Brugmann评分预测妊娠期糖尿病孕妇产前胰岛素治疗需求的应用价值  

Application value of Brugmann score in prediction of prenatal insulin therapy demand in pregnant women with gestational diabetes mellitus

作　　者：林亚南 陈海霞 郭学齐[2] LIN Ya-nan;CHEN Hai-xia;GUO Xue-qi(Department of Obstetrics and Gynecology,Lishui People's Hospital,Lishui,Zhejiang 323000,China;不详)

机构地区：[1]丽水市人民医院妇产科,浙江丽水323000 [2]丽水市人民医院生殖医学科

出　　处：《中国妇幼保健》2024年第21期4160-4163,共4页Maternal and Child Health Care of China

基　　金：浙江省卫生健康科技计划项目(2022KY1438)。

摘　　要：目的 探讨Brugmann评分预测妊娠期糖尿病(GDM)孕妇产前胰岛素治疗需求的应用价值。方法 选择2021年1月—2023年1月丽水市人民医院妇产科的GDM孕妇206例,根据产前是否应用胰岛素治疗分为产前胰岛素治疗组(35例)和非产前胰岛素治疗组(171例)。获取孕妇临床资料以及孕期血糖相关指标,应用Brugmann-口服葡萄糖耐量试验(OGTT)评分和Brugmann-空腹血糖(FBG)评分两个独立评分进行评估。结果 产前胰岛素治疗组孕前体质量指数(BMI),三酰甘油、FBG、1 h OGTT、2 h OGTT、血红蛋白(HbA1c)水平,Brugmann-OGTT评分及Brugmann-FBG评分分别为(24.53±2.81)kg/m^(2)、(3.70±0.71)mmol/L、(6.75±1.83)mmol/L、(11.46±2.10)mmol/L、(10.09±2.11)mmol/L、(5.61±0.70)%、(6.75±2.55)分、(4.86±2.08)分;非产前胰岛素治疗组孕前BMI、三酰甘油、FBG、1 h OGTT、2 h OGTT、HbA1c水平,Brugmann-OGTT评分及Brugmann-FBG评分分别为(23.10±2.17)kg/m^(2)、(2.93±0.66)mmol/L、(6.01±1.76)mmol/L、(9.18±1.83)mmol/L、(8.16±1.16)mmol/L、(5.18±0.35)%、(3.84±1.26)分、(3.18±1.55)分。两组上述指标比较差异均有统计学意义(均P<0.05)。多因素logistic回归分析结果显示:三酰甘油(OR=2.796)、Brugmann-OGTT评分(OR=4.163)、Brugmann-FBG评分(OR=2.538)是GDM孕妇产前胰岛素治疗需求的独立影响因素(均P<0.05)。受试者工作特征(ROC)曲线显示:Brugmann-OGTT评分、Brugmann-FBG评分以及两评分联合预测GDM孕妇产前胰岛素治疗需求的曲线下面积分别为0.873、0.802、0.889。结论 Brugmann-OGTT评分和Brugmann-FBG评分可较好地预测GDM孕妇产前胰岛素治疗需求,适宜在临床推广,用于优化GDM孕妇血糖控制方案和患者管理。Objective To explore the application value of Brugmann score in prediction of prenatal insulin therapy demand in pregnant women with gestational diabetes mellitus(GDM).Methods A total of 206 pregnant women with GDM in Department of Obstetrics and Gynecology,Lishui People's Hospital from January 2021 to January 2023 were selected and divided into prenatal insulin therapy group(35 cases) and non-prenatal insulin therapy group(171 cases) according to whether prenatal insulin therapy was applied.The clinical data of pregnant women and blood glucose related indicators during pregnancy were obtained.Brugmann-oral glucose tolerance test(OGTT) score and Brugmann-fasting blood glucose(FBG) score were used for evaluation.Results Pre-pregnancy body mass index(BMI),triglyceride,fasting blood glucose(FBG),1 h OGTT,2 h OGTT,hemoglobin(HbA1c) levels,Brugmann-OGTT score,and Brugmann-FBG score in prenatal insulin therapy group were(24.53±2.81) kg/m~2,(3.70±0.71) mmol/L,(6.75±1.83) mmol/L,(11.46±2.10) mmol/L,(10.09±2.11) mmol/L,(5.61±0.70)%,(6.75±2.55),and(4.86±2.08),respectively.Pre-pregnancy BMI,triglyceride,FBG,1 h OGTT,2 h OGTT,HbA1c levels,Brugmann-OGTT score,and Brugmann-FBG score in non-prenatal insulin therapy group were(23.10±2.17) kg/m~2,(2.93±0.66) mmol/L,(6.01±1.76) mmol/L,(9.18±1.83) mmol/L,(8.16±1.16) mmol/L,(5.18±0.35)%,(3.84±1.26),and(3.18±1.55),respectively.There were statistically significant differences in the above indexes between the two groups(all P<0.05).Multivariate logistic regression analysis showed that triglyceride(OR=2.796),Brugmann-OGTT score(OR=4.163),and Brugmann-FBG score(OR=2.538) were independent influencing factors of prenatal insulin therapy demand in GDM pregnant women(all P<0.05).Receiver operating characteristic(ROC) curve showed that the areas under the curve of Brugmann-OGTT score,Brugmann-FBG score,and the combination of the two scores in predicting the demand for prenatal insulin therapy in GDM pregnant women were 0.873,0.802,and 0.889,respectively(all P<0.05).Conclusion

关 键 词：Brugmann评分 妊娠期糖尿病 产前胰岛素治疗 口服降糖药物 影响因素 

分 类 号：R714.256[医药卫生—妇产科学]