妊娠期糖尿病孕妇酮体、肌醇含量变化与胎儿畸形的相关性

Application of three dimensional visualization technology for laparoscopic Resection of Follow-up study of gestational diabetes mellitus female ketone and inositol content and fetal malformation

目的对孕早期孕妇酮体含量及肌醇代谢水平进行分析,了解妊娠期糖尿病（GDM）孕妇酮体与肌醇含量的变化与胎儿出现畸形的相关性,从而达到在孕早期对胎儿畸形进行预防的目的。方法选取2010年1月~2013年6月间于我院确诊为GDM孕妇并在我院分娩产出畸形胎儿的患者19例,设为GDM组;另选取同期在我院进行常规检查并正常分娩的健康孕妇19例设为对照组。分别于两组研究对象怀孕3个月内时测定其体内酮体、肌醇和空腹血糖含量,并追踪统计畸形胎儿的类型,分析GDM孕妇酮体与肌醇含量的变化对胎儿出现畸形的影响。结果两组研究对象在年龄、孕周、BMI等一般资料比较中差异不具有统计学意义（P〉0.05）。经过对各项检测指标的分析发现,GDM组的孕妇酮体和空腹血糖含量显著高于对照组,而肌醇的含量水平则低于对照组。两组之间的比较差异具有统计学意义（P〈0.05）。GDM组的孕妇娩出的畸形胎儿主要有无脑儿、脊柱裂、肾脏畸形及其他神经中枢缺损。结论 GDM孕妇酮体的含量和肌醇的代谢水平能够影响胎儿的正常发育,在孕早期胎儿是否存在畸形的预测中具有一定的价值,以此为指标可以在临床上对妊娠期糖尿病孕妇及时的进行补救或终止妊娠,减少畸形胎儿的发生率。

Objective To understand GDM women ketones and inositol content changes and fetal deformity correlation to achieve in the first trimester of fetal malformations for the purpose of prevention.Methods Gestational diabetes（GDM） and pregnant women giving birth in hospital outputs 19 patients with fetal malformations collected from January 2010 to June 2013 in our hospital were set as GDM group.19 cases with routine examination and normal healthy pregnan were set as control group.Study groups within 3 months of pregnancy when measured in vivo ketone,inositol and fasting blood glucose levels,and tracking statistics fetal malformation type analysis GDM women ketones and inositol content change effects on fetal deformity.Results Subjects in age,gestational age,BMI and other general information had no significant difference（P0.05）.After an analysis for the detection of indicators found,GDM group of pregnant women ketones and fasting plasma glucose levels were significantly higher,while the levels of inositol lower than the control group.The difference between the two groups was statistically significant（P0.05）.GDM group of pregnant women delivered a major fetal malformations or without brain child,spina bifida,kidney malformations and other central nervous system defects.Conclusion GDM women ketone levels and inositol metabolism can affect the normal development of the fetus in the first trimester of fetal malformations forecast whether there has a certain value,as a possible indicator for gestational diabetes in pregnant women clinically timely remedy or termination of pregnancy,to reduce the incidence of fetal malformations.