血糖控制满意的妊娠期糖尿病孕妇血清脂肪细胞型脂肪酸结合蛋白与母儿并发症的关系  

Relationship between serum adipocyte fatty acid binding protein and maternal complications in gestational diabetes mellitus pregnant women with satisfactory glucose control

作　　者：杨春红[1] 王佳[1] 成丽[1] 韩晶[1] 

机构地区：[1]保定市妇幼保健院妇产科,河北省保定071000

出　　处：《中国基层医药》2016年第11期1606-1610,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：河北省保定市科学技术研究与发展指导计划项目（15ZF034）

摘　　要：目的探讨血糖控制满意的妊娠期糖尿病（GDM）孕妇血清脂肪细胞型脂肪酸结合蛋白（FABP4）、胰岛素抵抗与母儿并发症的关系。方法选取孕24—28周行葡萄糖耐量试验（OGTr）检查确诊的GDM孕妇60例，其中血糖控制满意的30例为血糖控制满意组，血糖控制不满意的30例为血糖控制不满意组。选取同期孕24—28周健康孕妇30例为健康对照组。分别于孕24—28周和孕足月后测定三组孕妇空腹血清FABP4、空腹血糖（FPG）和空腹胰岛素（FINS），计算稳态模型胰岛素抵抗指数（HOMA-IR），记录并观察三组的母儿并发症。结果血糖控制满意组孕妇妊娠期高血压疾病、羊水过多、胎膜早破、产后出血、剖宫产率、巨大儿、新生儿窒息、新生儿低血糖、新生儿高胆红素血症发生率分别为10．0％、6．7％、13．3％、6．7％、23．3％、16．7％、10．0％、16．7％、10．0％，明显低于血糖控制不满意组的23．3％、20．0％、23．3％、16．7％、33．3％、33．3％、20．0％、30．0％、36．7％，两组差异均有统计学意义（X2=4．33、6．12、6．01、3．97、7．41、5．46、10．02、4．79、9．22，均P〈0．05）；血糖控制满意组孕妇妊娠期高血压疾病、羊水过多、巨大儿发生率（分别为10．0％、6．7％、16．7％）与健康对照组（分别为3．3％、0．0％、6．7％）差异均有统计学意义（x2=7．45、8．46、4．69，均P〈0．05），血糖控制满意组孕妇产后出血、胎膜早破、剖宫产、新生儿窒息、新生儿低血糖、新生儿高胆红素血症发生率（分别为6．7％、13．3％、23．3％、10．0％、16．7％、10．0％）与健康对照组（分别为10．0％、10．0％、20．0％、6．7％、13．3％、3．3％）比较差异均无统计学意义（均P〉0．05）。孕24～28周时，血糖控制满意组FABP4、FINS、FPG、HOMA-IR分别为（1．78±0．33）ng／mL、（12．35�Objective To investigate the relationship between serum adipocyte fatty acid binding protein （ FABP4）, insulin resistance and maternal complications in patients with gestational diabetes mellitus （GDM） with satisfactory glucose control. Methods 60 cases of pregnancy between 24 and 28 weeks of OGTT diagnosed GDM pregnant women were selected. 30 cases with satisfactory blood sugar control were selected as satisfactory blood sugar control group,30 cases with unsatisfied blood sugar control were selected as unsatisfied blood glucose control group. Healthy control group was selected from 24 to 28 weeks of healthy pregnancy in 30 patients. Fasting serum FABP4, fasting blood glucose（FPG） and fasting insulin（FINS） were measured in three groups of pregnant women after 24 to 28 weeks and pregnant term. To calculate the insulin resistance index （ HOMA - IR） of the steady state model, and record and observe the complications of the three groups. Results In the satisfactory blood glucose control group, the incidence rates of pregnant hypertensive disorders, excessive amrriotic fluid, premature rupture of membranes, postpartum hemorrhage, cesarean section, macrosomia, neonatal asphyxia, neonatal hypoglycemia, hyperbilirubinemia of newborn were 10.0% ,6.7% ,13.3% ,6.7% ,23.3%, 16.7% , 10.0%, 16.7% , 10.0% ,which were significantly lower than those in the unsatisfied blood glucose control group （23.3%, 20.0% , 23.3% , 16.7% , 33.3%, 33.3%, 20.0%, 30.0% ,36.7% ）, the two groups had significant differences （ X2= 4.33,6.12,6.01,3.97,7.41,5.46,10.02,4.79, 9.22, all P 〈 0.05 ）. The incidence rates of pregnant hypertensive disorders, excessive amniotic fluid, macrosomia between the satisfactory blood glucose control group （ 10.0% ,6.7%, 16.7% ） and healthy control group （3.3%, 0. 0% ,6.7% ） had statistically significant differences （ X2 = 7.45,8.46,4.69, all P 〈 0.05 ）. The incidence rates of postpartum hemorrhage, premature rupture of membranes, cesarean section, neonatal asphyxia, neonatal

关 键 词：脂肪细胞型脂肪酸结合蛋白 妊娠期糖尿病 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]