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研究

Dietary Guidance during Pregnancy Improves Blood Lipid Metabolism to Prevent Gestational Diabetes Mellitus and Pregnancy-induced Hypertension

目的研究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效果。方法选取2018年2月~2019年2月在我院建卡产检的早期妊娠伴有血脂指标异常增高者146例,随机分为对照组和观察组,各73例。对照组正常进食不予特殊膳食指导,观察组给予孕期膳食指导,比较两组孕妇干预后血脂水平、妊娠期高血压发生率、妊娠期血压水平以及母婴妊娠结局。结果干预后观察组中孕期、晚孕期总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)均低于对照组,差异有统计学意义(P<0.05);观察组妊娠期高血压发生率为6.84%,低于对照组的17.81%,差异有统计学意义(P<0.05);观察组妊娠期舒张压(87.22±3.23)mmHg、收缩压(128.92±3.66)mmHg、空腹血糖(4.64±0.91)mmol/L、餐后2h血糖(6.16±1.06)mmol/L水平分别低于对照组的(90.46±3.42)mmHg、(133.02±4.01)mmHg、(4.98±0.94)mmol/L、(7.11±1.21)mmol/L,差异有统计学意义(P<0.05);观察组巨大儿发生率为1.36%,低于对照组的5.47%,差异有统计学意义(P<0.05);观察组妊娠不良结局发生率与对照组比较,差异无统计学意义(P>0.05)。结论孕期膳食指导可改善妊娠期孕妇血脂代谢,有效预防和降低妊娠期高血压和糖尿病的发生率,进一步有效确保母婴的健康。

Objective To study the clinical effects of dietary guidance during pregnancy to improve blood lipid metabolism and prevent pregnancy-induced diabetes and pregnancy-induced hypertension.Methods A total of 146 patients with early pregnancy with a blood lipid index from February 2018 to February 2019 in our hospital were enrolled.The patients were randomly divided into the control group and the observation group,73 cases each.In the control group,no dietary guidance was given for normal eating.The observation group was given dietary guidance during pregnancy.The blood lipid levels,the incidence of gestational hypertension,the blood pressure level during pregnancy,and the maternal and fetal pregnancy outcomes were compared between the two groups.Results After intervention,the total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C)and lowdensity lipoprotein cholesterol(LDL-C)in the observation group were lower than the control group during pregnancy and late pregnancy,the difference was statistically significant(P<0.05);the incidence of hypertension in the observation group was 6.84%,which was lower than 17.81%in the control group,the difference was statistically significant(P<0.05);the diastolic blood pressure in the observation group was observed(87.22±3.23)mmHg,systolic blood pressure(128.92±3.66)mmHg,fasting blood glucose(4.64±0.91)mmol/L,and postprandial 2h blood glucose(6.16±1.06)mmol/L levels were lower than those of the control group(90.46±3.42)mmHg(133.02±4.01)mmHg,(4.98±0.94)mmol/L,(7.11±1.21)mmol/L,the difference was statistically significant(P<0.05);the incidence of macrosomia in the observation group was 1.36%,which was lower than that of the control group 5.47%,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse pregnancy in the observation group compared with the control group(P>0.05).Conclusion Dietary guidance during pregnancy can improve the blood lipid metabolism in pregnant women,effectively prevent and reduce the incidence of hypertension and diabetes in pregnancy,and further effectively ensure the health of mother and baby.