妊娠期高血糖管理

Management of Hyperglycemia During the Pregnancy

目的探讨妊娠期高血糖发病危险因素、综合治疗管理。方法方便收集2017年1—11月于该院内分泌科住院治疗的妊娠期高血糖患者,共73例,进行多因素Logistic回归分析,分析孕妇年龄、孕前BMI、孕期增重、糖尿病家族史与妊娠期高血糖的相关性,并对部分入选人群进行胰岛素泵强化降糖治疗,观察治疗前后患者的血糖、血脂、血压、体重及空腹C肽变化情况,以期评估胰岛素泵强化治疗的效果。结果多因素Logistic逐步回归分析结果显示,年龄(30.51±10.12)岁(OR=1.689、P=0.001)、孕前BMI(23.11±3.62)kg/m2(OR=1.926、P=0.009)、孕期增重(16.41±3.20)kg(OR=1.521、P=0.007)、糖尿病家族史(OR=3.482、P=0.018)为妊娠期高血糖独立危险因素。胰岛素泵强化治疗后患者血糖FPG(4.16±1.86)mmol/L;2 h PG(5.23±2.01)mmol/L、甘油三酯(TG)(2.01±0.98)mmol/L、血压SBP(132±13)mm Hg;DBP(68±7)mm Hg较治疗前下降(P<0.05);总胆固醇(CHO)(5.87±1.46)mmol/L(t=6.513,P=0.0.061)、低密度脂蛋白(LDL)(1.48±0.52)mmol/L(t=0.966,P=0.376)较治疗前有降低趋势,但对比差异无统计学意义。结论胰岛素泵强化治疗帮助患者血糖快速达标,恢复胰腺功能,并有助血压、血脂的控制。

Objective to study the risk factors of hyperglycemia in pregnancy and the management of comprehensive treatment. Methods Convenient collected from January to November 2017 in gestational hyperglycemia in the hospital endocrinology hospitalized patients, a total of 73 cases, the multi-factor Logistic regression analysis, analysis of age, pregnant women pregnant BMI, weight gain during pregnancy, family history of diabetes and high blood sugar during pregnancy, and the part to be included in the crowd were insulin pump strengthening hypoglycemic treatment, observation of patients before and after the treatment of blood glucose, blood lipids, blood pressure, body weight, fasting C peptide changes, in order to evaluate the effect of insulin pump intensive treatment. Results Multi-factor Logistic stepwise regression analysis results showed that age（30.51±10.12）years（OR=1.689,P=0.001）, pre-pregnancy BMI（23.11±3.62）kg/m2 through（OR=1.926,P=0.009）, weight gain during pregnancy（16.41±3.20）kg（OR=1.521,P=0.007）, family history of diabetes（OR =3.482, P=3.482）independent risk factors for high blood sugar during pregnancy. Blood glucose FPG（4.16±1.86）mmol/L after insulin pump intensive treatment 2 h PG（5.23 ±2.01）mmol/L, triglyceride（TG）（2.01±0.98）mmol/L, bp（132±13）mm Hg;DBP（68±7）mm Hg was lower than before treatment（P〈0.05）. Total cholesterol（CHO）（5.87±1.46）mmol/L（t=6.513,P=0.0.061）, low density lipoprotein（LDL）（1.48±0.52）mmol/L was lower than before treatment, but the difference was not statistically significant. Conclusion The insulin pump entributes to control of blood pressure and blood liquid