基于血糖负荷概念的食物交换份法饮食干预对妊娠期糖尿病孕妇的影响

[目的]探讨基于血糖负荷概念的食物交换份法饮食干预对妊娠期糖尿病的影响.[方法]选择2012年5月-12月门诊常规产前检查,诊断为妊娠期糖尿病的孕妇158例作为研究对象,随机分为观察组（78例）和对照组（80例）,对观察组进行基于血糖负荷概念的食物交换份法饮食指导,对照组采用传统的饮食指导.[结果]治疗前两组孕妇的空腹血糖及餐后2h血糖比较差异均无统计学意义（P＞0.05）;治疗后两组孕妇的空腹血糖及餐后2h血糖比较差异均有统计学意义（P＜0.05）;血糖控制满意率比较差异有统计学意义（P＜0.05）,低血糖的发生率比较差异无统计学意义（P＞0.05）.孕妇的体重增加、体重指数变化和新生儿出生体重比较差异有统计学意义（P＜0.05）.[结论]血糖负荷的食物交换份法饮食干预,与传统的食物交换份法饮食干预进行比较,可以较好地控制孕妇孕期血糖和孕期体重的增加,降低母婴并发症,改善围生期结局.     

妊娠期糖尿病孕期干预对妊娠结局的影响

目的：探讨妊娠期糖尿病的孕期干预对妊娠结局的影响。方法回顾性分析妊娠糖尿病（GDM）患者120例,将孕期通过干预后血糖控制良好的76例孕妇为干预实验组,将未予孕期干预、血糖控制不佳者44例为干预对照组,同时,随机抽取110例血糖正常的分娩孕妇为正常对照组,比较三组孕妇妊娠结局及围生儿结局。结果干预实验组早产、羊水过多、巨大儿、FGR、糖尿病酮症、新生儿低血糖、新生儿窒息及高胆红素血症的发生率及剖宫产率均低于干预对照组,差异有统计学意义（P〈0.05）,而其与正常对照组比较差异无统计学意义（P〉0.05）。结论妊娠期糖尿病孕期有效干预可明显降低母婴并发症的发生率,改善母婴结局,甚至达到正常孕妇水平。     

食物血糖生成指数指导社区糖尿病患者饮食治疗的临床观察

目的通过食物交换份法与血糖生成指数膳食指导法对社区糖尿病病人进行饮食治疗，探索社区糖尿病饮食治疗的有效方法。方法选取社区内89例2型糖尿病患者，按年龄性别匹配后随机分为食物交换份（FEL）组和血糖生戍指数膳食指导（GI）组，进行为期1年的饮食干预，观察两组患者血糖、血脂、糖化血红蛋白、体重指数的变化。结果饮食干预后，GI组患者的FBG、PBG、HbAlc、TG、LDL．C、BMI均低于FEL组（P〈0.05），HDL-C高于FEL组（P〈0.05）结论用血糖生成指数膳食指导法进行饮食治疗，可以降低患者的FBG、PBG、HbAlc、TG、LDL-C、BMI，是一种有效的社区糖尿病饮食干预方法。     

中医运动处方对妊娠期糖尿病患者血糖及妊娠结局的影响

目的:探讨中医运动处方对妊娠期糖尿病(gestational diabetes mellitus,GDM)患者血糖控制及妊娠结局的影响。方法:选取200例GDM患者,随机分为观察组和对照组,每组100例。对照组给予常规孕期干预,观察组给予中医运动处方干预。比较两组患者空腹血糖(fasting blood-glucose,FBG)、餐后2 h血糖(2 hour postprandial blood glucose,2 hPBG)、糖化血红蛋白(hemoglobin Alc,HbA1c)及妊娠结局。结果 :干预后,观察组患者FBG、2 hPBG、HbA1c低于对照组(P0.05)。观察组子痫前期、羊水过多、胎膜早破、巨大儿、胎儿宫内窘迫、新生儿窒息、新生儿低血糖发生率低于对照组(P0.05)。结论:采用中医运动处方进行孕期干预,可提高GDM患者血糖控制水平,改善妊娠结局。     

血糖负荷概念的食物交换法联合中等强度有氧运动 在妊娠期糖尿病患者中的应用观察

目的：制定血糖负荷概念的食物交换法联合中等强度有氧运动干预方案,并探究其在妊娠期糖尿病患者中的应用效 果。 方法：选取 2017 年 1 月 ~2020 年 5 月收治的 108 例妊娠期糖尿病患者,按建档时间不同分成对照组和观察组,各 54 例。 对照 组接受常规干预,观察组于对照组基础上接受血糖负荷概念食物交换法联合中等强度有氧运动干预。 对比两组干预前、分娩后 1%d 糖代谢指标（糖化血红蛋白、餐后 2%h 血糖、空腹血糖）水平、孕期体质量指标（孕期每周体质量增加量、孕期体质量总增加量）、分娩 结局（羊水过多、剖宫产、胎膜早破）。结果：分娩后 1%d 观察组糖化血红蛋白、餐后 2%h 血糖、空腹血糖水平较对照组低（ P ＜0.05 ）;观 察组孕期每周体质量增加量、孕期体质量总增加量较对照组少（ P ＜0.05 ）;观察组分娩结局优于对照组（ P ＜0.05 ）。 结论：血糖负荷 概念食物交换法联合中等强度有氧运动应用于妊娠期糖尿病患者有利于调节血糖水平,控制体质量,改善分娩结局。     

妊娠糖尿病孕妇健康教育干预的效果

目的探讨健康教育在控制妊娠糖尿病（gestational diabetes mellitus，GDM）孕妇孕期血糖和改善妊娠结局中的作用，并摸索针对GDM孕妇的孕期教育模式。方法对干预组60例GDM孕妇进行糖尿病相关知识的问卷调查并实施糖尿病系统化教育和治疗，同时设60例常规产前护理的GDM孕妇为对照组，就其血糖变化和妊娠结局进行比较。结果实施糖尿病系统化教育前后，GDM孕妇的相关知识水平有了极大的提高（P〈0．01），干预组的血糖控制与对照组相比有显著差异（P〈0．01），其妊娠结局也明显优于对照组（P〈0．01）。结论对GDM孕妇实施健康教育能使她们更好地控制血糖，改善妊娠结局，从而保证母婴健康。     

孕期日记对妊娠期糖尿病孕妇的干预效果

探讨孕期日记对妊娠期糖尿病孕妇的干预效果。 方法 选择在上海市某三级甲等医院产科门诊产检的妊娠期糖尿病孕妇142 例,随机分为实验组和对照组,每组71 例。 实验组除接受常规产前检查和孕期指导外,还给予特制的孕期日记干预;对照组只进行常规产前检查和孕期指导。 比较两组血糖控制、母婴并发症等情况。 结果实验组干预后入院待产时空腹血糖、糖化血红蛋白均低于对照组,血糖达标率高于对照组,差异有统计学意义（P<0.05）。 实验组难产率低于对照组,差异有统计学意义（P<0.05）;实验组感染率低于对照组（P=0.05）;其他并发症发生率和新生儿结局差异无统计学意义（P>0.05）。 结论 给予妊娠期糖尿病孕妇孕期日记干预可有效促进孕妇控制血糖水平,减少部分并发症的发生。     

血清SF、HbA1c水平对妊娠期糖尿病孕妇围产结局的预测价值

目的 探讨血清铁蛋白(SF)、糖化血红蛋白(HbA1c)水平对妊娠期糖尿病(GDM)孕妇发生不良围产结局的预测价值。方法 选取2021年3月至2023年2月于邛崃市妇幼保健院(下称该院)行产前检查并住院分娩的GDM孕妇97例为观察组,另选取同期于该院产检的健康孕妇116例为对照组。比较两组的空腹血糖(FBG)、SF、HbA1c水平,对比分析观察组中不同围产结局孕妇的临床特征以及SF、HbA1c水平,分析GDM孕妇不良围产结局的影响因素以及血清SF、HbA1c水平预测GDM孕妇不良围产结局的价值。结果 观察组的FBG、总胆固醇(TG)、三酰甘油(TC)、低密度脂蛋白胆固醇(LDL-C)、SF、HbA1c水平均高于对照组,差异有统计学意义(P<0.05)。GDM孕妇中围产结局不良组的FBG、TG、TC、SF、HbA1c水平高于良好组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,FBG、TG、TC、SF、HbA1c是不良围产结局的独立影响因素(P<0.05)。受试者工作特征(ROC)曲线分析结果显示,SF、HbA1c及二者联合预测曲线下面积(AUC...     

孕期体质指数增加对妊娠结局的影响

目的探讨孕妇体质量过重与妊娠结局的关系,为降低高危妊娠的发生率、提高产科质量提供依据。方法以体质指数的标准分组,分析孕妇体质量增加与巨大儿发生率、分娩方式、孕期并发症的关系。结果两组间新生儿出生体质量有明显差异,巨大儿发生率有统计学差异（P〈0.05）。孕期体质量增加与新生儿体质量呈正相关（P〈0.05）,难产剖宫产率有显著差异。结论孕期体质量过重是影响妊娠结局的主要因素。     

两种饮食干预方法对2型糖尿病疗效比较

目的探讨基于血糖负荷的食物交换份法用于2型糖尿病患者饮食教育的有效性。方法随机抽取上海市某三级甲等医院糖尿病门诊2型糖尿病患者72例,随机分为实验组与对照组,每组各36例。实验组采用基于血糖负荷的食物交换份法,对照组采用传统的食物交换份法,通过多种方式实施3个月的饮食教育干预。于干预后3个月,随访3个月时进行干预效果的评价。结果实验组与对照组餐后空腹血糖、餐后2h血糖、糖化血红蛋白、总胆固醇水平和体质指数的差异具有统计学意义（P〈0．05及P〈0．01）。结论基于血糖负荷的食物交换份法用于2型糖尿病患者的饮食教育较传统的食物交换份法更有效,值得应用与推广。     

食物血糖负荷值在妊娠糖尿病患者饮食教育中的应用

目的:探讨参照食物血糖负荷值在妊娠糖尿病患者饮食教育中的应用价值。方法:将60例妊娠糖尿病患者随机分为对照组和试验组各30例,试验组患者采用食物交换份法时参照食物血糖负荷值进行饮食教育,对照组患者仅用食物交换份法进行饮食教育,患者根据等量食物交换表随意挑选。实施教育的形式为健康教育讲座结合个别指导。观察两组孕妇空腹血糖值和餐后血糖值。结果:饮食教育干预后对照组和试验组空腹血糖和餐后2 h血糖有统计学差异(P<0.05)。结论:饮食教育是控制血糖的有效手段;用食物血糖负荷知识来选择食物比用传统的食物交换份法更容易控制血糖,效果更为理想,值得在医院孕妇门诊教育中广泛推广和应用。     

A novel surface antigen expressed by a subset of human CD3- CD16+ natural killer cells. Role in cell activation and regulation of cytolytic function

The GL183 mAb was obtained by immunizing BALB/c mice with the E57 clone (CD7+CD2+CD3-CD16+CD56+) derived from human peripheral blood NK cells. In human peripheral blood, GL183-reactive cells ranged between 2 and 12% (mean 6.5%) in 10 different donors. Double fluorescence and FACS analysis showed that GL183+ cells were consistently included in the CD56+ or CD16+ cell populations. Moreover, since only a fraction of CD56+ or CD16+ cells (approximately 40%) coexpressed GL183 surface antigen, reactivity with GL183 mAb appears to define two subsets within the CD3- lymphocyte population expressing NK cell markers. Although, the majority of GL183+ cells were CD3-, approximately 1% expressed CD3 surface antigens. As shown by clonal analysis, these infrequent CD3+GL183+ cells coexpressed CD56 and CD16 antigens. Cloning of CD3-GL183+ or CD3-GL183- cell populations under limiting dilution conditions yielded clonal progenies that maintained their original surface phenotype. Therefore, expression or lack of expression of GL183 surface antigens represents a stable phenotypic property of a subset of human CD3- NK cells. Immunoprecipitation experiments and two-dimensional PAGE analysis indicated that GL183-reactive molecules were represented in different clones either by a single 58-kD chain or, more frequently, by two chains of approximately 55 and approximately 58 kD, respectively. Analysis of GL183+ or GL183- NK clones for their ability to lyse human (IGROV I) or murine (P815) tumor target cells indicated that GL183- clones were, on average, fivefold more efficient in inducing target cell lysis. GL183+ and GL183- clones produced comparable levels of TNF-alpha in response to PHA plus PMA or anti-CD16 mAb plus PMA. Importantly, production of TNF-alpha was also induced by stimulation of GL183+ clones with GL183 mAb plus PMA. These data indicated that GL183 antigen could mediate cell triggering. This concept was confirmed by the analysis of Ca2+ mobilization, as GL183 mAb induced (in GL183+ clones) increments of [Ca2+]i comparable with those induced by PHA. Moreover, GL183 mAb, or its F(ab')2 fragments, strongly enhanced the cytolytic activity of GL183+ clones against a panel of human tumor target cells, including U937, Raji, IGROV I, M14, and A549. In contrast, GL183 mAb, but not the F(ab')2 fragments, sharply inhibited the cytolytic activity of the same clones against P815, M12, and P3U1 murine target cells. In this case, the effect of GL183 mAb (inhibition) was opposite that of PHA or of stimulatory anti-CD2 or anti-CD16 mAbs, which consistently enhanced the target cell lysis.(ABSTRACT TRUNCATED AT 400 WORDS)     

人参皂苷Re通过内质网应激通路对妊娠期糖尿病大鼠妊娠结局的影响及相关机制

目的研究人参皂苷Re(GRE)对妊娠期糖尿病(GDM)大鼠的妊娠结局的影响及可能的作用机制。方法将孕鼠按照随机数字表法分为对照组、GRE组、GDM组和GRE+GDM组4组,每组各10只。GDM组和GRE+GDM组构建GDM模型孕鼠,GRE组和GRE+GDM组每天灌胃50 mg/kg的GRE混悬液,对照组和GDM组给予同体积的羧甲基纤维素钠(CMC-Na)混悬液,4组均连续给药至妊娠第19天。分别于妊娠第1、3、7、12、19天检测各组孕鼠的空腹血糖(FBG)值和空腹胰岛素(FINS)值,并计算胰岛素抵抗指数(HOMA-IR);观察妊娠结局,以窝为单位称取胎鼠体质量以及胎盘质量;采用酶联免疫吸附试验(ELISA)法检测胎盘组织中超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GPx)、谷胱甘肽(GSH)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)的表达水平;蛋白质印迹检测胎盘中内质网应激(ERS)相关蛋白葡萄糖调节蛋白78(GRP78)、CCAAT/增强子结合蛋白同源蛋白(CHOP)和磷酸化真核起始因子2α(p-eIF2α)的表达。结果自妊娠第3天开始,GDM组孕鼠的FBG和HOMA-IR显著高于对照组和GRE组(P<0.05),而GRE+GDM组孕鼠的FBG和HOMA-IR均显著低于GDM组(P<0.05)。GDM组活胎率显著低于对照组和GRE组(P<0.05),GRE+GDM组活胎率显著高于GDM组(P<0.05)。GDM组胎鼠体质量和胎盘质量均显著高于对照组和GRE组(P<0.05);而GRE+GDM组胎鼠体质量和胎盘质量均低于GDM组(P<0.05)。与对照组和GRE组相比,GDM组的SOD、GPx和GSH含量均较低,TNF-α和IL-6表达水平显著升高(P<0.05),GRE+GDM组的SOD、GPx和GSH含量均显著高于GDM组,而TNF-α和IL-6表达水平显著低于GDM组(P<0.05)。GDM组的GRP78、CHOP和p-eIF2α蛋白的相对表达量均显著高于对照组和GRE组(P<0.05);GRE+GDM组的GRP78、CHOP和p-eIF2α蛋白的相对表达量均显著低于GDM组(P<0.05),而对照组和GRE组以上指标相比差异均无统计学意义(P>0.05)。结论GRE可有效缓解GDM孕鼠的症状,改善妊娠结局,其机制可能与抑制炎症反应、氧化应激和ERS有关。     

Identification of four subsets of human CD3-CD16+ natural killer (NK) cells by the expression of clonally distributed functional surface molecules: correlation between subset assignment of NK clones and ability to mediate specific alloantigen recognition

In previous studies we identified a surface molecule (termed GL183) capable of mediating cell activation and selectively expressed by a subset of human CD3-CD16+ natural killer (NK) cells. In this study we analyzed whether other subset-specific functional molecules were expressed in GL183- NK cells. To this end, mice were immunized with the PE29 (CD3-CD16+GL183-) NK clone. Monoclonal antibodies (mAbs) were selected by screening the hybridoma supernatants for their ability to trigger the cytolytic activity of clone PE29 against the human myelomonocytic leukemia U937. The EB6 mAb (IgG1) triggered the PE29 clone, but not a GL183+ clone used as a control. EB6+ cells ranged between 1 and 13% of peripheral blood lymphocytes and were largely included in the CD3-CD16+CD56+ cell populations (only less than 2% of EB6+ cells were CD3+). Analysis of resting or activated CD3-CD16+ populations, or clones for the expression of EB6 or GL183 mAbs, allowed us to identify four distinct, phenotypically stable, NK subsets (EB6+GL183-; EB6+GL183+; EB6-GL183+; EB6-GL183-). Similar to GL183 mAb, the EB6 mAb selectively triggered the NK subset expressing the corresponding surface antigen to lyse human tumor cell lines including U937, IGROV-I, M14, and A549. In addition, EB6 mAb sharply inhibited the cytolytic activity of EB6+ clones against P815, M12, and P3U1 murine target cells. In EB6+GL183+ ("double-positive") clones both EB6 and GL183 mAb inhibited the redirected killing of P815 cells induced by anti-CD16, anti-CD2 mAbs and phytohemagglutinin (PHA). Similar to GL183 molecules, molecules precipitated by EB6 mAb were represented by either single 58-kD chain or double chains of 55 and 58 kD (with no detectable differences in EB6+GL183- or EB6+GL183+ clones). In sequential immunoprecipitation experiments using the double-positive clones CEG52 and CA25.50, preclearing of cell lysates with EB6 or GL183 mAb removed only EB6 or GL183 molecules, respectively, thus indicating that the two antigenic determinants are carried by two distinct molecules. Peptide map analysis indicated that EB6 (or GL183) molecules precipitated from double-positive clones were identical to the corresponding molecules isolated from single-positive ones. On the other hand, comparison of the EB6 and GL183 maps revealed peptides that were unique to each molecule, although most of the major peptides migrated to identical positions. We further investigated whether correlation existed between the phenotypic assignment of NK clones and their ability to mediate specific lysis of normal allogeneic cells.(ABSTRACT TRUNCATED AT 400 WORDS)     

洗胃对猪百草枯灌胃模型的清除效果分析

目的 评价不同时间点洗胃(gastric lavage,GL)清除猪胃内百草枯(paraquat,PQ)的效果,以及对血浆PQ浓度的影响.方法 将17头健康雌性家猪按随机数字表法分为PQ组(n=6)、PQ+1 h GL组(n=6)、PQ+6 h GL组(n=5).所有动物按60 mg/kg经胃管注入40％ PQ原液,PQ+1 h GL组和PQ+6 h GL组分别在1h和6h经胃管给予20 L温水单次洗胃,监测生命体征及血药浓度并持续观察24h,LC-MS法测量血浆及HPLC法测量胃洗出液中的百草枯浓度.结果 PQ组、PQ+6 h GL组和PQ +1 h GL组的24 h存活率分别为66.7％、80％、100％;血PQ峰浓度(μg/mL)分别为(5.12±3.38)、(3.99 ± 1.24)、(1.96±1.83);PQ+1hGL组和PQ+6 hGL组洗出液的PQ含量占总摄入量的(24.46±6.49)％vs.(30.72±9.86)％ (P＞0.05);前10 L和后10 L的洗出液中PQ的清除比例:PQ+1 h GL组为(20.44±5.59)％vs.(4.02±1.82)％(P＜0.01),PQ+6 h GL组为(26.17±7.19)％vs.(7.03±4.29)％(P＜0.01).结论 1h和6h洗胃均能有效清除PQ,减少24h病死率;尽早洗胃(1 h)能更明显降低血浆PQ峰浓度;洗胃液在后1/2体积(后10 L洗出液)时清除百草枯的能力明显下降.     

Early onset of subclinical atherosclerosis in women with gestational diabetes mellitus.

OBJECTIVE: Common carotid artery intima-media thickness (CIMT) is a non-invasively assessed marker of subclinical atherosclerosis. Our aim in this study was to investigate CIMT in women with gestational diabetes mellitus (GDM). METHODS: Thirty women with GDM and 40 unaffected women (as a control group) were included in the study. Blood samples were drawn from each woman in the morning after they had fasted for at least 8 h, and levels of fasting glucose, insulin, homocysteine, total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, low-density lipoprotein (LDL) cholesterol and very low-density lipoprotein (VLDL) cholesterol were measured, along with the CIMT in the two groups. RESULTS: The mean triglyceride (P = 0.016) and VLDL cholesterol (P = 0.011) levels in the GDM group were significantly higher than those in the unaffected women. There were no significant differences between the groups with respect to plasma levels of total cholesterol, HDL cholesterol, LDL cholesterol and insulin. The mean homocysteine (P = 0.027) and fasting glucose (P = 0.019) levels in women with GDM were significantly higher than those in the control group. Patients with GDM had significantly higher CIMT than did the unaffected women (0.582 +/- 0.066 mm vs. 0.543 +/- 0.049 mm, P = 0.006). CIMT correlated positively with maternal age (r = 0.316, P = 0.008), body mass index (BMI) at the time of a 50-g oral glucose load test (r = 0.414, P = 0.001) and homocysteine levels (r = 0.332, P = 0.008), and fasting glucose (r = 0.265, P = 0.031) and 1-h glucose value (r = 0.410, P = 0.001) at the time of the oral glucose tolerance test. There was a positive correlation between the presence of GDM and CIMT (r = 0.372, P = 0.001). However, stepwise multiple regression analysis showed that GDM/no GDM (95% CI +0.012 to +0.076, P = 0.008) and BMI at the time of the 50-g test (95% CI +0.001 to +0.009, P = 0.011) were independent parameters related to CIMT. CONCLUSION: Women with GDM have increased CIMT compared with unaffected women.     

孕早期年龄,BMI 和PAPPA 水平综合评价对GDM 的预测价值

目的 探讨孕早期年龄、身体质量指数(body mass index,BMI)和妊娠相关血浆蛋白A(pregnancy-associated plasma protein A,PAPPA)综合评价对妊娠糖尿病(gestational diabetes mellitus,GDM)的预测价值。方法 选取365例孕妇作为研究对象,其中GDM孕妇112例,非GDM孕妇253例; 收集孕妇孕期检查资料,分析孕妇孕早期BMI,年龄和PAPPA值等与GDM的相关性。结果 GDM组年龄、BMI,空腹血糖(gestational diabetes mellitus,FPG),餐后1h血糖(1hPG)和餐后2h血糖(2hPG)均高于对照组,差异具有统计学意义(t=-21.836～-0.459,均P=0.000); PAPPA与2hPG有显著相关性(r =-0.242,P=0.010); PAPPA,BMI及年龄与GDM有显著相关性(wald=7.011,7.174,20.476, 均P=0.000); PAPPA单项所得ROC曲线与联合(PAPPA+BMI+年龄)所得比较,差异无统计学意义(z=1.667,P=0.095)。PAPPA,BMI+年龄及PAPPA+BMI+年龄的敏感度、特异度和诊断准确度均<0.7,诊断比值比均<1。结论 PAPPA,BMI和年龄对GMD有一定的预测价值,但有限。     

妊娠糖尿病患者胎盘LPL基因Hind片段多态性与新生儿发生胰岛素抵抗风险的相关性研究

目的　研究妊娠糖尿病（gestational diabetes mellitus, GDM）患者胎盘脂蛋白酯酶（lipoprotein lipase, LPL）基因Hind片段多态性与新生儿发生胰岛素抵抗（insulin resistance, IR）的关系。方法　收集2018年4月～2020年4月84例GDM患者作为观察组,另纳入同期84例健康孕妇作为对照组。比较两组孕妇LPL多态性分布,比较两组新生儿血糖（FPG,HbA1c及2h PG）和血脂（TC,TG,HDL-C及LDL-C）指标水平,计算胰岛素抵抗指数（homeostasis model assessment of insulin resistance, HOMA-IR）值。分析胎盘LPL多态性与子代胰岛素抵抗的关系。结果　观察组H+H+基因型48例,H+H-基因型24例,H-H-基因型12例。对照组H+H+基因型32例,H+H-基因型38例,H-H-基因型14例,两组孕妇胎盘LPL基因型分布比较,差异有统计学意义（χ2=6.52,P<0.05）。GDM不同基因型患者所生新生儿TC,TG,HDL-C,LDL-C及HOMA-IR水平差异均有统计学意义（F=5.29~16.33,均P<0.05）。多元逐步回归分析结果显示胎盘LPL多态性是新生儿HOMA-IR的重要影响因素（t=2.86,P<0.05）。结论　胎盘LPL多态性与GDM发病有关,H+H+基因型产妇子代发生胰岛素抵抗的风险更高。     

妊娠糖尿病患者外周血γδ T细胞的改变及临床意义

目的比较分析妊娠糖尿病(GDM)患者及健康孕妇外周血中γδ T细胞的组成变化,为探讨γδ T细胞在GDM发病中的作用和意义提供线索。方法采用Ficoll-Hypaque密度梯度离心法分离GDM患者(病例组)及健康孕妇(对照组)外周血单个核细胞(PBMC),加入荧光标记鼠抗人T细胞抗原抗体(TCR)γδ单克隆抗体(McAb)及鼠抗人CD3 McAb双染,流式细胞术分析γδ T细胞所占比例。结果病例组PBMC中γδ T细胞的比例为(6.89±3.22)%,占CD3+T细胞的(10.87±4.91)%,对照组为(4.26±1.64)%,占CD3+T细胞的(8.21±0.35)%,病例组显著高于对照组,且差异具有统计学意义(P0.05);初诊组GDM患者外周血PBMC中γδ T细胞的比例为(8.79±2.33)%,占CD3+T淋巴细胞的(12.27±5.45)%,显著高于对照组,且差异具有统计学意义(P0.05)。结论 GDM患者γδ T细胞在外周血PBMC及CD3+T细胞中的比例增高,提示疾病发生影响和改变了T细胞亚群的分布。