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目的探讨妊娠期糖尿病(GDM)患者孕晚期血脂检测的临床意义。方法选择GDM孕妇160例(GDM组)和健康孕妇80例(对照组),对两组于孕8~12周(孕早期)、32~36周(孕晚期)进行总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白AI(APOAI)、载脂蛋白B(APOB)和脂蛋白A(LPA)水平检测,并进行组间、组内比较,并比较两组妊娠结局,根据孕晚期检测结果,将GDM患者分为高血脂组和正常血脂组,比较高血脂组和正常血脂组妊娠结局。结果孕早期GDM组TC、TG、LDL-C、APOB均高于对照组(P<0.05),孕晚期两组TC、TG、LDL-C、APOAI、APOB、LPA均显著升高(P<0.05),GDM组TC、TG、LDL-C、APOB、LPA显著高于对照组(P<0.05),HDL-C显著低于对照组(P<0.05);GDM组巨大儿、新生儿低血糖、手术产和子痫前期发生率高于对照组(P<0.05),GDM患者中高血脂组巨大儿、新生儿低血糖、子痫前期发生率高于正常血脂组(P<0.05)。结论孕晚期存在高脂血症的GDM患者不良结局发生率高,进行血脂检测有利于对高脂血症做出诊断,从而采取针对性治疗措施,减少妊娠并发症,改善母儿的结局。
Objective To investigate the clinical significance of serum lipids in third trimester of pregnancy in patients with gestational diabetes mellitus (GDM). Methods Totally 160 children with GDM (GDM group) and 80 healthy pregnant women (control group) were enrolled in this study. Total cholesterol (TC), tris (TG), HDL-C, LDL-C, APOAI, APOB and LPA were measured by real- The levels of pregnancy were compared between groups. The pregnancy outcomes were compared between the two groups. According to the results of the second trimester of pregnancy, GDM patients were divided into hyperlipidemia group and normal lipid group, and the pregnancy outcome was compared between hyperlipidemia group and normal lipid group. Results The levels of TC, TG, LDL-C and APOB in GDM group were significantly higher than those in control group (P <0.05). The levels of TC, TG, LDL-C, APOAI, (P <0.05). The levels of TC, TG, LDL-C, APOB, LPA in GDM group were significantly higher than those in control group (P <0.05) The incidence of surgical operation and preeclampsia was higher than that of the control group (P <0.05). The incidence of hypoglycemia and preeclampsia of hypercholesterolemia group, neonatal hypoglycemia and preeclampsia group was higher in GDM patients than that in normal lipids group (P <0.05). Conclusion The incidence of adverse outcomes in patients with GDM with hyperlipidemia in the third trimester of pregnancy is high. It is helpful to diagnose the hyperlipidemia by detecting the blood lipids in order to reduce the pregnancy complications and improve the outcome of the pregnant women.