1403例妊娠期糖尿病的篩查結(jié)果分析及臨床意義

【摘 要】 目的 分析1403例妊娠期糖尿病（GDM）篩查結(jié)果及其相關(guān)臨床意義。方法 對(duì)1403例孕前無糖尿病的孕婦于孕26周時(shí)進(jìn)行50g 葡萄糖篩查試驗(yàn)，對(duì)于陽(yáng)性者進(jìn)一步做75g葡萄糖耐量試驗(yàn)，并檢測(cè)BMI指數(shù)，將孕婦各項(xiàng)檢查數(shù)據(jù)記錄在案。結(jié)果 妊娠期糖尿病的發(fā)病率為3.14%，年齡>35歲者GDM的發(fā)生率為4.95%，隨年齡的增長(zhǎng)患GDM 的風(fēng)險(xiǎn)加大；肥胖組孕婦發(fā)生GDM幾率遠(yuǎn)高于非肥胖組，肥胖對(duì)妊娠期糖尿病的發(fā)生有影響；妊娠期糖尿病會(huì)導(dǎo)致巨大兒發(fā)生率增加。結(jié)論 妊娠期糖尿病篩查對(duì)診斷妊娠期糖尿病具有十分重要臨床意義，對(duì)控制孕期體重及防止出現(xiàn)巨大兒意義的作用，是對(duì)危險(xiǎn)因素進(jìn)行早期干預(yù)的基礎(chǔ)。

【關(guān)鍵詞】 孕婦妊娠期糖尿病；篩查

【中圖分類號(hào)】 R714.25 【文獻(xiàn)標(biāo)識(shí)碼】 B

Analysis of the results and clinical significance of 1403 cases of gestational diabetes screening

Fing Chunlong Luo Hang Shan Shan Peng Kangsheng Guo Huixin Xie Junchao Xiao Yuanyuan

（Tongji Hospital， Department of Cardiology，shanghai， 200065）

【Abstract】 Objective Analyze the relationship between age and BMI and gestational diabetes mellitus （GDM） and the effect of GDM on the incidence of giant baby. Methods Screen 1403 pregnant women without diabetes mellitus before pregnancy and have a test about 50 grams of glucose screening at 26 weeks of pregnant， and the positive should further do 75g oral glucose tolerance test， and record the inspection data of the women. Results The incidence of gestational diabetes mellitus is 3.14%，the incidence of diabetic whose Age is greater than 35 years is 4.95%.With the growth of age， the risk suffering from GDM is on the increase； the incidence of GDM of pregnant women in the Obesity group is much higher than non-obese group. Obesity have an effect on the incidence of GDM. And GDM will lead to an increase on the incidence of giant baby. Conclusion Further to define the necessity of screening for GDM and make early intervention for risk factors and face the effective treatment， it has great benefit to pregnant women and fetal infants.

【Keywords】 pregnant women； gestation； GDM screening

妊娠期糖尿病（gestational diabetes mellitus，GDM）是妊娠期孕婦首次出現(xiàn)或發(fā)現(xiàn)的糖代謝異常的疾病（不包括妊娠前已有糖尿病者）。屬于妊娠期較為常見的一種并發(fā)癥。如今，隨著人們的生活水平不斷提高，戶外體育鍛煉的減少，工作勞動(dòng)強(qiáng)度的降低，日常飲食結(jié)構(gòu)的改變，且高齡超重孕婦越來越增多，導(dǎo)致近些年來GDM的發(fā)病率逐年上升。美國(guó)報(bào)道GDM的發(fā)生率為1%～1.4%，而我國(guó)的發(fā)生率為2.5%～3.1%。該癥大多發(fā)生在妊娠的中期或者后期，如果未能及時(shí)發(fā)現(xiàn)和控制，不但會(huì)導(dǎo)致孕婦出現(xiàn)低血糖、酮癥酸中毒等癥狀，而且還會(huì)造成高膽紅素血癥、巨大兒、畸形兒、胎兒死亡等嚴(yán)重后果。所以妊娠期糖尿病的篩查工作十分重要。現(xiàn)將我院的妊娠期糖尿病的篩查情況報(bào)道如下：