不同诊断标准妊娠糖尿病产妇妊娠结局的比较

目的研究妊娠期糖尿病(GDM)及糖耐量异常(GIGT)的不同诊断标准与妊娠结局的关系。方法数据来源于1999—2005年绥化市卫校附属医院分娩档案,包括1 856个样本。将样本按不同诊断标准分为6组,第1组为正常孕妇组;第2组为乐杰标准GIGT组;第3组为曹泽毅标准GIGT组;第4组为乐杰标准GDM组;第5组为曹泽毅标准GDM组;第6组为75g糖耐量试验(OGTT)2 h血糖大于6.7 mmol/L组,回顾性评价各组的妊娠结局。结果1 856例患者中,乐杰标准GDM发病率为4.4%(82例),GIGT发病率为5.0%(92例);曹泽毅标准GDM发病率为3.0%(56例),GIGT的发病率为3.2%(60例),第6组标准GIGT人数为136例(7.3%)。与正常组相比,不同标准的GDM及GIGT各组巨大儿及早产发病率增加(P<0.05),而剖宫产率及新生儿窒息发病率无明显增加,差异无统计学意义(P>0.05)。而不同诊断标准的GDM及GIGT各组间妊娠结局无明显差异(P>0.05)。结论不同诊断标准的妊娠结局无明显差异,但GDM及GIGT是增加母亲及胎儿发病率的高危因素,积极有效的管理和正确的诊断可改善预后。

The Analysis of Outcome of Pregnancy with Gestational Diabetes Mellitus and with Impaired Glucose Tolerance Diagnosed by Different Criteria

Objective To study the outcome of gestational diabetes mellitus(GDM) and impaired glucose tolerance(GIGT) diagnosed with different criteria.Methods 1()856 subjects were collected from the births file of the hospital affiliated of Suihua Medical School from 1999 to 2005,which were divided into six groups(The first goup is control,the second Le Jie GIGT group,the third Cao Zeyi GIGT group,the forth GDM Le Jie group,the fifth Cao Zeyi GDM group,the sixth OGTT group) according to different dignosing criteria.Pregancy outcome of this six groups were analyzed and compared.Results Among 1()856 subjects,GDM by Le Jie criteria was 82(4.4%),GIGT by Le Jie criteria 92(5.0%),GDM by Cao Zeyi criteria 56(3.0%),GIGT by Cao Zeyi criteria 60(3.2%) and GIGT by OGTT was over 6.7 mmol/L 136(7.3%).Significant difference was shown(P<0.05) when groups 2~6 compared with control,and was not shown(P>0.05) when compared between groups 2~6.Conclusion Different dignosing criteria would not induce the different pregnancy outcome,but GDM and GIGT remain a high-risk situation that increases maternal and infant morbidity,timely and effective administration combining with accurate diagnose would improve the outcome of pregnancy.