妊娠相关性暴发性1型糖尿病妊娠结局分析  

Clinical characteristics and pregnancy outcomes of pregnancy-associated fulminant type-1 diabetes

作　　者：周航[1] 肖镇冬[1] 周燕 黄晶晶 顾宁[1] 王志群[1] 戴毅敏[1] ZHOU Hang;XIAO Zhendong;ZHOU Yan;HUANG Jingjing;GU Ning;WANG Zhiqun;DAI Yimin(Department of Obstetrics and Gynecology,Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing 210000,China)

机构地区：[1]南京大学医学院附属鼓楼医院妇产科,南京210000

出　　处：《空军航空医学》2024年第2期133-136,共4页AVIATION MEDICINE OF AIR FORCE

基　　金：国家自然科学基金项目(82071666);南京鼓楼医院临床研究资金项目(2022-YXZX-FC-02,2023-LCYJPY-31)

摘　　要：目的探讨妊娠相关性暴发性1型糖尿病的临床表现、实验室检查和胎儿结局。方法收集中英文数据库中妊娠相关性暴发性1型糖尿病相关文献,对符合纳入标准的43例患者及南京大学医学院附属鼓楼医院收治的5例患者资料进行汇总,分析其临床表现、实验室检查及胎儿结局。结果62.5%(30/48)的患者在孕晚期发病,消化道症状和高糖症状是患者起病的常见临床表现。胎儿活产率仅有16.7%(8/48),国内外患者活产率的差异无统计学意义(P>0.05);国外患者平均就诊时间0.50 d,少于国内患者2.19 d的平均就诊时间,差异有统计学意义(t=2.060,P=0.045);国内外患者在血糖、血钾等实验室检查方面的差异无统计学意义(P>0.05)。与胎死宫内患者的孕周相比,活产患者的发病孕周更晚(35.17周vs 32.54周,t=2.076,P=0.047),其他临床特点间的差异无统计学意义(P>0.05)。结论妊娠相关性暴发性1型糖尿病的临床表现各异,疾病进展迅速,活产率低,产科医师应加强对其认识,以期早发现、早治疗,从而改善母儿预后。Objective To analyze the clinical characteristics and pregnancy outcomes of pregnancy-associated fulminant type-1 diabetes.Methods The clinical data of 43 patients with pregnancy-associated fulminant type-1 diabetes collected from domestic and foreign databases,and of 5 patients from our hospital was included for analysis.Results The majority(62.5%)of patients had onset of symptoms in the third trimester of pregnancy.Gastrointestinal symptoms and hyperglycemic symptoms were common.Eight cases(16.7%)of live birth were reported,There is no statistically significant difference in live birth rates between domestic and international patients.The average interval between onset and treatment was 0.50 for foreign patients,compared with 2.19 for domestic ones with a significant difference(t=2.060,P=0.045).Meanwhile,no significant difference was observed in results of laboratory tests,such as glucose levels,blood sodium or potassium concentrations(P>0.05).However,there was significant difference in the onset of gestational age between patients with live birth and those with fetal loss(35.17 weeks vs.32.54 weeks,t=2.076,P=0.047).There is no statistically significant difference between other clinical features.Conclusion Patients with pregnancy-associated fulminant type-1 diabetes are likely to present with various clinical manifestations,which rapidly progress to critical illness with a high percentage of fetal loss.Obstetricians should be alert to this risk in order to improve maternal and neonatal outcomes through early intervention.

关 键 词：暴发性1型糖尿病 妊娠 临床特点 妊娠结局 

分 类 号：R714.25[医药卫生—妇产科学]