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目的研究妊娠期糖代谢异常孕妇尿微量蛋白阳性的发生率,以及尿微量蛋白阳性和阴性时不良妊娠结局的发生是否存在差异。方法选择2010年9月至2012年2月在南方医科大学南方医院定期产检并分娩的糖代谢异常孕妇152例,根据妊娠24~28周尿微量蛋白肌酐比情况分为尿微量蛋白阳性组23例,阴性组129例。比较两组孕妇临床特征和妊娠结局。结果 (1)妊娠期糖代谢异常孕妇微量蛋白尿的发生率为15.1%。尿微量蛋白阳性组孕妇年龄、体重指数(BMI)、平均动脉压、糖化血红蛋白、尿微量蛋白肌酐比以及胰岛素用量明显高于尿微量蛋白阴性组孕妇(P<0.05)。(2)尿微量蛋白阳性组和阴性组孕妇比较,子痫前期(34.8%vs.10.1%)、早产(39.1%vs.14.7%)、胎膜早破(26.1%vs.17.1%)和巨大儿(13.0%vs.27.1%)发生率差异均有统计学意义(P<0.05)。结论尿微量蛋白阳性组孕妇不良妊娠结局的发生率明显高于尿微量蛋白阴性组孕妇,提示尿微量蛋白可能是高危妊娠孕妇早期预测不良妊娠结局发生有效的指标。
Objective To study the incidence of urinary microalbumin positive pregnant women with abnormal glucose metabolism during pregnancy and whether there is any difference in the occurrence of adverse pregnancy outcomes when urine microalbumin is positive or negative. Methods A total of 152 pregnant women with abnormal glucose metabolism who were regularly inspected and delivered at Nanfang Hospital of Southern Medical University from September 2010 to February 2012 were divided into urine microalbumin positive group (23 cases) , Negative group of 129 cases. The clinical characteristics and pregnancy outcome of two groups of pregnant women were compared. Results (1) Gestational glucose metabolism in pregnant women, the incidence of microalbuminuria was 15.1%. Urine microalbumin positive group pregnant women age, body mass index (BMI), mean arterial pressure, glycosylated hemoglobin, urinary creatinine and urinary creatinine ratio was significantly higher than the amount of urine microalbumin negative pregnant women (P lt; 0.05). (2) Compared with the pregnant women with negative urine microalbuminuria, preeclampsia (34.8% vs.10.1%), preterm labor (39.1% vs.14.7%), premature rupture of membranes (26.1% vs.17.1% Children (13.0% vs.27.1%) were significantly different (P <0.05). Conclusion The incidence of adverse pregnancy outcomes in urinary microalbumin positive group is significantly higher than that in urine microalbumin negative group, suggesting that microalbuminuria may be an effective indicator for predicting adverse pregnancy outcomes in high-risk pregnant women in the early stage.