妊娠期血糖临界范围的临床干预及母婴结局  

The maternal and fetal outcomes by clinical intervention for patient whose blood glucose during gestational period rosed to limit

作　　者：范蓉[1] 乔晓林[1] 王丹[1] 张秋生[1] 

机构地区：[1]航空工业中心医院,北京100012

出　　处：《中国现代医药杂志》2011年第1期37-40,共4页Modern Medicine Journal of China

摘　　要：目的探讨75g葡萄糖耐量试验（OGTT）服糖后2h血糖临界范围的临床干预及母婴结局。方法前瞻性研究2006年10月~2008年10月间在我院产检并分娩的孕妇,24~28周行OGTT检查,依OGTT服糖后2h的血糖值分组：正常组OGTT2hPG〈6.7mmol/L组（Ⅰ组）;干预组OGTT2hPG在6.7~7.8mmol/L之间（Ⅱ组）;对照组OGTT2hPG在6.7~7.8mmol/L之间（Ⅲ组）。Ⅱ组给予糖尿病规范管理;Ⅰ、Ⅲ组不给与特殊干预,比较3组的母婴结局。结果①3组孕妇的一般情况比较无统计学意义;②孕妇剖宫产率：Ⅰ组C-S率为36%,Ⅱ组C-S率为53.1%,Ⅲ组C-S率为43.1%,Ⅱ组显著高于Ⅰ、Ⅲ组（P〈0.05）;③3组新生儿平均体重分别为（3472±514）g、（3399±514）g、（3488±490）g,无显著性差异。但Ⅱ组大于胎龄儿及巨大儿发生率低于Ⅰ组与Ⅲ组,差异有显著性（P〈0.05）;④3组新生儿转科率、新生儿低血糖、高胆红素血症、肺炎及缺血缺氧性脑病的发生率差异亦无显著性差异（P〉0.05）;⑤产后随访结果：3组的随访率分别是16%、36.6%、18.6%;未发现DM,Ⅱ组及Ⅲ组分别确诊1例IGT;3组空腹血糖及2h血糖无显著性差异（P〉0.05）。结论不建议血糖在6.7~7.8mmol/L就诊断为妊娠糖耐量减低（IGT）。Objective To study the maternal and fetal outcomes by clinical intervention to patient who recieved 75g oral glucose tolerance test（OGTT 2h PG） and blood glucose rosed to limit.Methods Prospective study on women delivered in Aviation Central Hospital from Dec 2006 to Dec 2008,pregnant woman examined OGTT during 24~28 weeks,and by using the OGTT 2h PG,pregnant woman were divided to three group（group Ⅰ OGTT 2h PG6.7mmol/L,group Ⅱ OGTT 2h PG 6.7~7.8mmol/L,group Ⅲ OGTT 2h PG6.7mmol/L）,group Ⅱ received diabetes＇ treat,group Ⅰ,Ⅱ didn＇t,the maternal and fetal outcomes of the three groups were compared.Results ①There was no significant difference in mean age,gestational week and the proportion of primipara et al.②The cesarean section rate in groupⅡ was 53.1%,which was significantly higher than groupⅠ（36%） and group Ⅲ（43.1%）（P0.05）.③Newborn infant mean weight of group Ⅰ,Ⅱ,Ⅲ were 3472±514、3399±514、3488±490（g）respectively,there were no significant difference;but compared with group Ⅰ,Ⅲ,groupⅡ had lower incidences of large for gestational age infant and large for gestational age infant（P0.05）.④There were no significant difference in the incidences of neonatal morbidities and neonatal hypoglycemia and hyperbilirubinemia and pneumonia and anoxic encephalopathy of tree group.⑤The rate of follow-up visit in group Ⅰ,Ⅱ,Ⅲ were 16%,36.6%,18.6% respectively;DM wasn＇t found,but one case of IGT was diagnosed in group Ⅱ and group Ⅲ;There were no significant difference in FBG and OGTT 2h PG.Conclusion The result didn＇t support pregnant women whose blood glucose during 6.7~7.8 mmol/L were diagnosed to IGT.

关 键 词：妊娠 糖尿病 糖耐量减低 母儿预后 

分 类 号：R714.2[医药卫生—妇产科学]