脐动脉血流动力学与孕中期妊娠期糖尿病患者围产儿预后的相关性研究  

Association between umbilical artery hemodynamics and perinatal prognosis in patients with second-trimester gestational diabetes

作　　者：葛明芹 牛洁 代燕 胡苹 李富元 佟爱华 Ge Mingqin;Niu Jie;Dai Yan;Hu Ping;Li Fuyuan;Tong Aihua(Department of Endocrinology,Linyi Central Hospital,Linyi 276400,China)

机构地区：[1]临沂市中心医院内分泌科,临沂276400

出　　处：《中华内分泌外科杂志（中英文）》2024年第2期299-302,共4页Chinese Journal of Endocrine Surgery

基　　金：临沂市重点研发计划(医学类)(2022YX0019)。

摘　　要：目的分析脐动脉血流动力学与孕中期妊娠期糖尿病(gestational diabetes mellitus,GDM)患者围产儿预后的相关性。方法选取2019年10月至2022年10月于临沂市中心医院就诊的孕中期GDM患者156例,设置为GDM组。另选取同期于本院产检的健康孕妇150例设置为健康组。根据GDM组围产儿预后将其分为不佳组、良好组。比较健康组、GDM组脐动脉血流动力学指标;比较不佳组、良好组脐动脉血流动力学指标及一般资料;采用Logistic回归分析法分析GDM患者围产儿预后的影响因素。结果与健康组比较,GDM组搏动指数(pulsation index,PI)、阻力指数(resistance index,RI)及收缩期峰值流速/舒张末期流速(peak systolic velocity/end diastolic velocity,S/D)均升高(0.71±0.05 vs.0.79±0.06,1.30±0.14 vs.1.57±0.21,2.69±0.53 vs.3.24±0.68)(P<0.05)。156例GDM患者围产儿预后良好有115例,设置为良好组,围产儿预后不良有41例,设置为不佳组。与良好组比较,不佳组PI、RI、S/D,年龄≥35岁、OGTT结果3项异常、血糖控制效果不满意构成比均升高(0.78±0.06 vs.0.81±0.06,1.55±0.21 vs.1.63±0.22,3.09±0.64 vs.3.65±0.63,13.91%vs.29.27%,26.09%vs.46.34%,30.43%vs.48.78%)(P<0.05)。Logistic回归分析显示,年龄、糖耐量试验(oral glucose tolerance test,OGTT)结果3项异常、血糖控制效果、PI、RI、S/D均是孕中期GDM患者围产儿预后的影响因素(P<0.05)。结论脐动脉血流动力学指标PI、RI、S/D与孕中期GDM患者围产儿预后密切相关,可为临床评估提供参考依据。Objective To analyze the relationship between umbilical arterial blood flow dynamics and perinatal outcomes in patients with gestational diabetes mellitus(GDM)during the second trimester.Methods A total of 156 patients with GDM in the second trimester of pregnancy were selected from our hospital from Oct.2019 to Oct.2022 and were set as GDM group.In addition,150 healthy pregnant women who underwent birth examination in our hospital during the same period were selected as the healthy group.According to the prognosis of perinatal infants in GDM group,they were divided into poor group and good group.The umbilical arterial blood flow dynamics indexes of healthy group and GDM group were compared.The indexes and general data of umbilical arterial blood flow in poor and good groups were compared.Logistic regression analysis was used to analyze the influencing factors of perinatal prognosis in GDM patients.Results Compared with the healthy group,the pulsation index(PI),resistance index(RI)and peak systolic flow rate/end-diastolic flow rate(S/D)were increased in GDM group(0.71±0.05 vs.0.79±0.06,1.30±0.14 vs.1.57±0.21,2.69±0.53 vs.3.24±0.68)(P<0.05).Among 156 GDM patients,115 had good perinatal prognosis and were set as good prognosis group,while 41 had poor perinatal prognosis and were set as poor prognosis group.Compared with good prognosis group,the ratio of PI,RI,S/D,age≥35 years old,OGTT results and unsatisfactory blood glucose control were all increased in poor prognosis group(0.78±0.06 vs.0.81±0.06,1.55±0.21 vs.1.63±0.22,3.09±0.64 vs.3.65±0.63,13.91%vs.29.27%,26.09%vs.46.34%,30.43%vs.48.78%)(P<0.05).Logistic regression analysis showed that age,glucose tolerance test(OGTT)results,glucose control effect,PI,RI,S/D were all influencing factors for the perinatal prognosis of GDM patients in the second trimester(P<0.05).Conclusion PI,RI and S/D of umbilical artery blood flow are closely related to the perinatal prognosis of patients with GDM in the second trimester,which can provide reference for clinical ev

关 键 词：妊娠期糖尿病 搏动指数 阻力指数 围产儿预后 

分 类 号：R714.256[医药卫生—妇产科学]