【摘要】 目的 了解妊娠相关暴发性1型糖尿病(PF)的临床特点。 方法 查找酮症酸中毒妊娠患者的资料，记录起病年龄、BMI、糖尿病家族史、高血糖症状出现时间、流感样症状、腹痛、妊娠时间、妊娠结局、起病时血糖、HbA1c、动脉血气PH值、二氧化碳结合力、FC-P和餐后2 hC-P、胰岛自身抗体及胰酶、血脂、每天所需胰岛素剂量。根据诊断标准分为PF组和DM组。 结果 2005年10月至2011年10月我院收治的PF患者6例，均出现胎死宫内。与DM组相比，PF组酮症酸中毒更严重、胰岛功能更差、HbA1c降低[(7.20±0.78)% vs (8.35±2.51)%，P<0.05]、每天所需胰岛素剂量升高[(0.65±0.23)U/kg/d vs (0.43±0. 42)U/kg/d，P<0.05)]。 结论 PF起病急、预后差，胎死宫内风险极高。

　　【关键词】 妊娠;糖尿病，1型，暴发性;胎死宫内

　　Clinical study on the pregnancy-associated fulminant T1DM YANG Zhi-fang, TANG Jia-zheng, LIU Jian-ying, et al. Department of Endocrinology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China

　　Corresponding author: YANG Zhi-fang, Email: yzf1977728@hotmail.com

　　【Abstract】Objective To investigate the clinical characteristics of pregnancy-associated fulminant (PF) T1DM. Methods The record data of pregnant women with diabetic ketoacidosis were retrieved. The information was abstracted, including the age of patients on the onset of disease, BMI, family history, the duration of hyperglycemic symptoms, flu-like symptoms, abdominal symptoms, prognosis of fetus, plasma glucose level, HbA1c, arterial blood gas pH, CO2-combing power, fasting serum C peptide (FC-P), peak serum C peptide, serum pancreatin, auto-antibodies, lipid, and daily insulin dose. The patients were divided into PF and DM groups according to the diagnostic criterion. Results There were six PF patients from October 2005 to October 2011 in our hospital. Fetal death occurred in all PF patients. The PF group showed a more severe acidosis and worse islet function than the DM group. The HbA1c was lower (7.20±0.78)% vs (8.35±2.51)%, P<0.05) and the daily insulin dose was higher (0.65±0.23)U/kg/d vs (0.43±0. 42)U/kg/d, P<0.05) in the PF group compared with the DM group. Conclusions The onset of PF is abrupt, the prognosis is poor, and the risk of fetal death is very high.

　　【Key words】Pregnancy; Diabetes mellitus, type 1; Fulminant; Fetal death