复方硫酸亚铁叶酸片早期干预与孕期血糖、血清铁蛋白及妊娠期糖尿病的关系

Correlation between Early Intervention of Compound Ferrous Sulfate and Folic Acid Tablets and Gestational Blood Glucose,Serum Ferritin and Gestational Diabetes Mellitus

目的:分析复方硫酸亚铁叶酸片早期干预与孕期血糖、血清铁蛋白及妊娠期糖尿病的关系。方法:选取中国人民解放军联勤保障部队第九二四医院2020年1月-2021年12月收治的150例孕妇作为研究对象。根据随机数字表法将其分为补铁A、B组及对照组,每组50例。所有孕妇均给予产前健康宣教,在此基础上补铁A组给予小剂量复方硫酸亚铁叶酸片,补铁B组给予大剂量复方硫酸亚铁叶酸片。比较三组孕12、20、24、28周时空腹血糖、餐后2 h血糖及糖化血红蛋白、血清铁蛋白水平,妊娠期糖尿病发生率。比较有无妊娠期糖尿病孕妇血清铁蛋白水平。结果:三组空腹血糖、餐后2 h血糖、糖化血红蛋白水平组间、时点、组间·时点交互作用比较差异均无统计学意义(P>0.05)。孕24、28周,补铁B组血清铁蛋白水平明显高于补铁A组和对照组(P<0.05),孕28周时补铁A组血清铁蛋白水平明显高于对照组(P<0.05)。孕24~28周时,共有38例出现妊娠期糖尿病。其中补铁A组、补铁B组、对照组妊娠期糖尿病发生率分别为22.00%(11/50)、38.00%(19/50)和16.00%(8/50),三组比较差异有统计学意义(P<0.05)。补铁B组妊娠期糖尿病发生率明显高于对照组(P<0.05)。妊娠期糖尿病孕妇血清铁蛋白水平明显高于无妊娠期糖尿病孕妇(P<0.05)。结论:大剂量复方硫酸亚铁叶酸片早期干预可明显提高孕期血清铁蛋白水平,血清铁蛋白水平与妊娠期糖尿病发生有关,应定期监测血糖水平,以减少妊娠期糖尿病发生。

Objective:To investigate the correlation between early intervention of Compound Ferrous Sulfate and Folic Acid Tablets and gestational blood glucose,serum ferritin and gestational diabetes mellitus.Method:A total of 150 pregnant women admitted to the 924th Hospital of the Joint Service Support Force of the People’s Liberation Army from January 2020 to December 2021 were selected as the study subjects.According to the random number table method,they were divided into iron supplement group A,B and control group,with 50 cases in each group.All pregnant women were given prenatal health education,on this basis,iron supplement group A was given a small dose of Compound Ferrous Sulfate and Folic Acid Tablets,and iron supplement group B was given a large dose of Compound Ferrous Sulfate and Folic Acid Tablets.The fasting blood glucose,postprandial 2 h blood glucose,glycosylated hemoglobin and serum ferritin levels at 12,20,24 and 28 weeks of gestation,the incidence of gestational diabetes mellitus were compared among the three groups.The serum ferritin levels of pregnant women with and without gestational diabetes mellitus were compared.Result:There were no significant differences in fasting blood glucose,postprandial 2 h blood glucose and glycated hemoglobin levels among the three groups intergroup,time point,intergroup · time point interaction (P>0.05).At 24 and 28 weeks of gestation,the serum ferritin level of iron supplement group B was significantly higher than that of iron supplement group A and control group (P<0.05).At 28 weeks of gestation,the serum ferritin level of iron supplement group A was significantly higher than that of control group (P<0.05).From 24 to 28 weeks of gestation,38 cases had gestational diabetes mellitus.Among them,the incidence of gestational diabetes mellitus was 22.00% (11/50),38.00% (19/50) and 16.00% (8/50) in iron supplementation group A,iron supplementation group B and control group respectively,and the difference among the three groups was statistically significant (P<0.05).The incidence of gestational diabetes mellitus in iron supplementation group B was significantly higher than that in control group (P<0.05).The serum ferritin level of pregnant women with gestational diabetes mellitus was significantly higher than that of pregnant women without gestational diabetes mellitus (P<0.05).Conclusion:The early intervention of large dose Compound Ferrous Sulfate and Folic Acid Tablets can significantly improve the serum ferritin level during pregnancy,the serum ferritin level is related to the occurrence of gestational diabetes mellitus,the blood glucose level should be monitored regularly to reduce the occurrence of gestational diabetes mellitus.