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目的调查长春市汽车产业开发区妊娠期糖尿病(GDM)的发病情况,分析导致GDM的相关危险因素,为临床早期识别、诊断和干预提供理论依据。方法对2006年9月至2007年8月到吉林大学第四医院(一汽总医院)接受产前检查的孕妇857例进行一般情况及临床资料的收集,并于孕24周采用50g糖激惹试验进行葡萄糖筛查(糖筛查),对筛查出阳性结果的患者或具有GDM高危因素者行75g口服葡萄糖耐量试验(OGTT)。将信息录入SPSS12.0软件,建立数据库,包括年龄、孕次、产次、职业、文化程度、体质指数(BMI)、家族史、ABO血型、是否贫血、乙肝表面抗原、首诊孕周等11种因素,并进行分析。结果 (1)首诊时,857例中3例经空腹血糖检查2次确诊为GDM;854例均排除孕前糖尿病,于孕24周进行糖筛查,异常174例,糖筛查异常率20.37%(174/854)。筛查异常者进一步行75gOGTT,结果确诊妊娠期糖耐量受损(GIGT)15例,确诊GDM8例,总的GDM(包含GIGT及GDM)发病率为3.03%(26/857)。(2)单因素分析,发现年龄、BMI及糖尿病家族史与GDM相关;多因素Logistic回归分析也证明糖尿病家族史、年龄、BMI为GDM的高危因素。结论长春市汽车产业开发区GDM的发病率为3.03%,与国内文献报告相当。BMI、糖尿病家族史、年龄为影响GDM的危险因素。加强GDM筛查,高度重视具有高危因素的妊娠期妇女,早期诊断,早期干预并系统化管理,可以改善妊娠结局,提高人口素质。
Objective To investigate the incidence of gestational diabetes mellitus (GDM) in Changchun Automobile Industry Development Zone and to analyze the risk factors of GDM, providing a theoretical basis for early diagnosis, diagnosis and intervention. Methods From September 2006 to August 2007, 857 pregnant women receiving antenatal examination from the Fourth Hospital of Jilin University (FAW General Hospital) were collected for general conditions and clinical data. Pregnancy was performed at week 24 with 50g sugar challenge test Glucose screening (sugar screening), 75g oral glucose tolerance test (OGTT) were performed on patients screened for positive results or those at risk for GDM. The information was entered into the SPSS12.0 software to establish a database including age, gestational age, parity, occupation, education level, BMI, family history, ABO blood type, anemia, hepatitis B surface antigen, Factors and analysis. Results (1) At the first visit, 3 of 857 cases were diagnosed as GDM by fasting blood glucose test 2 times; 854 cases were excluded pre-pregnancy diabetes mellitus, saccharide screening in 24 weeks of pregnancy, abnormal 174 cases, sugar screening anomaly rate 20.37% (174/854). Abnormal screening for further 75gOGTT, confirmed the diagnosis of gestational impaired glucose tolerance (GIGT) in 15 cases, diagnosed GDM in 8 cases, the total GDM (including GIGT and GDM) incidence was 3.03% (26/857). (2) Univariate analysis showed that age, BMI and family history of diabetes were related to GDM. Multivariate logistic regression analysis also showed that family history of diabetes mellitus, age and BMI were risk factors of GDM. Conclusion The incidence of GDM in Changchun Auto Industry Development Zone is 3.03%, which is comparable with the domestic literature. BMI, family history of diabetes, and age are the risk factors of GDM. Strengthen GDM screening, attaches great importance to risk factors of pregnant women, early diagnosis, early intervention and systematic management, can improve pregnancy outcomes and improve the quality of the population.