苏州地区妊娠期糖尿病筛查的多中心临床研究  

Multi-center clinical study on screening of gestational diabetes mellitus in Suzhou area

作　　者：沈彩娥[1] 姜梅芳[1] 许咏乐[2] 汪云[2] 钱志红 张淑琴[2] 杨如[2] 杨瑞兰[4] 杨伟文 

机构地区：[1]江苏省苏州市妇幼保健所,215002 [2]江苏省苏州市立医院 [3]苏大附属第二医院妇产科 [4]太仓市妇幼保健所 [5]苏大附属第一医院妇产科

出　　处：《中国妇幼保健》2010年第10期1330-1332,共3页Maternal and Child Health Care of China

摘　　要：目的:通过苏州地区妊娠期糖尿病(GDM)的筛查,了解妊娠期糖代谢异常的发病率及对妊娠的不良影响。方法:采用前瞻性的研究方法,2004年8月～2006年12月对苏州市各大医院及太仓市建卡的大部分孕妇采用50g葡萄糖负荷试验,共筛查孕妇4166例,阳性者再做75g葡萄糖耐量试验(OGTT)。设糖尿病组(GDM)及糖耐量异常组(IGT),以糖筛查正常的孕妇作对照组,对临床资料进行分析。结果:筛查4166例孕妇中GCT阳性者1394例(33.46%),总糖代谢异常率为6.29%,其中GDM150例(3.60%)、糖耐量异常(IGT)者为112例(2.69%)。GDM及IGT的发生率随孕妇年龄增大而显著升高(P<0.01)。新生儿出生体重GDM组和IGT组与对照组相比,有显著性差异(P<0.05),GDM孕妇巨大儿占19.33%。GDM孕妇中剖宫产76.67%,子痫前期9.33%、羊水过多7.33%,均明显高于对照组,早产4例,1例新生儿死亡。结论:妊娠期糖筛查有利于早期检出妊娠期糖代谢异常的孕妇,以便加强管理,减少对母儿的不良影响。Objective： To understand the incidence of abnormal glucose metabolism during pregnancy and its adverse effect on pregnancy by screening gestational diabetes mellitus （GDM） in Suzhou area. Methods： From August 2004 to December 2006, a prospective method was performed in Suzhou city and Taicang city, 4 166 pregnant women were screened with 50 g glucose challenge test （GCT） , then the positive pregnant women underwent 75 g oral glucose tolerance test （OGTF） . The pregnant women were divided into GDM group, im- paired glucose tolerance （IGT） group and control group, then the clinical data were analyzed. Results： The positive rate of GCT among 4 1615 pregnant women was 33.46% （ 1 394 pregnant women） , the abnormal rate of total glucose metabolism was 6. 29%, including 150 CDM pregnant women （3.60%） and 112 IGT pregnant women （2.69%） . The incidences of GDM and IGT increased with the ages of preg- nant women （P 〈 0. 01 ）, there was significant difference in birth weight among CDM group, IGT group and control group （P 〈 0. 05 ） . The incidences of maerosomia, preeclampsia and polyhydramnios and the rate of cesarean section in CDM group were 19. 33% , 9. 33% , 7.33% and 76. 67% , respectively, which were significantly higher than those in control group. 4 premature infants and 1 neonatal death occurred in GDM group. Conclusion： Glucose screening during pregnancy is beneficial to early detection of women with abnormal glucose metabolism during pregnancy, in order to enhance management and reduce harmful effects to mothers and fetus.

关 键 词：妊娠期糖尿病 糖筛查 葡萄糖耐量试验 

分 类 号：R587.1[医药卫生—内分泌]