妊娠早中期个体化医学营养管理降低妊娠期糖尿病发生率作用的研究  

Study on the effect of nutritional management on reducing the incidence of gestational diabetes mellitus in the early and middle stages of pregnancy

作　　者：莫琴[1] 胡翔[1] 林丽妮[1] 李萍华[1] 韩燕[1] 

机构地区：[1]深圳市宝安区石岩人民医院营养科,广东深圳518108

出　　处：《中国医药科学》2017年第12期187-191,198,共6页China Medicine And Pharmacy

基　　金：广东省深圳市科技计划项目(JCYJ20150402155418382)

摘　　要：目的探讨妊娠早中期个体化医学营养管理降低妊娠期糖尿病(GDM)发生率的作用。方法收集300例妊娠早中期(孕龄<24周)首次空腹血糖(FPG)≥5.1mmol/L且<7.0mmol/L的孕妇,按就诊先后顺序赋予计算机随机生成的序列数,分为研究组和对照组各150例,研究组给予一对一门诊个体化医学营养管理(含医学营养治疗和运动指导),对照组进行常规孕期营养指导,于妊娠24~32周观察葡萄糖耐量试验(OGTT)结果及GDM的发生率。结果研究组孕妇妊娠24~28周OGTT的FPG、1小时血糖(1hPG)、2小时血糖(2hPG)以及GDM发生率均低于对照组,差异具有统计学意义(P<0.01);妊娠32周后研究组GDM发生率为22%(33/150),明显低于对照组66.9%(97/145),研究组GDM发病风险是对照组的0.140倍,差异具有统计学意义(P<0.01)。结论对妊娠早中期FPG≥5.1mmol/L且<7.0mmol/L的孕妇积极开展个体化医学营养管理,能有效阻止糖耐量异常的进一步加重和降低中晚期GDM的发病率。Objective To explore the effect of nutritional management on reducing the incidence of gestational diabetes mellitus in the early and middle stages of pregnancy. Methods 300 cases of early and mid pregnancy （gestational age 〈 24 weeks） for the first time,fasting blood glucose （FPG） and 〈 7.0mmol/L more than 5.1mmol/L of pregnant women were selected.According to number of sequences randomly generated by the computer according to the order of visits,they were divided into study gi^oup and control group with 150 cases in each.Patients in study group were treated with One to one outpatient individualized medical nutrition management （including medical nutrition,treatment and exercise guidance）,and patients in control group were treated with routine prenatal nutrition instruction.The glucose tolerance test （OGTT） and the incidence of GDM were observed at 24-32 weeks of gestation. Results OGTT,FPG,1 hours blood sugar （lhPG）,2 hours blood sugar （2hPG） and GDM incidence rate at 24-28 weeks of pregnant women in study group were lower than those in control group.the differences were statistically significant （P 〈0.01）.After 32 weeks of gestation,the incidence of GDM in the study group was 22% （33/150）,which was significantly lower than that of the control group with 66.9% （97/145）,and the risk of GDM in the study group was 0.140 times that of the control group,and the correlation was statistically significant （P 〈 0.01）. Conclusion The individualized medical nutrition management of pregnancy FPG positive pregnant women and more than 5.1mmol/L 7.0mmol/L can effectively prevent further aggravation of impaired glucose tolerance and reduce the incidence of middle and advanced GDM.

关 键 词：妊娠 个体化医学营养管理 孕期营养指导 葡萄糖耐量试验 妊娠期糖尿病 

分 类 号：R714.256[医药卫生—妇产科学]