1例妊娠期糖尿病患者预后的临床证据

目的从循证医学角度探讨1例妊娠期糖尿病患者的预后。方法计算机检索ACPJournalClub(1991～2006年10月)、Cochrane图书馆(2006年第4期)、MEDLINE(1990～2006年10月)和中国生物医学文献数据库,查找妊娠期糖尿病预后的队列研究、病例-对照研究和病例系列研究等,并对所获证据的质量进行评价。结果临床证据表明,妊娠期糖尿病患者结束妊娠后6周至28年,2型糖尿病的发病率为2.6%～70%,发生自发性早产的几率为6.7%,患高血压和代谢综合征的比例增加,有感染阴道念珠菌的危险。结论患妊娠期糖尿病的妇女较未患糖尿病的孕妇结束妊娠后糖尿病的患病率增加,自发性早产、高血压、代谢综合征及阴道感染等并发症发病率增加。但其长期终点事件发生率有待进一步研究。

Clinical Evidence on the Prognosis of a Patient with Gestational Diabetes Mellitus

Objective Based on the methodology of evidence-based medicine ,we explored the prognosis of a patient with gestational diabetes mellitus (GDM). Methods? We searched ACP Journal Club (1991 to October 2006), The Cochrane Library (Issue 4, 2006), MEDLINE (1990 to October 2006) and Chinese Biomedicine database (CBM). Cohort studies, case-control studies and case series studies involving the prognosis of patients with GDM were collected. The available evidence was critically appraised. Results During the period from 6 weeks to 28 years after delivery, the incidenceof type 2 diabetes mellitus appeared to vary from 2.6% to 70%. Patients with GDM suffered from an increased incidence of spontaneous premature delivery, hypertension, metabolic syndrome and vaginal infection. Conclusion Patients with GDM appears to be more liable to overt diabetes mellitus, and to suffer from spontaneous premature delivery, hypertension, metabolic syndrome and vaginal infection than women with normal glucose tolerance during pregnancy. Further studies of the long-term follow-up data from GDM trials are needed.