妊娠期糖尿病孕妇分娩后血糖异常的相关因素分析  

Postpartum reclassification in women with gestational diabetes and analyzing the high risk factors associated with them

作　　者：吴连方[1] 刘冬岩[1] 黄醒华[1] 祖秀松[2] 杨敏[3] 刘维靖[4] 衡宗华[2] 迟心左[4] 贾晓芳[5] 胡敏华[5] 赵莲[6] 

机构地区：[1]首都医科大学附属北京妇产医院产科,100006 [2]北京友谊医院妇产科 [3]北京朝阳医院妇产科 [4]北京宣武医院妇产科 [5]北京天坛医院妇产科 [6]北京同仁医院妇产科

出　　处：《中华妇产科杂志》2003年第3期140-142,共3页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的　探讨妊娠期糖尿病 (GDM)孕妇分娩后 2个月的 75g葡萄糖耐量试验 (OGTT)结果 ,及其与血糖异常的相关因素。方法　对 2 94例GDM孕妇于分娩后 2个月行OGTT ,按世界卫生组织标准进行再分类 ,即 2型糖尿病 (2型DM)、糖耐量低减 (IGT)和血糖正常。并对其相关因素进行分析。结果　 (1) 2 94例孕妇中 160例 (5 4 4% )血糖正常 (血糖正常组 ) ,75例 (2 5 5 % )IGT (IGT组 ) ,5 9例 (2 0 1% ) 2型DM(2型DM组 )。 (2 ) 2型DM组的诊断孕周早于其他两组 (P <0 0 1) ;5 0g葡萄糖负荷试验 (GCT)的血糖、OGTT中的空腹血糖、以及诊断时的糖化血红蛋白 (HbA1c)均明显高于其他两组(P <0 0 1) ;胰岛素治疗的孕周最早 ,胰岛素使用率高于血糖正常组 (P <0 0 5 ) ,胰岛素的剂量也明显大于其他两组 ;分娩后 1周内的空腹和餐后 2h血糖仍明显高于其他两组 (P <0 0 1)。 (3 ) 3组孕妇间体重、年龄、家族史等比较 ,差异无显著性 (P >0 0 5 )。结论　GDM孕妇中约有 1/ 4为IGT ,1/ 5为 2型DM ;后者在孕期表现为发病早 ,空腹血糖高 。Objective To follow up the 75 g oral glucose tolerance test (OGTT) in gestational diabetes mellitus (GDM) at 2 month after birth for reclassifying and analyzing the risk factors associated with the abnormal blood glucose level Methods 294 cases of GDM underwent a 2 hours 75 g OGTT two months postpartum According to the WHO diagnostic criteria, they were divided into three groups: (1) type 2 diabetic mellitus (DM), impaired glucose tolerance (IGT) and normal The related factors during pregnancy were analysed Results 160 cases (54 4%) were normal, 75 cases (25 5%) and 59 cases (20 1%) were IGT and DM respectively (2) In the DM group, the gestational age at diagnosis was much earlier than those of the other two groups ( P <0 01), the glucose level of 50 gram glucose challenge test (GCT) and fasting blood glucose values in OGTT and the value of HbAlc at diagnosis were evidently higher than the other two groups ( P <0 01, P <0 01, P <0 01), the gestational age of use of insulin for treatment was earlier than normal group, the dosage used markedly greater than the other two groups, the fasting blood glucose and 2 hours postprandial glucose were significantly higher than other two groups ( P <0 01) within 7 days after birth Maternal age, body weight and family history did not show difference in the three groups Conclusion Among the GDM, about 1/4 were IGT and 1/5 were type 2 DM The DM group showed early diagnosis, high fasting blood glucose, high frequency to use insulin during pregnancy

关 键 词：孕妇 血糖异常 分娩后 诊断 OGTT GDM 正常 葡萄糖 孕周 胰岛素 

分 类 号：R714.25[医药卫生—妇产科学]