妊娠期糖尿病巨大儿的相关因素分析

Analyze of related factors of great children in patients with gestational diabetes mellitus

目的：研究妊娠期糖尿病（GDM）巨大儿的相关因素。方法选择2013年3月~2014年5月北京市昌平区中医医院收治的124例GDM患者，根据娩出胎儿是否为巨大儿将其分为巨大儿组（观察组，36例）和非巨大儿组（对照组，88例）。回顾性分析两组患者的一般情况、血糖水平、治疗开始孕龄、糖化血红蛋白、接受治疗情况、治疗方案和血糖控制的满意度。结果观察组患者的新生儿体重[（4389.2±369.6）g]显著高于对照组[（3367.1±386.3）g]，差异有高度统计学意义（t =13.539，P〈0.01）；两组产次及巨大儿分娩史比较，差异均有统计学意义（χ2=7.525、4.969，均P〈0.05）。两组患者OGTT 2 h血糖的水平及治疗开始孕龄比较，差异无统计学意义（t=0.475、0.357，均P＆gt;0.05），但是观察组糖化血红蛋白水平[（6.78±0.87）%]明显高于对照组[（5.21±0.97）%]，差异有高度统计学意义（t=8.421，P〈0.01）。观察组患者接受治疗率（55.56%）显著低于对照组（78.41%），差异有统计学意义（u=6.587，P〈0.05）。观察组患者的治疗方案主要是饮食调节，对照组则是在饮食调节下进行胰岛素治疗，差异有高度统计学意义（χ2=7.264，P〈0.01）。对照组的血糖控制满意度（92.05%）显著高于观察组（72.22%），差异有高度统计学意义（u=2.901，P〈0.01）。结论妊娠期糖尿病巨大儿的发生与多种因素相关，为此孕妇在产前应进行严格的产检，当确诊GDM后应当积极配合治疗，随时保持血糖处于理想水平的状态，有利于降低巨大儿的发生率。

Objective To study the related factors of great children in patients with gestational diabetes. Methods 124 cases of patients with GDM from March 2013 to May 2014 in Changping Hospital of Traditional Chinese Medicine were selected, and they were divided into great children group （observation group, 36 cases） and non-great children group （control group, 88 cases） according to whether delivered a great children. The general condition, blood sugar levels, gestation age of begin treatment, glycosylated hemoglobin, situation of treatment acceptation, treatment regimens and satisfaction of glycolic control of two groups were retrospectively analyzed. Results The weight of newborn in the obser-vation group [（4389.2±369.6） g] was significant higher than that of the control group [（3367.1±386.3） g], the difference was statistically significant （t = 13.539, P 〈 0.01）, production times and the history of great children between two groups had statistically significant differences （χ2=7.525, 4.969, all P〈0.05）. blood sugar levels at OGTT 2 h, gestation age of begin treatment of patients in two groups had no statistically significant difference （P＆gt; 0.05）, but glycosylated hemoglobin of the observation group [（6.78±0.87）%] was significantly higher than that of the control group [（5.21±0.97）%], the difference was statistically significant （t=8.421, P〈0.05）; rate of treatment acceptation of patients in the observation group （78.41%） was significantly higher than that of the control group （55.56%）, the difference was statisti-cally significant （u=6.5865, P〈0.05）; diet-regulated was the main therapy of the observation group, and insulin ther-apy assisted in regulation of diet was the main therapy of the control group, the difference was statistically significant （χ2=7.264, P〈 0.01）; satisfaction of blood glucose control in the control group （92.05%） was significantly higher than that of the observation group （72.22%）, the difference was statistically significant （u=2.9014, P〈0.01）. Conclusion Many factors are relate to great children in patients with gestational diabetes, so pregnant women should carry out strict prenatal check-ups and actively cooperate with treatment when diagnosed with CDM, and to keep blood sugar in the ideal levels, which will help to reduce the incidence of great children.