糖尿病与妊娠

　　【摘要】 目的 探讨同型半胱氨酸(Hcy)与IR对妊娠期糖尿病(GDM)患者并发妊娠期高血压(PIH)的影响。方法 选择2011年1月至2012年12月GDM+PIH组、单纯GDM组和正常妊娠者(NC)组，每组各46例。分析并比较3组间Hcy和IR水平。结果 GDM+PIH组Hcy和IR[(18.6±3.7)vs (11.5±3.6)，(7.3±2.9)μmol/L，(6.51±1.96)vs (4.06±1.62)，(2.03±1.04)]均高于GDM组(P均<0.05)。校正影响因素后，Hcy(OR=1.169，95%CI：1.002~2.946，P=0.018)和IR(OR=1.324，95%CI：1.104~3.645，P=0.026)是GDM患者并发PIH的相关因素。 结论 Hcy水平升高和IR可能是GDM患者并发PIH的危险因素。

　　【关键词】糖尿病, 妊娠;高血压, 妊娠性 ;同型半胱氨酸;胰岛素抵抗

　　【Abstract】ObjectiveTo study the effects of serum homocysteine(Hcy) and insulin resistance (IR) on the risk of pregnancy-induced hypertension (PIH) in patients with gestational diabetes mellitus (GDM). Methods 46 patients with GDM+PIH, 46 patients with GDM and 46 normal pregnancy (NC) females were recruited from Jan, 2011 to Dec, 2012. The levels of Hcy, IR and other biochemical indicators were compared amongthree groups. Results The levels of Hcy [(18.6±3.7) μmol/L]and HOMA-IR [(6.51±1.96)] in GDM+PIH patients were higher than those in GDM patients [(11.5±3.6) μmol/L, (4.06±1.62) ]and in NC group [(7.3±2.9) μmol/L，(2.03±1.04)], (all P<0.05). Logistic analysis showed that the levels of Hcy (OR=1.169，95%CI：1.002~2.946)and IR (OR=1.324，95%CI：1.104~3.645) are associated with the risk of PIH in GDM patients. Conclusion The high levels of Hcy and IR may be the risk factors for PIH in GDM patients.

　　【Key words】Diabetes, gestational ;Hypertension, pregnancy-induced ;Homocysteine;Insulin resistance