糖筛查异常而糖耐量正常孕妇血糖变化与妊娠结局关系研究  

Association between Variation of Maternal Glucose Concentration and Pregnant outcome in Pregnant Women with Normal Glucose Tolerance Test

作　　者：李明[1] 黄亚绢[1] 

机构地区：[1]上海交通大学附属第六人民医院,上海200233

出　　处：《实用妇产科杂志》2007年第9期538-540,共3页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:了解糖筛查试验(GCT)异常而糖耐量试验(OGTT)正常孕妇的妊娠结局。方法:采用回顾性研究方法,收集2003年1月至2004年12月在我院就诊的GCT异常而OGTT正常的孕妇359例。比较GCT和OGTT结果、胎儿大小、分娩方式。结果:GCT异常而OGTT正常者巨大儿的发生率(11.1%)较GCT正常孕妇(5.8%)高。GCT异常而OGTT正常者巨大儿组孕妇空腹血糖、糖耐量中2小时血糖值和血糖累积浓度较其正常体重儿组大;糖耐量试验中,空腹血糖>4.62 mmol/L、2小时血糖>8.31 mmol/L、血糖累积浓度>22.77 mmol/L者,其巨大儿发生率、剖宫产率增加。2小时血糖>8.31 mmol/L时,血糖的值与胎儿的大小相关。结论:围生期监护中,需重视GCT异常而OGTT正常孕妇的血糖控制,糖耐量中2小时血糖的监测对孕妇而言更为重要。Objective. To study the relationship between pregnant outcome and blood glucose concentration in pregnant women with normal Oral Glucose Tolerance Test （OGTT） and abnormal Glucose Challenge Test （GCT）. Methods：Medical histories of 990 pregnant women in Shanghai Jiaotong University Sixth Affiliated Hospital between Jun. 2003 and Dec. 2005 were retrospectively abstracted. After comparing GCT, OGTT, fetal body weight, ad delivery mode, there were 359 cases of normal OGTT and abnormal GCT. Results：The prevalence of macrosomla and dystocia were higher in normal OGTT, abnormal GCT pregnant women （ 11.1% ） than normal GCT women （5.8%）; And the fasting blood glucose, 2 hr glucose levels and glucose area under curve （AUC） of OGTT in macrosomia were higher than those with normal body weight. In women whose fasting glucose 〉 4.62mmol/L, 2 hr glucose 〉8.31mmol/L, and glucose AUC 〉 22.77mmol/L in OGTT, the incidence of macrosomia and cesarean section increased. The glucose value associated with fetal body weight when 2 hr glucose over than 8.31mmol/ L.Conclusions：This result notes that monitoring of 2 hr blood glucose concentration is more important than fasting blood glucose concentration. Attention should also be put on those pregnant women who have normal Oral Glucose Tolerance Test, abnormal Glucose Challenge Test.

关 键 词：糖筛查试验 糖耐量试验 巨大儿 分娩 

分 类 号：R714.25[医药卫生—妇产科学]