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目的探讨不同时点妊娠期糖耐量受损(GIGT)患者血糖代谢是否存在不同。方法回顾性分析2006年1月至2008年3月在贵阳医学院附属医院和贵阳医学院附属妇产儿童医院住院分娩的孕妇,将50g糖筛查异常(GCT)的286例患者作为研究对象,每例患者均经过口服葡萄糖耐量试验(OGTT),确诊妊娠期糖尿病(GDM)123例,GIGT121例(1h GIGT88例,2h GIGT30例,3h GIGT3例),糖代谢正常孕妇(NGT)42例。绘制并分析各组OGTT试验的血糖图;比较各组空腹血糖(FBG)、50g GCT结果、血糖曲线下面积(AUCG);比较各组孕妇妊娠期高血压疾病、胎膜早破发病率和剖宫产率;并比较新生儿结局。结果各组血糖图形态不同。GDM组FBG较其他3组明显增高(P<0.05);50g GCT GDM组与1h GIGT组、2h GIGT组及NGT组类似(P>0.05),其他各组间差异均有统计学意义(P<0.05);AUCG各组间差异均有统计学意义(P<0.05)。妊娠期高血压疾病发病率由GDM组至NGT组依次降低,但仅GDM组与NGT组比较差异有统计学意义(P<0.05)。胎膜早破、剖宫产率和早产、新生儿黄疸、新生儿窒息发生率及新生儿出生体重4组间比较差异无统计学意义(P>0.05)。巨大儿和新生儿低血糖发生率GDM组和1h GIGT组较2h GIGT组和NGT组明显增高(P<0.05)。结论不同时点妊娠期糖耐量受损孕妇血糖代谢表型及预后不同,按国际妊娠合并糖尿病研究组推荐的GDM新诊断标准,1h GIGT和2h GIGT虽均被纳入GDM,但仍有必要对其进行区别管理。
Objective To investigate whether there is difference in blood glucose metabolism in patients with impaired glucose tolerance (GIGT) at different time points. Methods A retrospective analysis of pregnant women hospitalized in Guiyang Medical College Affiliated Hospital and Guiyang Medical College Affiliated Obstetrics and Gynecology and Children Hospital from January 2006 to March 2008 was performed. A total of 286 patients with 50g glucose screening abnormalities (GCT) Each patient underwent oral glucose tolerance test (OGTT), 123 cases of gestational diabetes mellitus (GDM), 121 cases of GIGT (88 cases of 1h GIGT, 30 cases of 2h GIGT and 3 cases of GIGT 3 cases) and 42 cases of normal glucose metabolism (NGT). The blood glucose level of each OGTT group was plotted and analyzed. The fasting blood glucose (FBG), 50g GCT and the area under the curve of blood glucose (AUCG) were compared among groups. The incidences of gestational hypertension, premature rupture of membranes and incidence of premature rupture of membranes Palace birth rate; and compare the neonatal outcome. Results The blood glucose patterns of different groups were different. The FBG in GDM group was significantly higher than that in other three groups (P <0.05). The levels of FBG in 50g GCT group were similar to those in GIGT group 1h, GIGT 2h and NGT group (P> 0.05) 0.05). There was significant difference between AUCG groups (P <0.05). The incidence of hypertensive disorder complicating pregnancy decreased from GDM group to NGT group, but there was significant difference between GDM group and NGT group only (P <0.05). Premature rupture of membranes, cesarean section rate and premature delivery, neonatal jaundice, the incidence of neonatal asphyxia and newborn birth weight was no significant difference between the four groups (P> 0.05). The incidence of hypoglycemia in macrosomia and neonates was significantly higher in GDM group and 1h GIGT group than in 2h GIGT group and NGT group (P <0.05). Conclusions The pregnant women with impaired glucose tolerance at different time points have different phenotypes and prognosis of blood glucose metabolism. According to the new diagnostic criteria for GDM recommended by the International Pregnancy-Merged Diabetes Study Group, 1-hour GIGT and 2-hour GIGT are all included in GDM. However, Differentiate management.