妊娠期糖尿病不同血糖水平孕妇的临床特点与妊娠结局分析

Analysis on clinical characteristic and pregnancy outcome of women with gestational diabetes mellitus on different blood glucose levels

目的探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)不同血糖水平孕妇的临床特点与妊娠结局。方法选择2013年1月至2015年3月在山东省单县东大医院行产前检查并住院分娩的GDM孕妇150例,依据75g葡萄糖耐量试验(75g oral glucose tolerance test,75 g OGTT)各时点血糖结果,以其中1项血糖水平异常为GDM A组,2项血糖水平异常为GDM B组,3项血糖水平均异常为GDM C组。对3组孕妇的临床特点和妊娠结局进行分析。结果 GDM C组孕前体质量指数(body mass index,BMI)和肥胖率(26.2±4.8、36.0%)均明显高于GDM B组(24.3±3.8、17.6%)和GDM A组(24.3±3.8、2.7%)(P<0.05)。GDM C组胰岛素使用率(24.0%)明显高于GDM B组(3.9%)和GDM A组(1.3%)(P<0.05)。GDM C组空腹胰岛素、胰岛素抵抗指数(21.2±4.9、6.1±2.0)明显高于GDM B组(18.6±5.1、4.2±1.1)和GDM A组(13.2±3.3、2.8±0.8)(P<0.05)。GDM C组巨大儿发生率(44.0%)明显高于GDM B组(15.6%)和GDM A组(13.5%)(P<0.05)。结论 OGTT血糖多点异常的GDM患者与多项危险因素呈显著相关性,临床上应根据OGTT异常情况进行分层管理,积极干预。

Objective To study the clinical characteristic and pregnancy outcome of women with gestational diabetes mellitus （GDM） on different blood glucose levels. Methods 150 cases of pregnant women with GDM who hospitalized in Dongda hospital of Shah county in Shandong from January 2013 to March 2015 were selected. According to each time point blood glucose results of 75g oral glucose tolerance test （75g OGTT） , patients with once abnormal blood glucose level were chosen as GDM A group, patients with twice abnormal blood glucose levels were chosen as GDM B group, patients with thrice abnormal blood glucose levels were chosen as GDM C group. Analyze the clinical characteristics and pregnancy outcomes of 3 groups. Results The pre - pregnancy body mass index （BMI） and obesity rates of GDM C Group were significantly higher than those of group B and group A （ P 〈 0. 05 ）. Insulin usage rate of GDM C group was significantly higher than that of group B and group A （ P 〈 0. 05 ）. Fasting insulin, insulin resistance index of GDM C was significantly higher than group B and group A （ P 〈 0. 05 ）. The huge children occurrence rate of GDM C group were significantly higher than that of Group B and A group （ P 〈 0. 05 ）. Conclusion GDM patients with multiple abnormal blood glucose levels by OGTT were significantly correlated with a number of risk factors, clinical management should be based on the abnormal situation of OGTY, and intervene positively.