医学营养治疗对妊娠期糖尿病患者分娩结局及新生儿免疫功能的影响

Effect of Medical Nutrition Therapy on Delivery Outcome of Gestational Diabetes Mellitus Patients and Neonatal Immune Function

目的探讨医学营养治疗对妊娠期糖尿病患者分娩结局及新生儿免疫功能的影响。方法选择我院2014年7月—2016年7月期间收治的132例妊娠期糖尿病患者为研究对象,随机分为对照组与研究组,均66例。对照组患者采用常规糖尿病饮食指导,研究组采用医学营养治疗。比较两组患者空腹血糖、餐后2h血糖、分娩结局及新生儿脐带血免疫球蛋白IgA、IgG、IgM及T淋巴细胞亚群CD3^+、CD4^+、CD8^+水平。结果与治疗前比较,分娩前两组空腹血糖、餐后2h血糖均下降,且研究组下降幅度大于对照组,差异具有统计学意义(P<0.05);研究组胎儿窘迫、巨大儿、早产、新生儿窒息、剖宫产发生率均低于对照组,差异具有统计学意义(P<0.05);研究组剖宫产及阴道分娩新生儿IgG、CD3^+、CD4^+、CD8^+水平均高于对照组,差异具有统计学意义(P<0.05)。结论采用医学营养治疗妊娠期糖尿病可显著降低患者血糖水平,改善分娩结局,提高新生儿的免疫功能,临床优势显著,具有临床推广意义。

Objective To investigate the effect of medical nutrition therapy （MNT） on delivery outcome of gestational diabetes mellitus （GDM） patients and neonatal immune function. Methods 132 GDM patients admitted into our hos- pital from October 2014 to July 2016 were randomly divided into control group and research group, 66 cases in each. Control group took diet guidance of conventional diabetes, research group took MNT. The fasting blood - glucose （ FBG）, two hours postprandial blood glucose （2hPBG）, delivery outcome, neonate cord blood immunoglobulin of IgA, IgG, IgM, T lymphocyte subsets of CD3 ＋, CD4＋, CD8 ＋ levels in two groups were compared. Results Compared with before treatment, the FBG and 2hPBG of two groups decreased before delivery, and the descend range of research group was larger than control group （P 〈 0. 05） ; The incidence of fetal distress, macrosomia, premature birth, neonatal asphyxia, cesarean section of re- search group was lower than control group （P 〈 0. 05） ; The levels of IgG, CD3 ＋, CD4 ＋ , and CD8 ＋ in cesarean section and vaginal delivery neonates in the study group were higher than those in the control group, the difference was statistically significant （P 〈 0. 05）. Conclusion MNT for treating GDM can significantly decrease blood glucose level, improve delivery outcome, increase neonatal immune function, and have remarkable clinical advantages, which has significance of clinical pro- motion.