摘要
目的:探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)患者晚期血脂水平与围产结局的关系。方法:选择2010年1～12月在天津医科大学总医院检查并分娩、且资料完整的妊娠期糖尿病孕妇89例,并以同期40例正常孕妇为对照,详细记录其分娩前血脂水平、年龄、孕周、治疗方法、并发症。采用酶法测定糖代谢异常患者和正常孕妇的体内血脂水平。测定的血脂种类包括:血清甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)及高密度脂蛋白(HDL-C),并对妊娠期糖尿病产妇血脂含量与围产结局进行分析。结果:研究组TG水平显著高于对照组(P<0.05),其余各项血脂指标未见明显差异。研究组巨大儿、子痫前期、手术产、新生儿低血糖均高于对照组(P<0.05),胎膜早破、早产儿、新生儿窒息均未见明显差异。研究组中TG异常亚组巨大儿和子痫前期的发生率均高于血脂正常亚组(P<0.05),余未见显著差异。Logistic回归分析发现只有TG升高是发生巨大儿的独立危险因素(OR=1.77,P<0.01)。结论:妊娠期糖尿病患者存在脂代谢紊乱,且脂代谢紊乱与不良围产结局有关。
Objective： To explore the relationship between blood lipids levels and perinatal outcome among the patients with gestational diabetes mellitus （GDM） at late phase. Methods： 89 pregnant women who received prenatal examination and deliveried in the hospital from January to December in 2010 and had intact data （ study group） were selected, and 40 normal pregnant women were selected as control group at the same time. The blood lipids levels, ages, gestational weeks, therapeutic methods and complications in the two groups were recorded in detail. Enzymic method was used to detect the blood lipids levels in the two groups. The kinds of blood lipids detected included serum triglyceride （ TG）, total cholesterol （ TC ）, low density lipoprotein - cholesterol （ LDL - C ） and high density lipoprotein - cholesterol （ HDL - C） , the blood lipids contents and perinatal outcome of pregnant women with GDM were analyzed. Results ： The level of TG in study group was significantly higher than that in control group （ P 〈 0. 05 ） , there was no significant difference in the other blood lipids indexes between the two groups. The incidences of macrosomia, preeclampsia, neonatal hypoglycemia and the rate of cesarean section in study group were significantly higher than those in control group （ P 〈 0. 05 ） . There was no significant difference in the incidences of premature rupture of membrane, premature delivery and neonatal asphyxia between the two groups. In study group, the incidences of macrosomia and preeclampsia in abnormal TG subgroup were significantly higher than those in normal blood lipids subgroup （ P 〈 0. 05 ） , there was no significant difference in the other indexes between the two groups. Logistic regression analysis showed that the increase of TG was the only independent risk factor of macrosomia （ OR = 1.77, P 〈 0. 01 ） . Conclusion ： The patients with GDM have lipid metabolism disturbance, which is related to adverse perinatal outcome.
出处
《中国妇幼保健》
CAS
北大核心
2011年第25期3875-3877,共3页
Maternal and Child Health Care of China
关键词
妊娠期糖尿病
脂代谢
围产结局
Gestational diabetes mellitus
Lipid metabolism
Perinatal outcome
