妊娠糖尿病患者动态血糖的特征分析

Analysis on characteristics by continuous glucose monitoring system in pregnant women with gestational diabetes mellitus

目的应用持续动态血糖监测系统(continuous glucose monitoring system,CGMS)分析孕中晚期妊娠糖尿病(gestational diabetes mellitus,GDM)患者与正常糖耐量孕妇血糖的差异性。方法 2009年6月至2010年5月在南方医院行正规产检的初产妇,根据口服葡萄糖耐量试验(OGTT)结果分为两组,采用CGMS行72小时血糖监测,计算评估参数,分析两组各参数的差异性。结果 GDM组与对照组比较,平均血糖(MBG)波动幅度(3.5±1.0)mmol/Lvs(2.4±0.3)mmol/L、日内日血糖最大波动幅度(5.2±1.6)mmol/L vs(4.3±1.1)mmol/L、早餐后1小时MBG值(7.1±1.1)mmol/L vs(5.9±0.6)mmol/L、早餐后血糖峰值(8.5±1.1)mmol/L vs(6.8±1.1)mmol/L、早餐后血糖达峰时间(57.4±15.5)分钟vs(45.3±14.8)分钟,差异有统计学意义(均P<0.01)。结论 GDM患者存在血糖波动,CGMS可以发现GDM患者全天的特点,指导临床工作。

Objective To analyze the characteristics in pregnant women between gestational diabetes mellitus （GDM） and pregnant women with glucose profile of normal sugar tolerance by continuous glucose monitoring system （CGMS）. Methods Enrolled first pregnant women on regular check during Jun. 2009-May 2010 were then dividing into two groups by the result of oral glucose tolerance test（OGTT）. The parameters of CGMS were assessed on them. Results There were significant differences in mean amplitude of glycemic excursions （3.5 ± 1.0） mmol/L vs （2.4± 0.3） mmol/L,largest amplitude of glycemic excursions （5.2± 1.6） mmol/L vs （4.3± 1.1） mmol/L,the 1 h mean blood glucose after breakfast （7.1 ± 1.1 ） mmol/L vs （5.9 ± 0. 6） mmol/L, postPrandial peak glucose of breakfast （8.5 ± 1.1） mmol/L vs （6.8±1.1） mmol/L,the time to peak of breakfast （57.4±15.5） min vs （45.3±14.8） min. All the differences were significant in comparisons （all P 〈 0.01 ）. Conclusion There were fluctuations in blood glucose in GDM patients. CGMS could discover gestational diabetes mellitus,guiding clinical work.