维生素E对妊娠糖尿病患者血脂及妊娠结局的影响

Effect of vitamin E on blood lipids and pregnancy outcomes in patients with gestational diabetes mellitus

目的探究维生素E对妊娠期糖尿病患者血脂及妊娠结局的影响。方法选取北京大学首钢医院自2015年5月至2017年5月收治的90例妊娠糖期尿病患者,采取随机数字表法分为对照组与观察组,每组各45例,对照组给予个性化的饮食指导及运动治疗、皮下注射胰岛素,观察组在此基础上加用维生素E治疗,对比两组治疗前后血糖、血脂指标及不良妊娠结局发生率。结果两组患者治疗后空腹血糖(GLU)、餐后2h血糖(2hPBG)、甘油三酯(TG)、血清胆固醇(TC)及低密度脂蛋白(LDLC)均较治疗前显著下降,高密度脂蛋白(HDL-C)较治疗前显著升高(t=3.23~6.25,均P<0.05),但治疗后观察组GLU、2hPBG、TG、TC、LDL-C均较对照组显著下降,HDL-C显著升高(t=4.10~5.20,均P<0.05)。观察组胎儿窘迫、早产儿及新生儿窒息发生率均较对照组显著下降(χ~2值分别为6.45、5.91、6.10,均P<0.05)。结论在常规治疗的基础上加用维生素E治疗能够有效降低血脂浓度,从而改善妊娠结局。

Objective To explore the effects of vitamin E on blood lipids and pregnancy outcomes in patients with gestational diabetes mellitus（GDM）.Methods Ninety cases of GDM admitted in Peking University Shougang Hospital from May 2015 to May 2017 were selected and divided into control group and observation group based on random table method with 45 cases in each group.Patients in the control group were given individualized diet guidance,exercise therapy and subcutaneous insulin injections.Patients in the observation group were additionally given vitamin E on basis of treatment received in the control group.Blood sugar,blood lipids and incidence of adverse pregnancy outcomes were compared between two groups before and after treatment.Results Fasting plasma glucose（GLU）,2 hpostprandial blood glucose（2 hPBG）triglyceride（TG）,serum cholesterol（TC）and low density lipoprotein（LDL-C）in two groups after treatment were decreased significantly compared with those before treatment,and high density lipoprotein（HDL-C）in two groups after treatment was significantly higher than that before treatment（t value ranged3.23-6.25,all P〈0.05）,but decline of GLU,2 hPBG,TG,TC,LDL-C and increase of HDL-C after treatment in observation group were more significant than those in control group（t value ranged 4.10-5.20,all P〈0.05）.Incidences of fetal distress,premature infants and neonatal asphyxia in observation group were significantly lower than those in control group（χ^2 value was6.45,5.91 and 6.10 respectively,all P〈0.05）.Conclusion Treatment with vitamin E on basis of conventional treatment can effectively reduce blood lipid concentration and thus improve outcomes of pregnancy.