孕期持续性空腹高血糖对妊娠糖尿病预后的意义  

The significance of persistent fasting hyperglycemia in gestational diabetes.

作　　者：徐宜清[1] 田静[1] 白夷[1] 

机构地区：[1]南京医科大学附属妇幼保健院,南京210004

出　　处：《现代妇产科进展》2007年第9期664-666,共3页Progress in Obstetrics and Gynecology

摘　　要：目的：研究妊娠期空腹高血糖和餐后高血糖与产后发展为糖尿病（DM）之间的关系。方法：随访98例妊娠糖尿病（GDM）患者至产后8年，比较分析了需胰岛素治疗组、需使用夜间发挥作用的胰岛素组以及不需使用胰岛素组3组产后发展为DM几率的差别。结果：需使用夜间发挥作用的胰岛素GDM患者与不需胰岛素治疗者比较，前者有更大的可能产后发展为DM（RR=6．1，95％CI=2．8～14．2，P〈0．01）。仅餐前需使用短效胰岛素的患者，与不需使用胰岛素的患者相比，差异无显著性，产后发展为DM（RR=1．4，95％CI：0．4～3．9，NS）的可能性较小。结论：因使用夜间发挥作用的胰岛素用量可反映空腹血糖的水平，故推论孕期出现持续性空腹高血糖的GDM患者，产后进一步发展为DM的可能性更大。Objective：To study the relationship between tasting and postprandial hy- perglycemia in pregnancy, with the development of subsequent diabetes mellitus （DM）. Meth- od：Ninety-eight GDM patients were followed after their pregnancy, up to 8 years. The difference in future diabetes risk among participants with only requiring prandial short-acting insulin, requiring bedtime insulin and no require insulin was analyzed. Results：Needing for bedtime inter- mediate-acting insulin participants compared with participants not treated with insulin, they had higher probability of the development of diabetes, （ RR = 6. 1,95% CI = 2.8 - 14.2, P 〈 0. 01）. However,participants who required prandial insulin only did not have a higher likeli- hood of diabetes ,compared with those who did not require insulin （RR = 1.4,95% CI = 0.4 - 3.9 ,NS）. Condusion ：The GDM patient with persistent fasting hyperglycemia in pregnancy has highly probability of the development of subsequent DM, for the bedtime insulin reqirements can reflect the degree of fasting hyperglycemia.

关 键 词：糖尿病 妊娠 高血糖症 预后 

分 类 号：R714.256[医药卫生—妇产科学]