不同营养治疗方法在妊娠期糖代谢异常中的应用  

Application of different nutrition therapies in pregnancy with abnormal glucose metabolism

作　　者：马文君[1] 戚本华[1] 张燕军[1] 黄志宏[2] 肖本熙[1] 李远红[1] 余薇[1] 朱惠莲[3] 

机构地区：[1]广东省人民医院广东省医学科学院营养科,广州510080 [2]广东省人民医院广东省医学科学院妇产科,广州510080 [3]中山大学公共卫生学院营养系

出　　处：《中华预防医学杂志》2011年第5期426-429,共4页Chinese Journal of Preventive Medicine

基　　金：基金项目：广东省科技计划（2006836005013）

摘　　要：目的 探讨不同营养治疗方法对改善妊娠期糖代谢异常的代谢紊乱及妊娠结局的影响.方法 选择83例妊娠期糖代谢异常孕妇作为研究对象,孕30周前来营养门诊并按数字表法随机分为传统的食物交换份组（EFS组,42例）和基于血糖负荷概念的食物交换份组（FES＋GL组,41例）.分别采用相应的营养治疗方法进行干预直至分娩,观察不同的营养治疗方法对血糖及妊娠结局的影响.结果 FES＋GL组营养治疗后每日食物血糖负荷值（145.9±26.3）明显低于FES组（179.9±28.9）,差异有统计学意义（t=5.602,P＜0.01）.FES＋GL组营养治疗后的空腹血糖和餐后2 h 血糖[分别为（4.63±0.97）、（6.15±1.07）mmol/L]均较营养治疗前[分别为（4.96±0.81）、（9.13±1.61）mmol/L]明显下降（t值分别为2.237、11.202,P值均＜0.05）.FES＋GL组营养治疗后的餐后2 h血糖[（6.15±1.07）mmol/L]低于FES组[（6.86±1.26）mmol/L],差异有统计学意义（t=2.760,P＜0.05）.FES＋GL组孕妇总的并发症发生率为19.51%（8/41）,低于FES组的26.19%（11/42）,但差异无统计学意义（χ2=0.524,P＞0.05）.结论 基于血糖负荷概念的食物交换份比传统食物交换份更容易控制血糖.这两种营养治疗方法对改善糖代谢异常孕妇的妊娠结局均有帮助.Objective To explore the effect of different nutrition therapies on abnormal glucose metabolism during pregnancy and pregnancy outcomes. Methods The 83 cases of pregnant women withabnormal glucose metabolism who came to nutrition clinic were randomly divided into two groups before 30 weeks pregnancy： 42 cases in traditional food exchange serving group （ FES ） and 41 cases in foodexchange serving based on glycemic load group （FES ＋ GL）. Traditional food exchange serving and food exchange serving based on glycemic load were used as the different nutrition therapies for two groupsrespectively until the time of delivery. The influence of two nutrition therapies on the blood glucose andpregnancy outcomes were observed. Results The daily food glucose load （GL） after nutrition therapy in the FES ＋ GL group （ 145.9 ± 26. 3 ） were significantly decreased than that of the FES group（ 179.9 ± 28. 9,t =5. 602, P 〈 0.01 ）. Fasting plasma glucose （FPG） and 2 h postprandial glucose （ 2 h PG ） （ （ 4.63 ± 0.97 ）and （6. 15 ± 1.07） mmol/L,respectively） after nutrition therapy in the FES ± GL group were significantlylower than that in pre-nutrition therapy （ （4. 96 ± 0. 81 ） and （ 9. 13 ± 1.61 ） mmol/L, t = 2. 237,11. 202,respectively,all P values 〈 0. 05 ）. The 2 h PG in the FES ＋ GL group （ （6. 15 ± 1.07 ） rmmol/L） afternutrition therapy was significantly lower than that of the FES group （ （6. 86 ± 1. 26）mmol/L,t = 2. 760, P 〈0.05）. 19.51%（8/41 ）of the total incidence of complications in the FES ＋ GL group was lower than that （ 11/42,26. 19% ） in the FES group, but the difference was not significant （ χ2 = 0. 524, P 〉 0. 05 ）.Conclusion FES based on GL was much easier to reduce blood glucose compared with FES. Two nutrition therapies can improve maternal and neonatal outcomes in pregnant women with abnormal glucose metabolism.

关 键 词：糖尿病 妊娠 营养疗法 血糖 食物交换份 

分 类 号：R714.256[医药卫生—妇产科学]