糖尿病与妊娠

　　【摘要】目的 探讨妊娠期糖尿病(GDM)患者并发症相关危险因素。 方法 134例GDM患者分为无并发症组及并发症组。测定两组超敏C-RP、FPG、FIns及血脂水平;记录母婴妊娠并发症;分析各因素与并发症相关性。 结果 并发症组C-RP、FPG、孕前BMI和孕晚期BMI均高于无并发症组 [(5.46±4.20)vs(2.60±2.76)mg/L、(5.68±1.36) vs(5.25±0.77)mmol/L、(24.79±3.92)vs(23.03±2.51)kg/m2、(29.05±3.79)vs(27.25±2.58)kg/m2](P<0.05)。相关分析显示,C-RP与FPG呈正相关(P<0.05)。Logistic回归分析显示,孕晚期BMI、C-RP、TG和HDL-C是母体并发症的危险因素;C-RP是新生儿并发症的危险因素。结论 C-RP、血脂、孕晚期BMI与GDM母婴并发症密切相关;积极控制血糖、合理控制体重增加和血脂有助于减轻炎症反应,改善妊娠不良结局。

　　【关键词】 糖尿病,妊娠;并发症;危险因素;C-RP

　　[Abstract] Objective To explore the risk factors of pregnancy complications in patients with gestational diabetes mellitus (GDM). Methods 134 patients with GDM were divided into control group without complication (n=38) and complication group(n=96).Serum fasting levels of glucose (FPG) , insulin, lipid and C-reactive protein (C-RP) were measured. Both maternal and fetal complications of pregnancy were recorded. Results The levels of C-RP, FPG, pro gestation-BMI and late gestation BMI were significantly increased in complication group than in control group [(5.46±4.20)vs(2.60±2.76)mg/L,(5.68±1.36)vs(5.25±0.77)mmol/L,(24.79±3.92)vs(23.03±2.51)kg/m2,(29.05±3.79)vs(27.25±2.58)kg/m2 respectively, P<0.05].The C-RP level is significantly associated with FPG. Logistic analysis showed that maternal complications were significantly related to late gestation BMI, C-RP, TC and HDL-C.Infant complications were significantly related to C-RP. Conclusion C-RP, lipid and late gestation BMI play important roles in the development of maternal-neonatal complications during pregnancy. Keeping rational levels of glucose,-lipid and weight gain are helpful for improving pregnancy outcomes.

　　[Key Words] Diabetes, gestational;Risk factors;C-reactive protein