妊娠期糖尿病孕妇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)孕妇血脂水平的变化与妊娠结局的关系。方法 160例孕妇作为研究对象,根据口服葡萄糖耐量试验(OGTT)检查分为GDM组(64例)和正常组(96例)。根据GDM组孕妇的甘油三酯(TG)水平不同分为TG正常组(35例)和TG异常组(29例)。比较GDM组和正常组孕妇血脂相关指标甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(Apo-A1)及载脂蛋白B(Apo-B)];比较TG正常组和TG异常组孕妇妊娠结局及新生儿结局。结果 GDM组TG(5.49±1.32)mmol/L、Apo-B(1.52±0.11)g/L均高于正常组的(2.63±1.07)mmol/L、(1.08±0.23)g/L, LDL-C(2.51±1.06)mmol/L低于正常组的(3.69±1.42)mmol/L,差异有统计学意义(P<0.05);GDM组与正常组TC、HDL-C及Apo-A1水平比较差异均无统计学意义(P>0.05)。TG异常组剖宫产率、羊水量异常率、产后出血率及早产率均高于TG正常组,但差异均无统计学意义(P>0.05)。TG异常组巨大儿发生率17.24%高于正常组的2.86%,差异有统计学意义(P<0.05);TG正常组和TG异常组新生儿低血糖、新生儿窒息及高胆红素血症发生率比较差异无统计学意义(P>0.05)。结论 GDM孕妇出现血脂水平异常,增加了不良妊娠结局的发生风险。因此,在孕期体检中应加强对GDM孕妇血脂水平的监测,同时做好健康教育及营养指导,改善母婴结局。

A study on the correlation between blood lipid levels and pregnancy outcome in pregnant women with gestational diabetes mellitus

Objective To discuss the correlation between blood lipid levels and pregnancy outcome in pregnant women with gestational diabetes mellitus(GDM). Methods A total of 160 pregnant women as studysubjects were divided into GDM group(64 cases) and normal group(96 cases) by oral glucose tolerance test(OGTT) results. GDM group was divided by triglyceride(TG) level into TG normal group(35 cases) and TG abnormal group(29 cases). The blood lipid related indicators TG, serum total cholesterol(TC), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), apolipoprotein A1(Apo-A1) and apolipoprotein B(Apo-B)] in GDM group and normal group was compared. The pregnancy outcome and neonatal outcome in TG normal group and TG abnormal group were compared. Results TG(5.49±1.32) mmol/L and Apo-B(1.52±0.11) g/L in GDM group was higher than(2.63±1.07) mmol/L and(1.08±0.23) g/L in normal group, and LDL-C(2.51± 1.06) mmol/L was lower than(3.69±1.42) mmol/L in normal group. Their difference was statistically significant(P<0.05). There was no statistically difference in levels of TC, HDL-C and Apo-A1 between GDM group and normal group(P>0.05). The cesarean section rate, incidence of abnormal amniotic fluid volume, incidence of postpartum hemorrhage and preterm delivery rate in TG abnormal group was higher than those in TG normal group, but the difference was not statistically significant(P>0.05). The incidence of fetal macrosomia 17.24% in TG abnormal group was higher than 2.86% in normal group, and the difference was statistically significant(P<0.05). There was no statistically significant difference in incidence of neonatal hypoglycemia, neonatal asphyxia and hyperbilirubinemia between TG normal group and TG abnormal group(P>0.05). Conclusion Abnormal blood lipid level in GDM pregnant women increased the risk of adverse pregnancy outcomes. Therefore, the monitoring of blood lipid levels in GDM pregnant women should be strengthened in physical examination during pregnancy, while health education and nutrition guidance should be done to improve maternal and infant outcomes.