探讨妊娠合并糖尿病的筛查方法及妊娠期低血糖对母儿的影响  

The method of screening gestational diabetes mellitus and the effect of gestational hypoglycemia on mothers and infants

作　　者：程桂平[1] 程桂敏 邓丽娟[1] 叶丽萍[1] 

机构地区：[1]辽宁省人民医院妇产科,辽宁沈阳10015 [2]灯塔市中心医院妇产科,辽宁辽阳111300

出　　处：《中国计划生育和妇产科》2010年第1期18-21,共4页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的探讨妊娠合并糖尿病(gestational diabetes mellitus,GDM)筛查的优势方法(一步到位法)和提高妊娠期低血糖对母儿危害的认识。方法选出2007年1月至2008年12月在辽宁省人民医院妇产科门诊产检的254例孕妇进行50g葡萄糖负荷试验(glucose challenge test,GCT)和具有妊娠合并糖尿病高危因素的84例孕妇进行75g葡萄糖耐量试验(oral glucose tolerance test,OGTT)进行比较。妊娠期糖耐量异常(impaired glucose tolerance,IGT)孕妇分别为48例和6例,GDM确诊人数分别为2例和14例。同时随机选出169例孕妇在孕早期(<12周)和孕中期(24～28周)抽取空腹血糖(fasting plasma glucose,FPG)进行比较,低血糖发生人数分别为5例和22例。结果OGTT方法的GDM确诊率明显高于GCT方法(P<0.01),妊娠中期低血糖发生率明显高于妊娠早期(P<0.01)。结论75g OGTT明显优于50g GCT方法,即一步到位法;同时应重视妊娠期低血糖,提高其对母儿影响的认识。Objective To study the method of screening gestational diabetes mellitus （GDM） （one -step method） and to improve the knowledge about the harmful effect of gestational hypoglycemia on mothers and infants. Methods 50 g glucose challenge test（GCT） were taken to 254 pregnant women examined in out - patient clinic de- partment of gynaecology and obstetrics Liaoning provincial people＇ s hospital. Meanwhile 75 g oral glucose tolerance test （OGTF） was taken to 84 pregnant women with high risk factors of GDM. The data from 254 patients with GCT and 84 patients with OGTI＇ was analyzed and compared from Jan. 2007 to Dec. 2008. The number of the women with impaired glucose tolerance was 48 and 6 respectively. There were 2 and 14 women diagnosed with GDM. Fasting plasma glucose（FPG） was measured in 169 pregnant women （randomly selected） during early （less than 12 weeks） and middle （24 to 28 weeks） gestational stage. Hypoglycemia existed in 5 and 22 cases respectively. Results OGTT had a higher diagnosis rate than GCT. The incidence rate of hypoglycemia during middle gestational stage was obviously higher than that during early stage （ P 〈 0. 01 ）. Conclusion The method of 75 g OGTT was obviously bet- ter that the method of 50 g GCT （the one -step method）. At the same time, The obstetrists should pay more atten- tion to gestational hypoglycemia and improve the knowledge about its effect on mothers and infants.

关 键 词：妊娠合并糖尿病 妊娠期低血糖 筛查方法 

分 类 号：R714.25[医药卫生—妇产科学]