门诊妊娠糖尿病患者营养状况调查研究

Nutritional Status of Out- patient Pregnant Women With Gestational Diabetes Mellitus

目的探讨妊娠糖尿病(GDM)患者孕中期的膳食营养状况,为GDM干预措施的制定提供科学依据。方法选取2014年1—6月于郑州人民医院门诊行产前检查并确诊为GDM的孕妇92例为研究对象(GDM组),另选取同期健康孕妇92例为对照组。采用问卷调查的方法,收集年龄、身高、孕前体质量及孕中期血清总蛋白(TP)、清蛋白(Alb)和血红蛋白(Hb)水平。以食物模型和食物比例图谱辅助孕妇回忆调查前3 d的24 h食物及分量,详细记录每日各类食物摄入量,采用中西医结合营养治疗计算机专家系统(NCCW)进行营养素计算。结果 GDM组年龄、孕前体质量和孕前体质指数(BMI)大于对照组(t=5.853、2.955、3.948,P<0.05)。GDM组TP异常率、Alb营养不良率高于对照组(χ2=4.056、29.164,P<0.05)。GDM组能量摄入量高于参考摄入量1 852 kcal(t=20.574,P<0.001);蛋白质摄入量与参考摄入量93 g比较,差异无统计学意义(t=0.872,P=0.384),但低于参考产热比20%(t=7.442,P<0.001);脂肪摄入量低于参考摄入量62 g(t=4.812,P<0.001),与参考产热比30%比较,差异无统计学意义(t=0.731,P=0.466);碳水化合物摄入量高于参考摄入量232 g,且高于产热比50%(t=8.031,t=6.942,P<0.001)。GDM组能量、蛋白质、脂肪、碳水化合物摄入量均高于对照组(t=14.761、2.968、3.356、4.905,P<0.05),碳水化合物产热比高于对照组(P<0.05)。结论 GDM患者年龄和BMI较大,蛋白质营养不良发生率较高,膳食营养素结构比例不合理。

Objective To analyze the nutritional status of pregnant women with gestational diabetes mellitus（GDM）, to provide a scientific basis for GDM intervention measures. Methods From January to June 2014,in People＆#39;s Hospital of Zhengzhou,92 GDM pregnancy women（GDM group）and 92 healthy pregnancy women（control group）were enrolled in this study. Age,height,pre - pregnancy body mass and second trimester serum total protein（TP）,albumin（Alb）and hemoglobin （Hb）levels were collected by questionnaire survey. Model of food and atlas of food proportion were given to pregnant women to recall survey of 24 h before 3 d food and weight,and records of various types of daily food intake detailly,and the nutrient were calculated by Nutrition System of Chinese Traditional Medicine Combining with Western Medicine（NCCW）. Results The age, pre - pregnancy body mass（BM）and body mass index（BMI）were higher in GDM group than in control group（ t = 5. 853, 2. 955,3. 948,P 〈 0. 05）,and TP abnormal rate,Alb malnutrition rate higher（χ2 = 4. 056,29. 164,P 〈 0. 05）. In GDM group,the acceptable daily intake（ ADI）of energy was higher than reference intake（ RI）1 852 kcal（ t = 20. 574,P 〈0. 001）;ADI of protein was not different from RI 93g（ t = 0. 872,P = 0. 384）,but lower than reference heat production proportion（HPP）20%（ t = 7. 442,P 〈 0. 001）;ADI of fat lower than RI 62 g（t = 4. 812,P 〈 0. 001）,not different from reference HPP 30%（t = 0. 731,P = 0. 466）;ADI of carbohydrate higher RI 232 g,higher than HPP 50%（t = 8. 031,t =6. 942,P 〈 0. 001）. The intakes of energy,protein,fat,carbohydrate higher in GDM group than in control group（ t =14. 761,2. 968,3. 356,4. 905,P 〈 0. 05）,HPP of carbohydrate higher（ P 〈 0. 05）. Conclusion GDM patients has higher age,BMI,higher incidence of protein malnutrition than control group,and the ratio of dietary structure is irrational.