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不同孕产妇代谢特性对妊娠期糖尿病妇女的胎儿生长发育的影响 被引量:5

Effect of different maternal metabolic characteristics on fetal growth in women with gestational diabetes mellitus
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摘要 目的探究不同孕产妇代谢特性对妊娠期糖尿病妇女的胎儿生长发育的影响。方法选取广州市增城区妇幼保健院于2011年6月至2014年12月收治的128例妊娠期糖尿病患者作为研究对象,选取同期入院检查的健康怀孕妇女140例作为对照组。详细记录产妇的年龄、胎儿出生体重、妊娠期糖尿病史、糖尿病家族史、孕前体重、孕期体重、BMI、孕龄、录入时胎龄、空腹血糖、甘油三酯、总胆固醇、高密度脂蛋白、低密度脂蛋白、低密度脂蛋白/高密度脂蛋白、胰岛素等,统计分析采用SPSS 17.0数据包,计量资料组间比较采用t检验,计数资料组间比较采用χ2检验,相关分析采用Pearson相关分析法,P<0.05表示差异具有统计学意义。结果妊娠期糖尿病组和对照组糖尿病家族史和孕周的比较差异具有统计学意义(P<0.05);而妊娠期糖尿病组和对照组的年龄、胎儿出生体重、妊娠期糖尿病史、孕前体重、孕期体重、BMI、录入时胎龄比较,差异无统计学意义(P>0.05)。通过分析两组产妇28~32周、32~36周和>36周分娩的生化指标特征,结果表明,妊娠期糖尿病组和对照组空腹血糖、胰岛素和甘油三酯的比较差异具有统计学意义(P<0.05);而妊娠期糖尿病组和对照组产妇总胆固醇、低密度脂蛋白、高密度脂蛋白水平比较,差异无统计学意义(P>0.05)。比较28~32周、32~36周和>36周分娩,妊娠期糖尿病组总胆固醇、低密度脂蛋白、低密度脂蛋白/高密度脂蛋白、胰岛素和甘油三酯差异具有统计学意义(P<0.05)。对照组血糖、甘油三酯、总胆固醇、低密度脂蛋白差异具有统计学意义(P<0.05)。通过比较两组新生儿结局,结果表明,孕周、新生儿血糖、BMI、Apgar(1 min)、Apgar(5 min)、巨大儿及大于胎龄儿的比较,差异具有统计学意义(P<0.05)。相关分析表明,甘油三酯水平增高与胰岛素抵抗和胰岛素抵抗指数增加呈显著相关关系(P<0.001)。结论甘油三酯水平增高与胰岛素抵抗和胰岛素抵抗指数增加呈显著相关关系,甘油三酯水平可能预测妊娠期糖尿病孕产妇胰岛素水平变化情况。 Objective To explore the effect of different maternal metabolic characteristics on fetal growth in women with gestational diabetes mellitus. Methods 128 cases of gestational diabetes mellitus patients were selected from June 2011 to December 2014 as study group, 140 cases of pregnant women in the same period were selected as the control group. Record the maternal age, birth weight, gestational diabetes, family history of diabetes, weight gain before pregnancy, pregnancy weight, BMI and gestational age, record gestational age, fasting blood glucose, TG, TC, high density lipoproteins, low density lipoproteins, LDL/HDL, insulin, SPSS 17.0 package was used in statistical analysis, measurement data sets were compared by t test, count data compared with the χ2 test, the correlation analysis was Pearson correlation analysis, P<0.05 said the difference was statistically significant. Results There was statistically significant difference in gestational diabetes group and control group, family history of diabetes and gestational age(P<0.05); but there was no statistically significant difference in gestational diabetes group and control group of age, birth weight, gestational diabetes, weight before pregnancy, pregnancy weight, BMI, gestational age(P>0.05). Through analysis the 28-32 and 32-36 weeks of childbirth and 36 weeks-biochemical characteristics of two groups, results showed that there was statistically significant difference of plasma glucose, insulin, and triglycerides(P<0.05); there was no statistically significant difference in gestational diabetes group and control group of total cholesterol, low density lipoprotein cholesterol, high-density lipoprotein levels(P>0.05). Through analysis the 28-32 and 32-36 weeks of childbirth and >36 weeks biochemical characteristics, total cholesterol, low density lipoprotein, low density lipoprotein/HDL, insulin, and triglycerides, the difference was statistically significant in gestational diabetes group(P<0.05). There was statistically significant difference of blood glucose, triglycerides, total cholesterol, low density lipoprotein in control group(P<0.05). By comparing the two groups of newborn outcomes, results showed that the gestational age, newborn blood glucose, BMI, Apgar(1 min), Apgar(5 min), macrosomia and gestational age, the difference was statistically significant(P<0.05). Correlation analysis showed that the triglyceride levels and insulin resistance and insulin resistance index was significantly positively correlated(P<0.001). Conclusion High triglycerides and insulin has a positive correlation with birth weight, triglyceride levels may predict changes in maternal insulin level in gestational diabetes.
出处 《中华临床医师杂志(电子版)》 CAS 2016年第10期1359-1363,共5页 Chinese Journal of Clinicians(Electronic Edition)
关键词 孕产妇 代谢特性 妊娠期糖尿病 胎儿 Maternal Metabolic characteristics Gestational diabetes mellitus Fetus
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