabetes Mellitus

【目的】探讨妊娠期糖尿病(GDM)空腹血糖(FBG)的特点和对妊娠结局的影响。【方法】采用回顾性研究的方法,选择2006年1月至2007年6月在我院进行常规产前检查和住院分娩确诊为GDM的孕妇182例,根据75g糖耐量试验(OGTT)中FBG或FBG分为FBG正常组(A组)114例和FBG升高组(B组)68例进行临床资料分析。【结果】①FBG与GCT及OGTT各时点血糖呈正相关。GCT1h血糖≥11.1mmol/L的GDM中FBG≥5.8mmol/L占71.1%。②两组孕产妇并发症比较差异无显著性(P>0.05)。但FBG升高的GDM孕妇需胰岛素治疗发生率(19.1%)明显高于FBG正常组(5.3%),两组差异有显著性(P<0.05)。③FBG升高组新生儿出生体重高于FBG正常组,巨大儿、新生儿窒息、新生儿高胆红素血症发病率明显增加。【结论】①GCT1h血糖≥11.1mmol/L时,应先行FBG检查确诊是否为GDM。②FBG升高的GDM围产儿危险性增加,必须加强监测。

[Objective] To study the feature of the fasting blood glucose and its effect on the pregnant outcome of the women with gestation diabetes mellitus （GDM）, [Methods] Retrospective analysis was utilized to analyze the FBG and the pregnant outcome of 182 in-and out-pregnant women who were diagnosed as GDM in the 3th Affiliated Hospital of SUN Yet Sen University from January 2006 to June 2007. According to the FBG results of 75g oral glucose tolerance test （OGTT） or FBG, the patients were divided into Group A with the normal FBG and Group B with the elevating FBG . [Result] FBG was positively related with the plasma glucose of every time point in the glucose challenge test （GCT） and the OGTT. The women with FBS ≥ 5.8 mmol/L took up 71.1% of the women with the plasma glucose of GCTlh equal or more than 11.1 mmol/L. There were no significant difference between the two groups in the pregnancy complication. The rate of insulin treatment in Group B （19.1%） is much higher than Group A （5.3%） （P 〈 0.05）. The birth weight in Group B as well as the rate of fetal macrosomia, the neonatal asphyxia and the newborn hyperbilirubinemia was higher than that in group A. [ Conclusion ] FBS must be examined for the diagnosis of GDM if the plasma glucose of GCTlh is equal or more than 11.1 mmol/L. The risk of the perinatal fetus in the patients of GDM rises with the elevation of FBG, which need the strengthening monitoring.