孕期膳食指导改善血脂代谢预防妊娠期糖尿病与妊娠高血压疾病的临床研究

Prevention of gestational diabetes mellitus and pregnancy-induced hypertension by dietary guidance during pregnancy to improve blood lipid metabolism: A clinical study

目的:探讨膳食指导对孕期血脂代谢及妊娠期糖尿病和妊娠高血压疾病的影响。方法:选取2015年1月至2016年1月在广西壮族自治区妇幼保健院门诊建卡产检的早期妊娠并伴有血脂指标异常增高的女性作为研究对象,根据受试者意愿分为膳食指导试验组(152例)与对照组(97例)。检测并记录干预前后血脂、血糖、血压、体质量和妊娠并发症发生情况。结果:膳食指导干预后,试验组孕期内血浆总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)含量均显著低于对照组(P<0.05),孕期血压、空腹血糖和餐后2 h血糖显著低于对照组(P<0.05),妊娠期高血压和巨大儿发病率显著低于对照组(P<0.05),先兆子痫、妊娠期糖尿病和窒息、早产、感染和产后出血等妊娠不良结发生率局低于对照组,但差异无统计学意义P>0.05)。结论:膳食指导能够显著改善妊娠期血脂代谢,预防妊娠期高血压。

Objective：To investigate the effects of dietary guidance on blood lipid metabolism during pregnancy and gestational diabetes mellitus and pregnancy-induced hypertension. Methods：The women with early pregnancy and abnormal increase of blood lipid indicators,who were examined in the Department of Outpatient, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region between January 2015 and January 2016,were included as the subjects in the study. All the subjects were divided into the dietary guidance study group （ n=152） and the control group （ n=97） according to their wishes. The blood lipids,blood glucose,blood pressure,body weight and pregnancy complications were measured and recorded before and after the intervention. Results：After the intervention of dietary guidance, the plasma levels of total cholesterol （ TC ） , triglyceride （ TG） ,high density lipoprotein （ HDL-C） and low density lipoprotein （ LDL-C） during the pregnancy in the study group were significantly lower than those in the control group （ P〈0.05）;the blood pressure,fasting blood glucose and postprandial 2h blood glucose during the pregnancy were significantly lower than those in the control group （ P〈0.05）;the incidences of pregnancy-induced hypertension and fetal macrosomia were significantly lower than those in the control group （ P〈0. 05 ）; the incidences of adverse pregnancy findings, such as preeclampsia, gestational diabetes mellitus and asphyxia, preterm birth, infection and postpartum hemorrhage were lower than those in the control group,but there were no statistically significant differences （P〉0.05）. Conclusion：Dietary guidance can significantly improve the metabolism of blood lipids during pregnancy, and prevent pregnancy-induced hypertension.