妊娠期糖尿病孕妇产后糖代谢异常情况分析

The Influence Factors of Gravida Postpartum Glucose Dysbolism of Gestational Diabetes Mellitus

目的 分析妊娠期糖尿病（GDM）患者产后6～8周内糖代谢异常情况.方法 选取2011年5月至2012年12月深圳市南山妇幼保健院确诊的GDM并正常分娩的患者119例作为研究对象,根据患者产后6～8周糖代谢恢复情况分为糖代谢异常组和糖代谢正常组.观察两组患者的母乳喂养率、口服葡萄糖耐量试验（OGTT）分时测量值以及胰岛素使用情况.结果 糖代谢正常组患者诊断孕周较晚、空腹血糖水平较低、BMI较低、孕次及产次均显著少于糖代谢异常组（P＜0.01）;糖代谢正常组患者母乳喂养率显著高于糖代谢异常组（P＜0.05）,OGTT分时测量值均显著低于糖代谢异常组（P＜0.01）;糖代谢正常组饮食控制率显著高于糖代谢异常组,但胰岛素使用情况显著低于糖代谢异常组（P＜0.01）.结论 孕妇既往史及孕前资料、孕期糖代谢水平及诊断孕周、产后治疗及婴儿喂养方式等均可影响产妇产后糖代谢水平变化.

Objective To investigate the abnormal glucose metabolism within postpartum 6-8 weeks and the influence factors of gestational diabetes mellitus（GDM） patients.Methods Total of 119 patients with diagnosed GDM and normal delivery in Shenzhen Nanshan Women and Children Health Care Hospital from May 2012 to Dec.2011 were included as the research objects,according to the glucose metabolism recovery status within postpartum 6-8 weeks,the patients were divided into abnormal glucose metabolism group and the normal glucose metabolism group.The general stauts,the rate of breast feeding,oral glucose tolerance test （OGTT） measurements and insulin usage time were observed.Results Diagnosis of gestational age of normal glucose metabolism group was later,BMI was lower,gravidity and parity were lower than abnormal glucose metabolism group,with statistically significant difference（P 〈 0.01）,breast feeding rate of normal glucose metabolism group was significantly higher than the abnormal glucose metabolism group（P 〈 0.05）,OGTT values at different times were significantly lower than those of abnormal glucose metabolism group（P 〈 0.01）,diet control rate of normal glucose metabolism group was significantly higher than that of abnormal glucose metabolism group,but insulin using was significantly lower than that of abnormal glucose metabolism group（P 〈 0.01）.Conclusion The glucose postpartum metabolism level is influenced by the past history of pregnant woman and pregnancy data,glycometabolism during pregnancy,diagnosis gestational weeks,postpartum treatment and infants feeding way.