论文部分内容阅读
目的:检测妊娠期糖尿病(GDM)妇女血清胆固醇(TC)、总胆红素(TBil)、尿酸(UA)和尿微量蛋白(m Alb)等各项指标的水平,并观察改变程度和预后,分析其临床意义及可能对孕妇产生的影响,为妊娠期糖代谢异常患者临床诊断和治疗提供参考和依据。方法:随机选择该院2012年1月~2013年9月的72例GDM孕妇为观察组,选取同期正常妊娠妇女70例作为对照组。观察组中≤28周孕妇32例,为孕中期组,>28周孕妇40例,为孕晚期组。测定各组血清TC、TBil、UA和m Alb等指标,并观察患者妊娠结果。结果:观察组TC浓度[(4.40±0.59)mmol/L]高于对照组(P<0.05);观察组TBil[(9.14±0.45)μmol/L]低于对照组(P<0.05);观察组UA和m Alb浓度[(279.86±15.52)μmol/L和(18.89±1.90)mg/L]均明显高于对照组(P<0.05)。孕晚期组TC浓度[(4.52±0.63)mmol/L]高于孕中期组(P<0.05);观察组TBil浓度[(9.05±0.38)μmol/L]低于孕中期组(P<0.05);观察组UA和m Alb浓度分别为(288.21±17.84)μmol/L和(19.46±2.11)mg/L,均明显高于孕中期组(P<0.05)。治疗后TC浓度[(2.96±0.55mmol/L)]低于治疗前(P<0.05);治疗后TBil浓度为(11.06±0.41)μmol/L,高于治疗前(P<0.05);观察组UA和m Alb浓度[(213.42±16.76)μmol/L和(11.93±1.83)mg/L]均明显低于治疗前(P<0.05)。观察组出现早产、子痫前期、胎儿生长受限、巨大儿和胎膜早破总计为18.06%(13/72),高于对照组(P<0.05)。结论:GDM患者血清存在TG升高现象,尿m Alb升高,可作为早期肾脏损伤的诊断指标;及时检测妊娠期GDM患者血清TC、TBil和UA浓度及尿m Alb有助于判断GDM的代谢异常及早期肾损害,为GDM肾病的早期诊断和干预治疗提供了依据,GDM孕妇可对母体和胎儿产生一定的不良反应,使母婴并发症增高,早期预防和诊断GDM,具有重要的临床意义。
Objective: To detect the levels of serum cholesterol (TC), total bilirubin (TBil), uric acid (UA) and urinary microalbumin (MbA) in women with gestational diabetes mellitus (GDM) and to observe the changes and prognosis, To analyze the clinical significance and the possible impact on pregnant women and provide reference and basis for the clinical diagnosis and treatment of patients with abnormal glucose metabolism during pregnancy. Methods: Seventy-two pregnant women with GDM from January 2012 to September 2013 in our hospital were randomly selected as the observation group. 70 normal pregnant women were selected as the control group. 32 cases of pregnant women in the observation group ≤ 28 weeks, for the second trimester group,> 28 weeks of pregnant women 40 cases for the third trimester of pregnancy. The serum levels of TC, TBil, UA and m Alb in each group were measured and the pregnancy outcome was observed. Results: The TC concentration in the observation group was significantly higher than that in the control group [(4.40 ± 0.59) mmol / L] (P <0.05) The concentrations of UA and m Alb in group [(279.86 ± 15.52) μmol / L and (18.89 ± 1.90) mg / L] were significantly higher than those in control group (P <0.05). The concentration of TCil in the third trimester was lower than that in the third trimester ([4.52 ± 0.63] mmol / L], but lower than that in the third trimester (P <0.05) . The concentrations of UA and m Alb in the observation group were (288.21 ± 17.84) μmol / L and (19.46 ± 2.11) mg / L, respectively, which were significantly higher than those in the second trimester group (P <0.05). After treatment, the concentration of TBil was (2.96 ± 0.55mmol / L) lower than that before treatment (P <0.05); the TBil concentration was (11.06 ± 0.41) μmol / L after treatment, The concentrations of UA and m Alb [(213.42 ± 16.76) μmol / L and (11.93 ± 1.83) mg / L] were significantly lower than those before treatment (P <0.05). The observation group appeared premature, preeclampsia, fetal growth restriction, macrosomia and premature rupture of membranes a total of 18.06% (13/72), higher than the control group (P <0.05). CONCLUSIONS: Serum TG in GDM patients is elevated and urine m Alb is elevated, which may be used as a diagnostic index for early renal injury. The timely detection of serum TC, TBil and UA concentrations and urinary m Alb in pregnant GDM patients may help to determine the metabolism of GDM Abnormalities and early renal damage provide the basis for the early diagnosis and intervention treatment of GDM nephropathy. GDM pregnant women can have some adverse reactions to the maternal and fetus, so maternal and neonatal complications, early prevention and diagnosis of GDM, has an important clinical significance .