妊娠期糖尿病经产妇口服葡萄糖耐量试验时间-血糖曲线的曲线下面积与妊娠结局的相关性  

Correlations between area under curve of time-glucose curve of oral glucose tolerance test and perinatal outcomes in multiparas with gestational diabetes mellitus

作　　者：陈玲[1] 陈文玮 陈黎 张国英 CHEN Ling;CHEN Wenwei;CHEN Li;ZHANG Guoying(Department of Obstetrics,Women′s Hospital of Nanjing Medical University,Nanjing,Jiangsu,210004;Department of Obstetrics,The First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu,210036)

机构地区：[1]南京医科大学附属妇产医院产科,江苏南京210004 [2]南京医科大学第一附属医院产科,江苏南京210036

出　　处：《实用临床医药杂志》2021年第19期98-100,106,共4页Journal of Clinical Medicine in Practice

基　　金：江苏省妇幼保健协会科研课题资助项目(FYX201810)。

摘　　要：目的探讨妊娠期糖尿病(GDM)经产妇口服葡萄糖耐量试验(OGTT)时间-血糖曲线的曲线下面积(AUC)与妊娠结局的相关性。方法选取551例单胎GDM经产妇,分为AUC≤15.59 mmol/(L·h)组、AUC>15.59~16.79 mmol/(L·h)组、AUC>16.79~17.67 mmol/(L·h)组和AUC>17.67 mmol/(L·h)组。分析AUC与GDM经产妇不良妊娠结局的相关性。结果4组孕妇年龄、分娩孕周比较,差异有统计学意义(P<0.05)。4组孕妇早产、胎膜早破、羊水异常、剖宫产及产后出血的发生率比较,差异无统计学意义(P>0.05)。AUC≤15.59 mmol/(L·h)组新生儿平均出生体质量高于AUC>15.59~16.79 mmol/(L·h)组,差异有统计学意义(P<0.05)。AUC≤15.59 mmol/(L·h)组、AUC>16.79~17.67 mmol/(L·h)组与AUC>17.67 mmol/(L·h)组的新生儿转儿科发生率差异有统计学意义(P<0.05)。Logistic二元回归分析显示,AUC与GDM孕妇新生儿转儿科发生率有显著相关性(P<0.05)。结论GDM经产妇的OGTT时间-血糖曲线的AUC可以作为评价血糖水平的指标,在预测新生儿转儿科发生率方面有一定的价值。Objective To explore the correlations between the area under curve(AUC)of time-glucose curve of oral glucose tolerance test(OGTT)and perinatal outcomes in multiparas with gestational diabetes mellitus(GDM).Methods Totally 551 GDM multiparas with single fetus were selected,and they were divided into AUC≤15.59 mmol/(L·h)group,AUC>15.60 to 16.79 mmol/(L·h)group,AUC>16.79 to 17.67 mmol/(L·h)group and AUC>17.67 mmol/(L·h)group.Correlations between AUC and adverse perinatal outcomes were analyzed in GDM multiparas.Results There were significant differences in age and gestational weeks of delivery among the four groups(P<0.05).There were no significant differences in the incidence rates of preterm delivery,premature rupture of membranes,abnormal amniotic fluid,cesarean section and postpartum hemorrhage among the four groups(P>0.05).The average birth weight of newborns in the AUC≤15.59 mmol/(L·h)group was significantly higher than that in the AUC>15.59 to 16.79 mmol/(L·h)group(P<0.05).There was significant difference in the incidence of neonates transferring to department of pediatrics among the AUC≤15.59 mmol/(L·h)group,AUC>16.79 to 17.67 mmol/(L·h)group and AUC>17.67 mmol/(L·h)group(P<0.05).Logistic binary regression analysis showed that AUC was significantly correlated with the incidence of neonates transferring to department of pediatrics in GDM pregnant women(P<0.05).Conclusion AUC of OGTT time-glucose curve in GDM multiparas can be used as an index for evaluation of blood glucose level,and it has a certain value in predicting the incidence of neonates transferring to department of pediatrics.

关 键 词：经产妇 妊娠期糖尿病 口服葡萄糖耐量试验 曲线下面积 妊娠结局 

分 类 号：R714.25[医药卫生—妇产科学] R589[医药卫生—临床医学]