妊娠期糖筛查异常患者血糖表现分析  

The performance analysis of gestational impaired glucose tolerance patients

作　　者：颜彦[1,2] 孙长学[1] 孙袁[3] 

机构地区：[1]贵阳医学院附属医院妇产科,贵州贵阳550004 [2]上海市第七人民医院妇产科,上海200137 [3]贵阳医学院附属妇产儿童医院产科,贵州贵阳550003

出　　处：《中国实用妇科与产科杂志》2012年第9期699-701,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨不同时点妊娠期糖耐量受损(GIGT)患者血糖代谢是否存在不同。方法回顾性分析2006年1月至2008年3月在贵阳医学院附属医院和贵阳医学院附属妇产儿童医院住院分娩的孕妇,将50g糖筛查异常(GCT)的286例患者作为研究对象,每例患者均经过口服葡萄糖耐量试验(OGTT),确诊妊娠期糖尿病(GDM)123例,GIGT121例(1h GIGT88例,2h GIGT30例,3h GIGT3例),糖代谢正常孕妇(NGT)42例。绘制并分析各组OGTT试验的血糖图;比较各组空腹血糖(FBG)、50g GCT结果、血糖曲线下面积(AUCG);比较各组孕妇妊娠期高血压疾病、胎膜早破发病率和剖宫产率;并比较新生儿结局。结果各组血糖图形态不同。GDM组FBG较其他3组明显增高(P<0.05);50g GCT GDM组与1h GIGT组、2h GIGT组及NGT组类似(P>0.05),其他各组间差异均有统计学意义(P<0.05);AUCG各组间差异均有统计学意义(P<0.05)。妊娠期高血压疾病发病率由GDM组至NGT组依次降低,但仅GDM组与NGT组比较差异有统计学意义(P<0.05)。胎膜早破、剖宫产率和早产、新生儿黄疸、新生儿窒息发生率及新生儿出生体重4组间比较差异无统计学意义(P>0.05)。巨大儿和新生儿低血糖发生率GDM组和1h GIGT组较2h GIGT组和NGT组明显增高(P<0.05)。结论不同时点妊娠期糖耐量受损孕妇血糖代谢表型及预后不同,按国际妊娠合并糖尿病研究组推荐的GDM新诊断标准,1h GIGT和2h GIGT虽均被纳入GDM,但仍有必要对其进行区别管理。Objective To investigate the heterogeneity in women with GIGT. Methods Totally, between Jan. 2006 and Mar. 2008 in the Affiliated Hospital of Gniyang Medical College and the Affiliated Women＇s and Child＇s Hospital of Guiyang Medical couege 286 pregnant women with abnormal 50 g GCT were included. All women were followed up and divided into four groups according to the resuhs of 75 g OGTF ： GDM group （ n = 123 ）, 1 h GIGT group （ n = 88 ）, 2 h GIGT group（ n = 30） and NGT group （n = 42 ）. Four groups＇ glucose curves were protracted and analyzed. The outcomes of FBG, 50 g GCT and AUCG were compared. The maternal-fetal prognoses among the four groups were compared. Results The four groups＇ glucose curves were different. FBG of GDM group was significantly higher than other three groups （ P 〈 0. 05 ）. GDM group was similar to 1 h GIGT group and 2 h GIGT group was similar to NGT group in 50 g GCT outcomes（P〉0. 05）. And there were significant differences in AUCG of the four groups with multiple comparison（P 〈 0. 05 ）. The incidence of HDCP successively fell from GDM group to NGT group （ P 〈 0. 05 ）, but there was significant difference only between GDM and NGT groups. There were no significant differences in the incidences of PROM, cesare- an, premature birth, neonatal jaundice, neonatal asphyxia and NBW of the four groups （ P 〉 0. 05 ）. The incidences of macrosomia and neonatal hypoglycemia of GDM group and 1 h GIGT group were significantly higher than 2 h GIGT group and NGT group（P 〈 0. 05）. Conclusion GIGT is a heterogeneous metabolic disorder. Though 1 h GIGT and 2 h GIGT will be combined into GDM, recommended by international association of Diabetes and pregnancy study group, it is still necessary for us to treat them differently.

关 键 词：妊娠 糖尿病 血糖 

分 类 号：R714.256[医药卫生—妇产科学]