GDM孕妇肠道益生菌及氧化应激水平与妊娠结局的相关性研究

Relationship between intestinal probiotics, oxidative stress and pregnancy outcome in pregnant women with GDM

目的探讨妊娠期糖尿病(GDM)孕妇肠道益生菌及氧化应激水平与妊娠结局的相关性。方法选取2016年1月至2018年1月于承德医学院附属医院产科分娩的60例健康妊娠妇女为对照组,100例GDM孕妇为观察组,按照血糖控制程度分为观察1组(50例血糖控制较好)和观察2组(50例血糖控制不佳)。检测三组孕妇分娩前肠道乳酸杆菌和双歧杆菌,孕妇氧化应激指标(TAOC、MDA、SOD及GSH)。分析GDM孕妇肠道益生菌及氧化应激水平与妊娠结局的相关性。结果与对照组比,观察1、2组乳酸杆菌、双歧杆菌、MDA、TAOC降低(P <0.05),GSH、SOD、新生儿低血糖、巨大儿及剖宫产发生率均增高(P <0.05),与观察1组比,观察2组乳酸杆菌、双歧杆菌、MDA、TAOC降低(P <0.05),GSH、SOD、新生儿低血糖、巨大儿及剖宫产发生率均增高(P <0.05),早产、胎盘早剥及胎膜早破的发生率差异无统计意义(P>0.05)。GDM孕妇乳酸杆菌、双歧杆菌、GSH及SOD与新生儿低血糖呈负相关,乳酸杆菌与剖宫产及巨大儿负相关,MDA与剖宫产及巨大儿正相关,TAOC与新生儿低血糖正相关,GSH与剖宫产负相关,SOD与巨大儿负相关(P <0.05)。结论相比而言,血糖控制较好的GDM孕妇的肠道益生菌数量氧化应激能力及妊娠结局均有改善。

Objective To investigate the relationship between intestinal probiotics, oxidative stress and pregnancy outcome in pregnant women with gestational diabetes mellitus(GDM).Methods 60 healthy pregnant women who were delivered in the Obstetrics and Gynecology department of Affiliated Hospital of Chengde Medical College from January 2016 to January 2018 were selected as the control group and 100 pregnant women with GDM were selected as the observation group.Among them, 50 were GDM pregnant women with better glycemic control as the observation group 1 and 50 cases of GDM pregnant women with poor glycemic control as the observation group 2.The blood and feces of the three groups before delivery were collected.The lactobacilli, bifidobacteria, and the oxidative stress index(TAOC, MDA, SOD and GSH) of the three groups were detected.The correlation between gut microbiota and oxidative stress levels in GDM pregnant women and pregnancy outcomes were analyzed.Results Compared with the control group, the Lactobacillus, Bifidobacterium, MDA, TAOC in the observation group 1 and observation group 2 had decreased(P < 0.05).The GSH, SOD, and incidence of neonatal hypoglycemia, macrosomia and cesarean section had increased(P < 0.05).Compared with the observation group1, the Lactobacillus, Bifidobacterium, MDA, TAOC had decreased in the observation group 2(P < 0.05), the GSH, SOD, the incidence of neonatal hypoglycemia, macrosomia and cesarean section had increased in the observation group 2(P < 0.05).There was no difference in the incidence of premature delivery, placental abruption and premature rupture of membranes among the three groups(P > 0.05).The level of lactobacilli, bifidobacteria, GSH and SOD in GDM pregnant women were negatively correlated with neonatal hypoglycemia, the lactobacillus was negatively correlated with cesarean section and macrosomia.The level of MDA was positively correlated with macrosomia and cesarean section.TAOC was positively correlated with neonatal hypoglycemia.GSH was negatively correlated with cesarean section, and SOD was negatively correlated with macrosomia(P < 0.05).Conclusion GDM pregnant women with better blood sugar control could improved intestinal probiotics, oxidative stress and pregnancy outcome.