孕早期孕激素应用与妊娠期糖尿病发病率的临床研究

Clinical study on the application of progesterone in the early pregnancy and the incidence of gestational diabetes

目的观察孕早期孕激素应用与妊娠期糖尿病(gestational diabetes mellitus,GDM)发病率的关系。方法选取产检的孕早期低孕酮水平孕妇663例,应用孕激素治疗的424例孕妇作为观察组,同期未应用孕激素的239例孕妇作为对照组。观察组中根据给药方式及给药总剂量的不同,分为口服组185例及肌注组239例(其中小剂量组106例、中剂量组46例、大剂量组87例)。比较各组间GDM的发病率。结果观察组GDM发病率高于对照组(P<0.05)。口服组GDM发病率与对照组差异无统计学意义(P>0.05);口服组GDM发病率低于肌注组(P<0.05);肌注组GDM发病率高于对照组(P<0.05)。肌注小剂量组GDM发病率低于中剂量组及大剂量组(P<0.05);肌注中剂量组GDM发病率低于大剂量组(P<0.05)。结论孕早期孕激素应用与GDM发病率有关;口服给药对GDM发病率无明显影响,肌注给药增加GDM发病率,且用药总剂量越大,GDM发病率越高。

Objective To investigate whether the use of progesterone is related to the incidence of gestational diabetes mellitus(GDM).Methods Six hundred and sixty-three cases of pregnant women with low progesterone level in early pregnancy selected,and application of progesterone therapy in 424 cases of pregnant women as a group,239 pregnant women who did not use progestin during the same period as a control group.In the observation group,185 cases of oral administration and 239 cases of intramuscular injection were divided into two groups according to the difference of the way of administration and the total dose of the administration(including 106 small dose groups,46 cases of medium dose group and 87 cases of large dose group).The incidence of GDM among groups was compared.Results The incidence of GDM in the observation group was greater than that of the control group(P<0.05).There was no significant difference in the incidence of GDM in the oral group with the control group(P>0.05).The incidence of GDM in oral group was less than that of intramuscular injection group(P<0.05).The incidence of GDM in intramuscular injection group was greater than that in the control group(P<0.05).The incidence of GDM in the small dose group was significantly lower than that in the medium dose group and the large dose group(P<0.05).The incidence of GDM in the middle dose group was significantly lower than that in the large dose group(P<0.05).Conclusion The application of progesterone is related to the incidence of GDM.The incidence of GDM was not significantly affected by oral administration,and the incidence of GDM was increased by intramuscular injection,and the higher the total dose,the greater the incidence of GDM.