妊娠糖尿病母亲新生儿和健康孕妇巨大儿的血糖、胰岛素、皮质醇和并发症的观察

Observation on blood glucose,insulin,cortisol and complication in infants of gestational diabetic mothers and healthy macrosomia

目的探讨妊娠糖尿病(GDM)母亲新生儿和健康孕妇巨大儿的血糖、胰岛素、皮质醇和并发症的特点。方法 2014年1月至2015年6月廉江市人民医院新生儿科出生的单胎、足月新生儿107例,分为GDM新生儿组(GDM孕妇所产)38例,巨大儿组(健康孕妇所产)34例和健康新生儿组(健康孕妇所产)35例。检测3组的血糖、胰岛素和皮质醇的水平,同时记录3组窒息、低血糖、高胆红素血症、低血钙、红细胞增多症的发病情况。结果 GDM新生儿和巨大儿的血糖均明显比健康新生儿低,而胰岛素和皮质醇水平均比健康新生儿高,差异有统计学意义(P<0.05)。血糖、胰岛素和皮质醇水平在GDM新生儿和巨大儿之间比较差异无统计学意义(P>0.05)。低血糖在GDM新生儿组的发病率明显高于健康新生儿组,差异有统计学意义(P<0.017)。结论 GDM新生儿和巨大儿的血糖、胰岛素和皮质醇水平存在异常的比率高,GDM新生儿要注意低血糖并发症。

Objective To observe the characteristics of blood glucose, insulin, eortisol and complication in neonates of mothers with gestational diabetes mellitus（GDM） and healthy rnacrosomia. Methods The 38 cases of neonates of GDM mothers（group A）, 34 cases of healthy macrosomia of mothers without GDM（group B） and 35 healthy neonates of mothers without GDM（group C） born in our hospital from January 2014 to June 2015 were included in the study. The level of blood glucose,insulin and cortisol were measured in the three groups, and complication were also recorded in the 3 groups, including asphyxia, hypoglycemia, hyperbil- irubinemia, hypocalcemia and polycythemia. Results Compared with group C,the level of blood glucose in group A and group B was apparently lower（P〈0.05）, while the level of insulin and cortisol in group A and group B was apparently higher, the difference was of statistical significance. There was no difference in blood glucose, insulin or cortisol between group A and group B（P〉0.05）. The incidence of hypoglycemia in group A was significantly higher than that in group C and the difference was statistical（P〈0. 017）. Conclusion The abnormal rate of blood glucose,insulin and cortisol in the infants of gestational diabetic mothers and healthy macrosomia is high, and GDM neonates should be monitored for hypoglycemia.