OGTT试验单项血糖升高的妊娠期糖尿病患者母婴结局分析

Analysis of Maternal and Infant Outcomes in Patients with Gestational Diabetes Mellitus with Elevated Blood Glucose in OGTT Test

目的探究口服糖耐量检测(oral glucose tolerance test,OGTT)试验单项血糖升高的妊娠期糖尿病(gestational diabetes mellitus,GDM)患者母婴结局。方法选择2022年1—12月周宁县医院收治的72例OGTT试验单项升高的GDM患者为研究对象,根据OGTT试验结果分为空腹血糖升高组(n=34),餐后1 h血糖升高组(n=15),餐后2 h血糖升高组(n=23)。比较3组患者饮食运动干预血糖控制达标率、胰岛素治疗占比、分娩方式、不良母婴结局发生情况。结果空腹血糖升高组饮食运动干预后血糖控制达标率低于餐后1 h血糖升高组和餐后2 h血糖升高组,使用胰岛素治疗占比高于餐后1 h血糖升高组和餐后2 h血糖升高组,差异有统计学意义(P均<0.05)。空腹血糖升高组、餐后1 h血糖升高组、餐后2 h血糖升高组分娩方式比较,差异无统计学意义(P>0.05)。空腹血糖升高组巨大儿发生率高于餐后1 h血糖升高组和餐后2 h血糖升高组,差异有统计学意义(P<0.05)。结论在OGTT试验单项指标升高的GDM患者中,应重视空腹血糖升高患者,其血糖控制达标率更低,巨大儿发生率更高。

Objective To explore the maternal and infant outcomes of gestational diabetes mellitus(GDM)patients with elevated blood glucose in oral glucose tolerance test(OGTT).Methods From January to December 2022,72 patients with GDM with elevated OGTT test in Zhouning County Hospital were selected as the research objects.According to the results of OGTT test,they were divided into fasting plasma glucose elevation group(n=34),1-hour postprandial plasma glucose elevation group(n=15)and 2-hour postprandial plasma glucose elevation group(n=23).The compliance rate of blood glucose control,the proportion of insulin treatment,the mode of delivery and the occurrence of adverse maternal and infant outcomes were compared among the three groups.Results The rate of blood glucose control after diet and exercise intervention in the fasting plasma glucose elevation group was lower than that in the 1-hour postprandial plasma glucose elevation group and the 2-hour postprandial plasma glucose elevation group,and the proportion of insulin treatment was higher than that in the 1-hour postprandial plasma glucose elevation group and the 2-hour postprandial plasma glucose elevation group,the differences were statistically significant(both P<0.05).There was no significant difference in the mode of delivery among the fasting plasma glucose elevation group,the 1-hour postprandial plasma glucose elevation group and the elevated 2-hour postprandial plasma glucose elevation group(P>0.05).The incidence of macrosomia in the fasting plasma glucose elevation group was higher than that in the 1-hour postprandial plasma glucose elevation group and the 2-hour postprandial plasma glucose elevation group,and the difference was statistically significant(P<0.05).Conclusion In GDM patients with elevated single index of OGTT test,attention should be paid to patients with elevated fasting plasma glucose,whose blood glucose control compliance rate is lower and the incidence of macrosomia is higher.