论文部分内容阅读
目的:探讨妊娠期糖尿病(GDM)合并妊娠期高血压疾病(PIN)孕妇的糖代谢及胰岛素抵抗特征。方法:选择妊娠晚期孕妇58例分为3组:GDM合并PIH12例(Ⅰ组),单纯GDM21例(Ⅱ组),正常妊娠孕妇25例(Ⅲ组)。在24～32周进行葡萄糖耐量实验,利用胰岛素敏感指数(ISI)、血糖曲线下面积(SAUC)和胰岛素曲线下面积(IAUC)分析各组孕妇糖代谢及胰岛素抵抗特征。结果:Ⅰ组与Ⅱ组比较胰岛素敏感性降低2倍,Ⅰ组与Ⅲ组比较胰岛素敏感性降低5倍,Ⅰ组胰岛素水平高于Ⅲ组,差异有显著性。各组孕妇平均动脉压(MAP)与胰岛素敏感性呈负相关。结论:GDM合并PIN比单纯GDM具有更强的胰岛素抵抗,在正常妊娠和异常糖耐量孕妇中,MAP是预测胰岛素抵抗的有力指标。
Objective: To investigate the glycometabolism and insulin resistance in pregnant women with gestational diabetes mellitus (GDM) complicated with gestational hypertension (PIN). Methods: Fifty-eight pregnant women in the third trimester of pregnancy were divided into three groups: 12 cases of GDM combined with PIH (group Ⅰ), 21 cases of simple GDM (group Ⅱ) and 25 cases of normal pregnant women (group Ⅲ). Glucose tolerance test was conducted at 24 to 32 weeks, and the pregnant women’s glucose metabolism and insulin resistance were analyzed by insulin sensitivity index (ISI), area under the curve of blood glucose (SAUC) and area under the curve of insulin (IAUC). Results: The insulin sensitivity of group Ⅰ and group Ⅱ was reduced by 2 times. The insulin sensitivity of group Ⅰ and group Ⅲ was decreased by 5 times. The insulin level of group Ⅰ was higher than that of group Ⅲ. The difference was significant. The mean arterial pressure (MAP) of pregnant women in each group was negatively correlated with insulin sensitivity. CONCLUSION: GDM combined with PIN has more insulin resistance than GDM. MAP is a powerful predictor of insulin resistance in normal and abnormal glucose tolerance pregnant women.