妊娠期糖代谢异常孕妇产后饮食管理对糖脂代谢的影响  

Impact of Diet Management on Glycolipid Metabolism in Postpartum Women with Abnormal Glucose Metabolism during Pregnancy

作　　者：戚本华[1] 张燕军[1] 肖本熙[1] 李远红[1] 余薇[1] 李琳[1] 黄志宏[2] 欧阳维富[3] 马文君[1] 

机构地区：[1]广东省人民医院广东省医学科学院营养科,广东省广州市510080 [2]广东省人民医院广东省医学科学院妇产科,广东省广州市510080 [3]广东省人民医院广东省医学科学院检验科,广东省广州市510080

出　　处：《中国全科医学》2012年第5期529-532,共4页Chinese General Practice

基　　金：广东省科技计划项目基金(2009B030801249)

摘　　要：目的探讨妊娠期糖代谢异常孕妇产后强化饮食管理对糖、脂代谢的影响,为预防糖尿病的发生提供依据。方法 160例妊娠期糖代谢异常孕妇随机分为试验组和对照组,每组80例。试验组孕期及产后均在营养门诊随诊并强化饮食管理,对照组孕期仅在产科随诊,产后按普通免糖饮食管理,观察两组孕妇产后第1年和第3年的血糖和血脂情况。结果试验组完成2次随访者63例,随访率为78.75%(63/80),对照组完成2次随访者48例,随访率为60.0%(48/80),差异有统计学意义(χ2=6.6189,P<0.05)。试验组产后第1年和第3年糖代谢异常的发生率分别为25.4%(16/63)和14.3%(9/63),转阴率为68.8%(11/16),新发糖耐量异常(IGT)4例;对照组产后第1年和第3年糖代谢异常的发生率分别为18.8%(9/48)和25.0%(12/48),转阴率为11.1%(1/9),新发IGT 4例,新发2型糖尿病(T2DM)1例,试验组与对照组转阴率比较差异有统计学意义(χ2=5.5314,P<0.05)。试验组产后第3年的餐后2 h血糖及三酰甘油较产后第1年明显降低,差异有统计学意义(P<0.05)。结论实施强化饮食管理的妊娠期糖代谢异常孕妇产后随访率高,有利于血糖和血脂的改善。Objective To investigate the impact of intensified diet management on glycolipid metabolism in postpartum women who had abnormal glucose metabolism during pregnancy.Methods A total of 160 pregnant women with abnormal glucose metabolism were randomly and equally divided into intervention group that received intensified dietary management at nutrition clinic both during pregnancy and postpartum and control group that had the routine check in obstetrics clinic during pregnancy and received general free-sugar dietary management after delivery.Blood glucose and blood lipid profiles of both groups were observed in the first and the third year after delivery.Results Totally 63 cases in the intervention group received follow-up visits twice,yielding a follow-up rate of 78.75%（63/80）;48 cases in the control group received follow-up visits twice,yielding a follow-up rate of 60.0%（48/80）（χ2=6.6189,P0.05）.The incidences of abnormal glucose metabolism in the intervention group in the first and the third year after delivery were 25.4%（16/63） and 14.3%（9/63）respectively.In the first year after delivery,the negative-conversion rate of the blood glucose was 68.8%（11/16）,with 4 new patients developed impaired glucose tolerance（IGT）.The incidences of abnormal glucose metabolism in control group in the first and the third year after delivery were 25.4%（16/63） and 14.3%（9/63） respectively.In the first year after delivery the negative-conversion rate of blood glucose was 11.1%（1/9）,with 4 new patients developed IGT and 1 new patients developed gestational diabetes mellitus（GDM）（χ2=5.5314,P0.05）.The 2-hour plasma glucose（2hPG） level and total cholesterol（TC） in the third year in intervention group significantly decreased compared with those in the first year（P0.05）.Conclusion Pregnancy women with abnormal glucosemetabolism after delivery are more possible to benefit from intensified dietary management.

关 键 词：糖尿病 妊娠 产后期 随访 饮食管理 

分 类 号：R714.256[医药卫生—妇产科学]