妊娠期糖尿病视网膜病变临床分析  

Clinical analysis of 28 cases with diabetic retinopathy during pregnancy

作　　者：曾敏[1,2] 李彬彬[3,2] 

机构地区：[1]中国江西省赣州市人民医院妇产科 [2]南昌大学附属赣州医院,341000 [3]中国江西省赣州市人民医院眼科

出　　处：《国际眼科杂志》2013年第10期2048-2050,共3页International Eye Science

摘　　要：目的:探讨妊娠期糖尿病视网膜病变进展和防治效果。方法:通过糖尿病筛查确诊的妊娠期糖尿病(GDM)伴糖尿病视网膜病变(DR)孕妇28例(A组),GDM不伴DR孕妇28例(B组),正常孕妇28例(C组),分别在妊娠6,9mo和产后6mo对三组孕妇进行视力、眼底照相、糖化血红蛋白(HbAlc)等检查。结果:GDM的发病率为5.6%,妊娠期DR的发生率为16.7%,妊娠期DR的进展率为39.3%。在妊娠9mo时,A组的平均最佳矫正视力(BCVA)低于B组和C组(P<0.05),B组和C组的视力无统计学差异(P>0.05);A组平均最佳矫正视力(BCVA)在妊娠9mo低于妊娠6mo和产后6mo(P<0.05)。妊娠6,9mo和产后6mo,HbAlc为A组>B组>C组(P<0.05)。结论:妊娠会促进DR进展,可能与血中HbAlc增高有关,密切观察和严格控制血糖,能够有效减低糖尿病孕妇的视力损害。AIM： To investigate the progress, prevention and cure effect of diabetic retinopathy （DR） during pregnancy. METHODS： Eighty-four gravidas were enrolled in this prospective study. The patients were divided into three groups, group A consisting of 28 gravidas with gestational diabetic mellitus （GDM） with DR, group B consisting of 28 gravidas with GDM alone, and group C consisting of 28 normal gravidas. The best corrected visual acuity （BCVA） and glycosylated hemoglobin HbAlc） were determined and fundus photography was performed at 6, 9 months of pregnancy and 6 months after parturition respectively. RESULTS; During pregnancy, the morbidity of GDM and DR was respectively 5.6% and 16.7% ; the progress rate of gestational DR was 39. 3%. At 9 months of pregnancy, the mean BCVA of group A was significantly poorer than that of group B or C （P〈0.05） while there was no significant difference in BCVA between group B and C （P〉0.05）. The BCVA of group A at 9 months of pregnancy was poorer than that at 6 months of pregnancy or 6 months after parturition. At all times, the mean level of HbAIc of group A were significantly higher than that of group B or C P〈0.05）. CONCLUSION. DR progressing during pregnancy may be related to the increased HbAIc level, so close monitoring and control of blood glucose may help to reduce the visual impairment among DM gravidas.

关 键 词：妊娠 糖化血红蛋白 糖尿病视网膜病变 

分 类 号：R714.25[医药卫生—妇产科学] R774.1[医药卫生—临床医学]