妊娠期糖尿病的相关危险因素分析  

The incidence of gestational diabetes and its related risk factors

作　　者：王丽萍[1] 吕淑英[1] 荆淑华[1] 

机构地区：[1]吉林大学第四医院妇产科,长春市130011

出　　处：《中国临床研究》2010年第11期956-959,共4页Chinese Journal of Clinical Research

摘　　要：目的调查长春市汽车产业开发区妊娠期糖尿病(GDM)的发病情况,分析导致GDM的相关危险因素,为临床早期识别、诊断和干预提供理论依据。方法对2006年9月至2007年8月到吉林大学第四医院(一汽总医院)接受产前检查的孕妇857例进行一般情况及临床资料的收集,并于孕24周采用50g糖激惹试验进行葡萄糖筛查(糖筛查),对筛查出阳性结果的患者或具有GDM高危因素者行75g口服葡萄糖耐量试验(OGTT)。将信息录入SPSS12.0软件,建立数据库,包括年龄、孕次、产次、职业、文化程度、体质指数(BMI)、家族史、ABO血型、是否贫血、乙肝表面抗原、首诊孕周等11种因素,并进行分析。结果 (1)首诊时,857例中3例经空腹血糖检查2次确诊为GDM;854例均排除孕前糖尿病,于孕24周进行糖筛查,异常174例,糖筛查异常率20.37%(174/854)。筛查异常者进一步行75gOGTT,结果确诊妊娠期糖耐量受损(GIGT)15例,确诊GDM8例,总的GDM(包含GIGT及GDM)发病率为3.03%(26/857)。(2)单因素分析,发现年龄、BMI及糖尿病家族史与GDM相关;多因素Logistic回归分析也证明糖尿病家族史、年龄、BMI为GDM的高危因素。结论长春市汽车产业开发区GDM的发病率为3.03%,与国内文献报告相当。BMI、糖尿病家族史、年龄为影响GDM的危险因素。加强GDM筛查,高度重视具有高危因素的妊娠期妇女,早期诊断,早期干预并系统化管理,可以改善妊娠结局,提高人口素质。Objective To investigate the incidence of gestational diabetes mellitus （ GDM ） of pregnant women in Changchun Auto Industry Development Zone and search risk factors associated with GDM to provide theoretical basis for early find, diagnosis and treatment. Methods The general conditions and clinical data of 857 pregnant women who accepted exami- nation in the Fourth Hospital of Jilin University, between September 2006 and August 2007 were collected. The glucose screen- ing test （GCT） was detected in all participants besides diagnosed as diabetes before pregnancy and 75g oral glucose tolerance test （OGTT） was assayed in the individuals with GCT positive result and having high risk factors. The information is analyzed by SPSS12.0 software, including age, times of pregnancy and childbirth, occupation, education, body mass index （ BMI ）, family history,ABO blood type,whether anemia,HbsAg and pregnancy weeks of first seeing a doctor. Results A total of 854 cases were examined with GCT （3 cases diagnosed as GDM hv fasting blood glucose of two times）. Of 854 individuals, 174 had ab-normal GCT, and the abnomal rate of GCT was 20. 37% （ 174/ 854）. Further OGTT was measured in this 174 cases,and 8 cases were diagnosed as GDM. The results showed that 15 easers were confirmatively diagnosed as gestational impaired glucose tolerance （GIGT） ,and 8 cases as GDM. Overall incidence of GDM （including GIGT and GDM） was 3.03% （26/857）. Single factor analysis showed age,BMI and diabetes family history correlated with GDM. Multi- factor logistic analysis showed mentioned above 3 factors correlated with GDM as well, so age, BMI and diabetes family history were independent high risk factors of GDM. Conelusions The incidence of GDM in Changchun Auto Industry Development Zone is 3.03% ,and the result is same as in other domestic areas. BMI, diabetes family history and age are high risk factors to GDM. Enhancing the screening of GDM is very important for the pregnant women having high risk factors. Early

关 键 词：妊娠期糖尿病 发病率 危险因素 

分 类 号：R714.25[医药卫生—妇产科学] R587.1[医药卫生—临床医学]