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1、妊娠期糖尿病孕婦產(chǎn)后糖代謝異常的影響因素【摘要】目的探討妊娠期糖尿病(gestationaldiabetesmellitus,GDM)患者產(chǎn)后糖代謝轉(zhuǎn)歸情況及產(chǎn)后糖代謝異常的相關(guān)因素。方法收集并分析2008年1月至2010年12月在北京婦產(chǎn)醫(yī)院進(jìn)行產(chǎn)前檢查、分娩及產(chǎn)后隨訪的624例妊娠期糖尿病孕婦的臨床資料,根據(jù)產(chǎn)后6~8周糖代謝恢復(fù)情況分為糖代謝正常組(444例)和糖代謝異常組(180例),了解兩組轉(zhuǎn)歸的相關(guān)因素。結(jié)果1)444例孕婦產(chǎn)后6~8周糖代謝恢復(fù)正常,占71.2%,180例孕婦產(chǎn)后6~8周糖代謝仍然異常,占28.8%,其中糖尿病(diabetesme
2、llitus,DM)18例,空腹血糖受損(impairedfastingglucose,IFG)32例,糖耐量受損(impairedglucosetolerance,IGT)130例;2)產(chǎn)后糖代謝異常組孕期GDM診斷的孕周較糖代謝正常組早,空腹血糖、孕前及產(chǎn)后體質(zhì)量指數(shù)(bodymassindex,BMI)、血脂均較正常組高,孕期應(yīng)用胰島素控制血糖、合并相關(guān)合并癥、DM家族史的比例較正常組高,差異有統(tǒng)計(jì)學(xué)意義(P<0.05),而兩組母乳喂養(yǎng)比例差異無統(tǒng)計(jì)學(xué)意義(P>0.05);3)兩組孕婦的年齡、孕產(chǎn)次以及孕期體質(zhì)量增長相比較,差異無統(tǒng)計(jì)學(xué)意義(P>0.05)
3、。結(jié)論1)大部分GDM孕婦產(chǎn)后6~8周糖代謝可恢復(fù)正常,28.8%(180例)的孕婦產(chǎn)后仍然存在糖代謝異常;2)孕婦GDM診斷孕周早、孕期空腹血糖高、DM家族史、孕期應(yīng)用胰島素控制血糖、孕期合并相關(guān)合并癥、孕前及產(chǎn)后高BMI、高脂血癥等均為產(chǎn)后糖代謝異常的高危因素。【關(guān)鍵詞】妊娠期糖尿病;口服葡萄糖耐量試驗(yàn);產(chǎn)后隨訪【Abstract】ObjectiveToinvestigatetheprognosisandrelatedfactorsofglucosemetabolisminpostnatalwomenwithgestationaldiabetesmellit
4、us(GDM).MethodsDataof624womenwithGDMduringpregnancydeliveredinourhospitalfromJanuary2008toDecember2010werecollected.Accordingtothe6~8weekspostnatalglucosemetabolismthe624womenweredividedintotwogroups,444glucosemetabolism;180abnormalpostnatalglucosemetabolism.Results1)Amongthe624subje
5、cts,444(71.2%)womenglucosemetabolismreturntonormal6~8weeksafterdelivery;180(28.8%)stillhadabnormalglucosemetabolism6~8weeksafterdelivery,including18withdiabetesmellitus(DM),32withimpairedfastingglucose(IFG),130withimpairedglucosetolerance(IGT).2)ThetimepointofdiagnosingGDMwasearlieri
6、nabnormalglucosemetabolismgroupthaninnormalglucosemetabolismgroup,theleveloffastingbloodglucose,bodymassindex(BMI)inprenatalandpostnatalandthelipidlevelswerehigherinabnormalglucosemetabolismgroupthaninnormalglucosemetabolismgroup.Significantdifferencewasfoundinusinginsulinduringpregn
7、ancy,accompanyingrelatedcomplicationsandwithDMfamilyhistorybetweenthetwogroups(P<0.05),whichwashigherinabnormalglucosemetabolismgroup.Nosignificantdifferencewasfoundintheratioofbreastfeeding(P>0.05).3)Nosignificantdifferencewerefoundinage,thetimesofpregnancyanddeliveryandbodymassgain
8、ingduringpre