复合益生菌粉对妊娠期糖尿病高危孕妇血生化指标及阴道菌群的影响  

Effects of complex probiotic powder on blood biochemical indices and vaginal flora in pregnant women with high risk of gestational diabetes mellitus

作　　者：王永霞 刘银秀 张洁[3] 秦智娟 李亚琴 肖黎明 李怀轩 黄智勇 WANG Yongxia;LIU Yinxiu;ZHANG Jie;QIN Zhijuan;LI Yaqin;XIAO Liming;LI Huaixuan;HUANG Zhiyong(Department of Obstetrics and Gynecology,Affiliated Rugao Hospital,Nantong University,Nantong,Jiangsu 226500,China;Department of Nutrition,Affiliated Rugao Hospital,Nantong University,Nantong,Jiangsu 226500,China;Department of Medical Affairs,Affiliated Rugao Hospital,Nantong University,Nantong,Jiangsu 226500,China)

机构地区：[1]南通大学附属如皋医院妇产科,江苏南通226500 [2]南通大学附属如皋医院营养科,江苏南通226500 [3]南通大学附属如皋医院医务科,江苏南通226500

出　　处：《重庆医学》2024年第18期2781-2787,2792,共8页Chongqing Medical Journal

基　　金：江苏省南通市卫生健康委科研课题指导性项目(MSZ2022079)。

摘　　要：目的观察复合益生菌粉对妊娠期糖尿病(GDM)高危孕妇血生化指标和阴道菌群的干预作用。方法选取该院妇产科和营养科门诊招募的110例GDM高危孕妇为研究对象,将其随机分为益生菌干预组(n=55)和安慰剂对照组(n=55),益生菌干预组给予每日1袋复合益生菌粉,安慰剂对照组给予每日1袋安慰剂粉,两组粉剂的颜色、形状、大小及味道均保持一致。该试验的干预时间为23周。分别在基线和干预终点进行问卷调查,分别在基线、孕24~28周和孕34~38周后进行血液生化指标检测。此外,检测两组GDM高危孕妇在干预终点时阴道菌群结构的组成。结果最终干预结束后共有97例被纳入统计分析。其中,益生菌干预组50例,安慰剂对照组47例。23周干预结束后,益生菌干预组与安慰剂对照组孕妇空腹血糖、红细胞、血红蛋白、白细胞、铁蛋白、总蛋白、ALT、AST、总胆红素等各项指标差异无统计学意义(P>0.05)。在阴道菌群方面,益生菌干预组和安慰剂对照组的α多样性部分指标差异有统计学意义(P<0.05),β多样性两组间差异无统计学意义(P>0.05)。在阴道菌群门水平上,两组厚壁菌门、放线菌门、脱硫菌门、脱铁杆菌门和δ-变性菌门等菌门差异有统计学意义(P<0.05)。在阴道菌群属水平上,益生菌干预组乳酸杆菌属的相对丰度明显高于对照组(P<0.05)。结论复合益生菌粉补充可能在改善GDM高危孕妇血糖等生化指标方面作用有限,但其在调节GDM高危孕妇阴道微生态平衡方面具有一定作用。Objective To observe the interventional effects of complex probiotic powder on blood biochemical indices and vaginal flora in pregnant women with high risk of gestational diabetes mellitus(GDM).Methods One hundred and ten pregnant women with high risk of GDM recruited from the outpatient clinics of the obstetric department and nutrition department in this hospital were randomly divided into the probiotic intervention group(n=55)and the placebo control group(n=55).The intervention group was given 1 bag of complex probiotic powder per day,and the control group was given 1 bag of placebo powder.The colors,shapes,sizes and tastes of powders in the two groups remained the consistency.The intervention duration in this trial was 23 weeks.The questionnaire survey were conducted at baseline and at the intervention endpoint,and the blood biochemical indexes detections were performed at baseline,after 24-28 weeks of gestation,and after 34-38 weeks of gestation,respectively.In addition,the differences in the composition of the vaginal flora structure between the two groups of high risk pregnant women with GDM were detected at the intervention endpoint.Results A total of 97 cases were eventually included in the statistical analysis.Among them,there were 50 cases in the probiotic intervention group and 47 cases in the placebo control group.At the end of the 23 week intervention,there were no statistically significant differences in fasting blood glucose,red blood cells,hemoglobin,leukocytes,ferritin,total protein,albumin,glutamic transaminase,glutamic oxalate transaminase and total bilirubin between the probiotic intervention group and placebo control group(P>0.05).In terms of vaginal flora,there was a significant difference in some indicators ofαdiversity between the probiotic group and placebo control group(P<0.05),and there was no significant difference inβdiversity between the two groups(P>0.05).At the level of vaginal flora phyla,there were significant differences in the Firmicutes,Actinobacteria,Desulfobacterota,Deferr

关 键 词：益生菌 妊娠期糖尿病 高危孕妇 血糖 阴道菌群 

分 类 号：R587.1[医药卫生—内分泌]