妊娠期糖尿病孕妇孕早期及孕晚期血脂水平与妊娠结局的关系

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 收集住院分娩的产妇200例,其中,GDM产妇98例为观察组,非GDM产妇102例为对照组。对两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、新生儿体质量与血脂水平的关系。结果 两组孕早期TC、TG、HDL、LDL、ApoA及ApoB水平差异无统计学意义(P＞0.05)；两组孕晚期TC、TG、HDL、LDL、ApoA及ApoB水平均较孕早期升高,差异有统计学意义(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(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(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 mellitus and their effects on mother and infant

Objective To investigate the characteristic changes of serum lipid levels in gestational diabetes mellitus(GDM)pregnant women and their effect on mothers and infants.Methods Two hundred cases of pregnant women delivering.Among them,98 cases were pregnant women with GDM(observation group),and another 102 cases were non-GDM women(control group).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 There was no differences in TC,TG,HDL,LDL,ApoA and apoB levels between 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 statistically significant 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 statistically significant differences(P<0.05).The premature rupture of fetal membrane and ratio of neonatal macrosomia in the observation group were all higher than those in the control group and there were statistically significant differences(P<0.05).Conclusions The level of serum lipids in patients with GDM can increase with the gestational age,which has a certain impact on mother and fetus.Early monitoring of maternal serum lipid levels and necessary intervention should be given.