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目的探讨妊娠期糖尿病(GDM)孕妇糖化血红蛋白(HbA1c)及血脂水平与妊娠结局的关系。方法选取2013—2015年唐山市妇幼保健院孕检并分娩的妊娠期糖尿病(GDM)孕妇177例(GDM组)和同期114例正常孕妇(正常组),采用美国贝克曼库尔特AU5800全自动生化仪及配套试剂盒来测定二组孕妇糖化血红蛋白(HbA1c)和血脂(胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白)水平,测无忧血糖分析仪GLM-77检测血糖,以及记录二组孕妇剖宫产率、分娩时的新生儿体重、巨大儿发生率及新生儿低血糖发生率,分析HbA1c、血脂水平在二组之间的差异及其与妊娠结局的关系;根据GDM组新生儿是否为巨大儿将孕妇分为二组,比较二组孕妇HbA1c、血脂(胆固醇、甘油三酯)水平。结果 GDM组孕妇的低密度脂蛋白(LDL)及高密度脂蛋白(HDL)与正常组比较,差异均无统计学意义(P>0.05);GDM组孕妇的HbA1c、胆固醇(TC)及甘油三酯(TG)与正常组比较,差异均有统计学意义(P<0.05),且均明显高于正常组。GDM组剖宫产率、巨大儿发生率和新生儿低血糖发生率均高于正常对照组,差异有统计学意义(P<0.05)。GDM组孕妇HbA1c、TC、TG水平与新生儿体重存在显著的正相关性r=0.74、0.69、0.62(P<0.05)。GDM组中巨大儿组孕妇HbA1c、TC、TG水平大于非巨大儿组,二者比较差异有统计学意义(P<0.05)。结论 GDM孕妇HbA1c、TC及TG水平与妊娠结局有着密切的关系。
Objective To investigate the relationship between gestational diabetes mellitus (HbA1c), serum lipids and gestational diabetes in pregnant women with gestational diabetes mellitus (GDM). Methods Totally 177 pregnant women with gestational diabetes mellitus (GDM) and 114 normal pregnant women (normal group) from Tangshan Municipal Maternal and Child Health Hospital during 2013-2015 were enrolled in this study. The American Beckman Coulter AU5800 fully automatic Biochemical analyzer and kit to determine the levels of HbA1c and serum lipids (cholesterol, triglycerides, low density lipoprotein, high density lipoprotein) in the two groups, GLM-77 blood glucose test, and The cesarean section rate, the birth weight, the incidence of macrosomia and the incidence of neonatal hypoglycemia in the two groups were recorded. The differences of HbA1c and blood lipid levels between the two groups and their relationship with pregnancy outcome were analyzed. According to GDM The group of newborns is a huge child will be divided into two groups of pregnant women, pregnant women HbA1c comparison, serum lipids (cholesterol, triglyceride) levels. Results There was no significant difference in LDL and HDL between GDM group and normal group (P> 0.05). The levels of HbA1c, cholesterol (TC) and triglyceride Ester (TG) compared with the normal group, the difference was statistically significant (P <0.05), and were significantly higher than the normal group. The incidence of cesarean section, macrosomia and neonatal hypoglycemia in GDM group were significantly higher than those in normal control group (P <0.05). The levels of HbA1c, TC and TG in pregnant women of GDM group were positively correlated with the weight of newborn infants (r = 0.74,0.69,0.62, P <0.05). The levels of HbA1c, TC and TG in the GDM group were significantly higher than those in the non-Giant group (P <0.05). Conclusion The levels of HbA1c, TC and TG in pregnant women with GDM are closely related to the outcome of pregnancy.