GDM孕妇孕早期及孕晚期血脂水平与妊娠结局的关系研究

目的：探讨妊娠期糖尿病(GDM)孕妇血脂水平变化的特点及其对母儿的影响。方法：收集在铜陵市第四人民医院住院分娩的产妇信息200例,其中,GDM产妇98例,非GDM产妇102例。对2组研究对象孕早期及孕晚期血脂甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)水平进行检测；调查各组研究对象分娩方式、新生儿体重与血脂水平的关系。结果：2组孕早期TC、TG、HDL、LDL、ApoA及ApoB水平差异无统计学意义(P＞0.05)；2组孕晚期TC、TG、HDL、LDL、ApoA及ApoB水平均较孕早期升高,且有统计学差异(P＜0.05)；观察组孕晚期TC、TG、HDL、LDL、ApoA及ApoB水平升高程度均高于对照组,且2组比较差异有统计学差异(P＜0.05)。GDM组产妇胎膜早破及新生儿为巨大儿的比例高于非GDM组,2组比较差异有统计学意义(P＜0.05)。结论：GDM患者血脂水平可随孕周的增加而不断升高,高血脂水平可对母体及胎儿产生一定影响,临床应及早监测孕产妇血脂水平并给予必要的干预。

Characteristics of blood lipid levels in patients with gestational diabetes mellitusand their effects on the mother and infants

Objective: To investigate the characteristic changes of serum lipid levels in gestational diabetes mellitus(GDM) pregnant women and the effect of on mothers and infants. Methods: 200 cases of maternal information in the Fourth People''s Hospital of Tongling city were chosen. Among them, 98 cases were pregnant women with GDM, 102 cases were non-GDM women. The triglyceride) (TG), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), lipoprotein a (ApoA), apolipoprotein B (ApoB) between the two groups at early pregnancy and late pregnancy were compared.The mode of delivery, neonatal weight and blood lipid level were also analyzed. Results: Theere was no difference of the TC, TG, HDL, LDL, ApoA and apoB levels in the two groups at early pregnancy(P>0.05) . The TC, TG, HDL, LDL, ApoA and apoB levels in the two groups at late pregnancy were all higher than those at early pregnancy and there were differences (P<0.05).The TC, TG, HDL, LDL, ApoA and apoB levels in the observation group were all higher than those in the control group at late pregnancy and there were differences (P<0.05). The maternal fetal membranes early broken and ratio of neonatal macrosomia in the observation group were all higher than those in the control group and there were differences (P<0.05). Conclusion: The level of serum lipids in patients with GDM can increase with the gestational age and which has a certain impact on maternal and fetal. Early monitoring of maternal serum lipid levels and necessary intervention should be given.