非贫血孕妇妊娠早期红细胞参数与妊娠期糖尿病的关系  

Relationship of red blood cells parameters and gestational diabetes mellitus in early non anemia pregnant women

作　　者：卢红梅[1] 葛志平[1] 孙丽洲[1] 

机构地区：[1]南京医科大学第一附属医院产科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2013年第9期1247-1250,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省十二五科教兴卫医学重点学科-妇产科学[苏卫科教(2011)12号]

摘　　要：目的:探讨非贫血孕妇妊娠早期红细胞参数与妊娠糖尿病(GDM)发生的相关性,为临床早期预测妊娠糖尿病提供有效的参考手段。方法:采用前瞻性研究方法,选择2012年7月1日-2012年12月31日在本院完成产前检查并住院分娩且资料完整符合条件的1 342例妊娠妇女作为研究对象,所有孕妇在初次产检时登记其妊娠5-13+6周之间血常规检查的红细胞参数值,于妊娠24-28周产检时进行75 g糖耐量试验(OGTT),根据妊娠14周前血红蛋白(Hb)第25、50、75位百分位数水平将孕妇分为4组:A组(≤P25)、B组(P25-P50)、C组(P50-P75)以及D组(≥P75),分析GDM与孕妇妊娠14周前血红蛋白(Hb)、红细胞计数(RBC)、红细胞压积(HCT)之间的关系;并研究导致GDM的独立相关危险因素。结果:D组GDM发生率明显高于其他3组(P<0.05);而RBC中C组与D组GDM发生率分别高于A组、B组,差异均有统计学意义(P<0.05);HCT中GDM发生率:B组、C组以及D组3组明显高于A组(P<0.05),但是B组、C组以及D组组间无统计学差异(P>0.05)。Logistic回归分析发现妊娠期14周前Hb(β=0.028,OR=1.032)、RBC(β=0.743,OR=2.286)和HCT(β=0.089,OR=1.107)水平是导致GDM发生的独立危险因素。结论:妊娠14周前不同红细胞参数水平与GDM发生率密切相关,随着Hb、RBC、HCT水平增加,GDM发生率也有增加;且Hb、RBC、HCT是导致GDM的独立危险因素,临床上可以作为GDM的早期预测指标。Objective：To explore the correlation between erythrocyte parameters and gestational diabetes mellitus in early non anemic pregnant women,and to provide the reference for early clinical prediction. Methods：The prospective study was conducted in 1 342 cases of pregnant women from July 1,2012 to December 31,2012. All subjects were randamly divided into A,B,C,D group. All pregnant women received blood routine examination. The relationship between pregnancy and Hb,RBC,GDM HCT,and the independent risk factors of pregnancy GDM were analyzed. Results：Before 14 weeks of gestation GDM of group D was significantly higher than the other three groups （P 〈 0.05）;while in RBC,the incidence rate of GDM in group C and D was higher than that in group A and B（P 〈 0.05）;The incidence of HCT in GDM of group B,C and D was significantly higher than that in group A （P 〈 0.05）,but there are no significant difference among group B,C and D（P 〉 0.05）. Logistic regression analysis showed that gestational 14 weeks Hb,RBC and HCT levels are independent risk factors of GDM occurrence. Conclusion：Different red blood cell parameters in pregnant women before 14 weeks was closely related to the rate of GDM,GDM incidence, and increase with the increase of Hb,RBC,HCT significantly;and Hb,RBC,HCT are independent risk factors for GDM,so red blood cell parameters could be the main indexes to predict pregnancy GDM.

关 键 词：妊娠 红细胞参数 糖尿病 血红蛋白 红细胞计数 红细胞压积 

分 类 号：R714.256[医药卫生—妇产科学]