妊娠期糖尿病的转归及相关因素分析  

Analysis on the turnover of women with gestational diabetes and its associated factors

作　　者：徐艳[1] 张运平[1] 刘晓红[1] 

机构地区：[1]北京市海淀区妇幼保健院产科,100080

出　　处：《中国妇幼保健》2008年第19期2646-2648,共3页Maternal and Child Health Care of China

摘　　要：目的:分析妊娠期糖尿病(GDM)孕妇产后42天的75g葡萄糖耐量试验(OGTT)的结果,探讨其相关因素。方法:采用回顾性研究的方法,收集2006年4～11月在我院产科住院并在产后42天行OGTT的175例GDM孕妇的临床资料,根据OGTT的结果(按照WHO标准)进行再分类,即糖尿病(DM)、糖耐量减低(IGT)、空腹血糖过高(IFG)和血糖正常,并对其相关因素进行统计分析。结果:①175例GDM孕妇,产后42天行OGTT,有99例(56.6%)血糖正常(Ⅰ组),76例(43.4%)血糖异常(Ⅱ组),其中7例(4.0%)IFG,55例(31.4%)IGT,14例(8.0%)DM;②单因素分析显示:Ⅰ组的平均年龄小于Ⅱ组(P<0.05);Ⅱ组有糖尿病家族史者明显多于Ⅰ组(P<0.01);Ⅰ组产后42天的体重指数(BMI)均值小于Ⅱ组(P<0.05)。Ⅰ组50g葡萄糖负荷试验(GCT)的血糖均值低于Ⅱ组(P<0.05)。两组孕妇的文化程度、身高、家庭月收入及孕产次无显著差异。③广义线性回归的结果显示,影响产后42天空腹血糖的因素有糖尿病家族史及年龄;影响OGTT2h后血糖的因素除这两个因素外还有复查时的体重指数。结论:有近一半的GDM孕妇产后仍有糖代谢异常,应根据其相关因素给予积极干预。Objective：Analyzing the results of 75g oral glucose tolerance test（OGTT）in gestational diabetes mellitus（GDM）at 42 days after birth to investigate the associated factors of the abnormal blood glucose level.Methods：A retrospective study was conducted on the clinical data of 175 pregnant women with gestational diabetes,who delivered and underwent a 2 hours 75g OGTT at 42 days postpartum from April to November in 2006 in our hospital.On the basis of the results of OGTT（according to the WHO diagnosis criteria）,they were reclassified：diabetic mellitus（DM）,impaired glucose tolerance（IGT）,impaired fasting blood glucose（IFG）and normal.The related factors were analyzed.Results：①99 cases（56.6%）were normal（Ⅰgroup）,76 cases（43.4%）were abnormality（Ⅱgroup）,among the second group,7 cases（4.0%）were IFG,55 cases（31.4%）were IGT,14cases（8.0%）were DM;②The results of single factors analysis：in theⅠgroup,the mean age was much younger than those of theⅡ group（P〈0.05）;The numbers of women who had the family medical history of diabetes in the Ⅱ group were more than that of the Ⅰ group（P〈0.01）;The BMI of 42 days after birth of women in the Ⅰ group was smaller than that in the Ⅱ group（P〈0.05）;The mean blood glucose values of 50 gram glucose challenge test（GCT）in theⅠgroup was lower than that in the Ⅱ group（P〈0.05）.Culture level,body height,the income of family and the time of pregnancy and delivery did not show difference in the two groups.③The results of general linear model analysis：the effect factors of fasting blood glucose at 42 days after birth was the age and the family medical history of diabetes of pregnant women,expect for the two factor,the related factors of 2 hours 75 g OGTT was the BMI at 42 days after birth.Conclusion：Among the GDM,about fifty percent have the abnormal glucose metabolism after birth.There are some directional preventive measures should be used.

关 键 词：糖尿病妊娠 产后 葡葡糖耐量 相关因素 

分 类 号：R714.256[医药卫生—妇产科学]