妊娠糖尿病患者分娩后胰岛素抵抗及胰岛B细胞功能状态变化研究

目的 了解妊娠糖尿病患者分娩后6周糖耐量异常发生情况，探讨胰岛素抵抗及胰岛 B 细胞功能状态改变在妊娠糖尿病患者分娩后糖耐量异常发生中的作用。方法 选择69例既往诊断为妊娠糖尿病患者，于分娩6周后对所有患者进行口服葡萄糖耐量试验（OGTT），根据试验结果分为糖耐量减低（IGT）组和糖耐量正常（NGT）组。胰岛素抵抗用胰岛素抵抗指数（HOMA-IR）和胰岛素敏感指数（ISI）表示，胰岛 B 细胞功能状态用第一时相胰岛素分泌量表示，比较观察两组患者的基线资料、胰岛素抵抗及胰岛 B 细胞功能状态变化情况。结果 OGTT 试验结果显示，69例患者中 NGT 组38例，IGT 组31例。IGT 组 HOMA-IR 显著高于 NGT 组，ISI、第一时相 INS 显著低于 NGT组，差异有统计学意义（P ＜0．05）；两组患者第二时相 INS 比较差异无统计学意义（P ＞0．05）。结论 胰岛素抵抗及胰岛 B 细胞功能缺陷可能在妊娠糖尿病患者分娩后糖耐量异常发生中起一定作用，值得进一步深入研究。

The change of insulin resistance and islet B cell function in patients with gestational diabetes after delivery

Objective To understand the situation of abnormal glucose tolerance in patients with gestational diabetes after delivery for six weeks,to explore the change of insulin resistance and islet B cell function in patients with gestational diabetes after delivery.Methods Select 69 cases patients who were diagnosed with of gestational diabetes mellitus previously,take the oral glucose tolerance test （OGTT）after delivery for six weeks,they were divide into impaired glucose tolerance（IGT）group and normal glucose tolerance（NGT）group according to the result of the test.Insulin resistance was used with insulin resistance （HOMA IR）and insulin sensitive index （ISI）,Islet B cell function was used with first phase insulin secretion,contrastively observe the baseline data,the change of insulin resistance and islet B cell function in two groups.Results OGTT showed that there were 31 cases patients in IGT group,38 cases patients in NGT group.HOMA-IR in IGT group is significantly higher than in NGT group,ISI and the first phase INS in IGT group is significantly lower than in NGT group（P 〈0.05）,while there was no significantly difference in the first 2 phase INS between two group（P 〉0.05）.Conclusion Insulin resistance and islet B cell function defect may play a role in happen of Gestational diabetes mellitus patients with abnormal glucose tolerance after delivery,it’s worth of deep study.