目的：比较国际糖尿病与妊娠研究组（ International Association 0f Diabetes in Pregnancv Study Groups， IADPSG）妊娠期糖尿病（ gestational diabetes mellitus，GDM）诊断标准与美国国家糖尿病数据组（ National Diabetes data G...目的：比较国际糖尿病与妊娠研究组（ International Association 0f Diabetes in Pregnancv Study Groups， IADPSG）妊娠期糖尿病（ gestational diabetes mellitus，GDM）诊断标准与美国国家糖尿病数据组（ National Diabetes data Group，NDDG）GDM诊断标准下GDM发病率及妊娠结局。方法：选取太原市妇幼保健院2011-2012年分娩的、接受规范的GDM筛查和诊断的非孕前糖尿病产妇5340例，对其病历资料进行回顾性分析，比较两种诊断标准计算的妊娠期糖尿病的发生率及对妊娠结局的影响；以同期妊娠分娩的糖代谢正常孕妇为对照。结果：发病率：NDDG诊断标准下，妊娠期糖尿病的发病率为4．87％，IADPSG诊断标准下发病率为11．7％；2011年该院按照NDDG标准诊治，回顾性将所有孕妇按照IADPSG标准诊断，新增GDM78例未经治疗，与新标准下的非GDM孕妇比较妊娠结局，未经治疗的GDM孕妇妊娠期高血压疾病、子痫前期、羊水过多、剖宫产率、产后出血、巨大儿、新生儿高胆红素血症的发生率明显增高（ P﹤0．05）；2012年该院按照IADPSG标准对GDM进行诊治，其中有123例GDM未达到NDDG标准，子痫前期、剖宫产率、巨大儿发生率明显低于2011年未治疗的新增GDM孕妇（ P﹤0．05）。结论：IADPSG诊断标准降低，可使更多患者被纳入到GDM的规范管理系统中，GDM孕妇经治疗后明显减少了巨大儿及剖宫产率，提示新的诊断标准对母婴保健是有意义的。展开更多
妊娠期糖尿病是孕期常见并发症,其诊断标准尚未达成共识。2011年国际糖尿病与妊娠研究组制订了国际糖尿病与妊娠研究组(International Association of Diabetic Pregnancy Study Group,IADPSG)标准,得到包括美国糖尿病学会、WHO、我国...妊娠期糖尿病是孕期常见并发症,其诊断标准尚未达成共识。2011年国际糖尿病与妊娠研究组制订了国际糖尿病与妊娠研究组(International Association of Diabetic Pregnancy Study Group,IADPSG)标准,得到包括美国糖尿病学会、WHO、我国医疗卫生部门和行业的认可,但此标准的临床适用性尚存在争议。本文结合近期临床研究介绍IADPSG标准的相关内容,并比较该标准与其他经典诊断标准在妊娠期糖尿病诊断中存在的优势与不足,探讨该标准在我国孕妇妊娠期糖尿病临床诊断中的适用性。展开更多
Objective: Pregnancy-induced hypertension with proteinuria (preeclampsia- PE) is linked to increased vascular reactivity, increased vasoconstrictors, endothelial damage and platelet hyperaggregation, which are also ty...Objective: Pregnancy-induced hypertension with proteinuria (preeclampsia- PE) is linked to increased vascular reactivity, increased vasoconstrictors, endothelial damage and platelet hyperaggregation, which are also typical features of migraine patients. Thus, we investigated the association between headache and PE. Methods: In a case-control study, we evaluated the occurrence of primary headache forms in 75 women with a recent history of PE. Seventy-five controls were selected from women having uneventful pregnancy at term. Both groups were matched for age and parity. Subjects’ headache history was evaluated by using an ad hoc structured questionnaire. The International Headache Society criteria for primary headaches were applied to diagnose the specific form of headache. Results: In PE cases, gestational age at parturition was 34.2 ± 3.8 weeks and birthweight was 1820 ± 746 g, whereas in controls they were 39.3± 1.5 weeks and 3365 ± 437 g, respectively (P < 0.01). Sixty-six (44% ) subjects suffered from headache. Headache was significantly more frequent in PE (47/75) than in controls (19/75), OR 4.95 (95% CI, 2.47- 9.92). Migraine without aura was more frequently present in cases than in controls while episodic tension-type headache was equally distributed among groups. Fifty-two patients met the criteria of severe PE. The number of patients suffering from headache was significantly higher in severe patients (39 cases, 75% ) than in those with moderate PE (8 cases, 34.8% ), OR = 5.63 (95% CI, 1.97- 16.03). With respect to controls, PE patients reported a more frequent onset at menarche, more menstrually related attacks and an increased rate of improvement during pregnancy. Conclusion: This study shows that there is a strong association between migraine history and PE development, namely with the severe form of PE.展开更多
妊娠期糖尿病（gestational diabetes mellitus,GDM）是指妊娠期发生的不同程度的糖代谢异常[1].基于全球著名的高血糖与妊娠不良结局（Hyperglycemia and Adverse Pregnancy Outcome,HAPO）研究[2],国际糖尿病与妊娠研究组（Internatio...妊娠期糖尿病（gestational diabetes mellitus,GDM）是指妊娠期发生的不同程度的糖代谢异常[1].基于全球著名的高血糖与妊娠不良结局（Hyperglycemia and Adverse Pregnancy Outcome,HAPO）研究[2],国际糖尿病与妊娠研究组（International Association of Diabetes and Pregnancy Study Groups,IADPSG）于2010年提出了新的GDM诊断标准[3].但国内外有关GDM的诊断标准仍一直争议不断.美国国立卫生研究院（National Institutes of Health,NIH） 2013年3月发布报告指出,采用IADPSG诊断标准后,GDM的患病率快速上升,过度诊断会带来相应的医疗干预及医疗资源的投入.展开更多
文摘目的：比较国际糖尿病与妊娠研究组（ International Association 0f Diabetes in Pregnancv Study Groups， IADPSG）妊娠期糖尿病（ gestational diabetes mellitus，GDM）诊断标准与美国国家糖尿病数据组（ National Diabetes data Group，NDDG）GDM诊断标准下GDM发病率及妊娠结局。方法：选取太原市妇幼保健院2011-2012年分娩的、接受规范的GDM筛查和诊断的非孕前糖尿病产妇5340例，对其病历资料进行回顾性分析，比较两种诊断标准计算的妊娠期糖尿病的发生率及对妊娠结局的影响；以同期妊娠分娩的糖代谢正常孕妇为对照。结果：发病率：NDDG诊断标准下，妊娠期糖尿病的发病率为4．87％，IADPSG诊断标准下发病率为11．7％；2011年该院按照NDDG标准诊治，回顾性将所有孕妇按照IADPSG标准诊断，新增GDM78例未经治疗，与新标准下的非GDM孕妇比较妊娠结局，未经治疗的GDM孕妇妊娠期高血压疾病、子痫前期、羊水过多、剖宫产率、产后出血、巨大儿、新生儿高胆红素血症的发生率明显增高（ P﹤0．05）；2012年该院按照IADPSG标准对GDM进行诊治，其中有123例GDM未达到NDDG标准，子痫前期、剖宫产率、巨大儿发生率明显低于2011年未治疗的新增GDM孕妇（ P﹤0．05）。结论：IADPSG诊断标准降低，可使更多患者被纳入到GDM的规范管理系统中，GDM孕妇经治疗后明显减少了巨大儿及剖宫产率，提示新的诊断标准对母婴保健是有意义的。
基金国家自然科学基金(81641059),上海市加强公共卫生体系建设三年行动计划(SCREENING STUDY GWIV-26)。
文摘妊娠期糖尿病是孕期常见并发症,其诊断标准尚未达成共识。2011年国际糖尿病与妊娠研究组制订了国际糖尿病与妊娠研究组(International Association of Diabetic Pregnancy Study Group,IADPSG)标准,得到包括美国糖尿病学会、WHO、我国医疗卫生部门和行业的认可,但此标准的临床适用性尚存在争议。本文结合近期临床研究介绍IADPSG标准的相关内容,并比较该标准与其他经典诊断标准在妊娠期糖尿病诊断中存在的优势与不足,探讨该标准在我国孕妇妊娠期糖尿病临床诊断中的适用性。
文摘Objective: Pregnancy-induced hypertension with proteinuria (preeclampsia- PE) is linked to increased vascular reactivity, increased vasoconstrictors, endothelial damage and platelet hyperaggregation, which are also typical features of migraine patients. Thus, we investigated the association between headache and PE. Methods: In a case-control study, we evaluated the occurrence of primary headache forms in 75 women with a recent history of PE. Seventy-five controls were selected from women having uneventful pregnancy at term. Both groups were matched for age and parity. Subjects’ headache history was evaluated by using an ad hoc structured questionnaire. The International Headache Society criteria for primary headaches were applied to diagnose the specific form of headache. Results: In PE cases, gestational age at parturition was 34.2 ± 3.8 weeks and birthweight was 1820 ± 746 g, whereas in controls they were 39.3± 1.5 weeks and 3365 ± 437 g, respectively (P < 0.01). Sixty-six (44% ) subjects suffered from headache. Headache was significantly more frequent in PE (47/75) than in controls (19/75), OR 4.95 (95% CI, 2.47- 9.92). Migraine without aura was more frequently present in cases than in controls while episodic tension-type headache was equally distributed among groups. Fifty-two patients met the criteria of severe PE. The number of patients suffering from headache was significantly higher in severe patients (39 cases, 75% ) than in those with moderate PE (8 cases, 34.8% ), OR = 5.63 (95% CI, 1.97- 16.03). With respect to controls, PE patients reported a more frequent onset at menarche, more menstrually related attacks and an increased rate of improvement during pregnancy. Conclusion: This study shows that there is a strong association between migraine history and PE development, namely with the severe form of PE.
文摘妊娠期糖尿病（gestational diabetes mellitus,GDM）是指妊娠期发生的不同程度的糖代谢异常[1].基于全球著名的高血糖与妊娠不良结局（Hyperglycemia and Adverse Pregnancy Outcome,HAPO）研究[2],国际糖尿病与妊娠研究组（International Association of Diabetes and Pregnancy Study Groups,IADPSG）于2010年提出了新的GDM诊断标准[3].但国内外有关GDM的诊断标准仍一直争议不断.美国国立卫生研究院（National Institutes of Health,NIH） 2013年3月发布报告指出,采用IADPSG诊断标准后,GDM的患病率快速上升,过度诊断会带来相应的医疗干预及医疗资源的投入.
