目的探讨医学营养疗法(MNT)联合运动训练对妊娠期糖尿病(GDM)患者血清脂联素、血清铁蛋白及妊娠结局的影响。方法选择GDM患者83例随机分为对照组42例和观察组41例。对照组患者由营养医师进行常规GDM饮食指导,观察组患者采用MNT联合运动训练进行治疗,对两组患者血糖水平、胰岛细胞功能、血清脂联素、血清铁蛋白水平及妊娠结局进行分析。结果治疗后观察组患者空腹血糖、餐后2 h血糖水平显著低于对照组患者,糖化血红蛋白水平显著高于对照组患者,胰岛素抵抗指数显著低于对照组患者,胰岛β细胞分泌功能指数显著高于对照组患者,血清铁蛋白水平显著低于对照组患者,血清脂联素水平显著高于对照组患者,两组差异均有统计学意义(P<0.05)。观察组患者子痫前期、羊水过多、早产、巨大儿、产后出血、剖宫产、伤口感染以及新生儿呼吸窘迫综合征等不良妊娠结局发生率显著低于对照组患者,差异有统计学意义(P<0.05)。结论 MNT联合运动训练能够显著降低GDM患者血清铁蛋白水平,升高血清脂联素水平,有效控制GDM患者血糖水平,改善妊娠结局,具有较好的临床应用前景。 Objective To investigate the effect of medical nutrition therapy (MNT) combined exercise training on serum adiponectin, serum ferritin and pregnancy outcome in patients with gestational diabetes mellitus (GDM). Methods Eighty-three patients with GDM were randomly divided into control group (n = 42) and observation group (n = 41). Patients in the control group were given routine GDM dietary guidance by nutritionists. Patients in the observation group were treated with MNT combined with exercise training. Blood sugar level, islet cell function, serum adiponectin, serum ferritin level and pregnancy outcome were analyzed in both groups. Results After treatment, the fasting blood glucose in the observation group was significantly lower than that in the control group at 2 h postprandial, the level of HbA1c was significantly higher than that in the control group, the insulin resistance index was significantly lower than that in the control group, and the secretion index of pancreatic β-cell was significantly higher The level of serum ferritin was significantly lower in the control group than in the control group, and the level of serum adiponectin was significantly higher than that of the control group. There was significant difference between the two groups (P <0.05). The incidence of adverse pregnancy outcomes such as preeclampsia, polyhydramnios, preterm labor, macrosomia, postpartum hemorrhage, cesarean section, wound infection and neonatal respiratory distress syndrome in observation group were significantly lower than those in control group, the difference was statistically significant (P <0.05). Conclusions MNT combined exercise training can significantly reduce serum ferritin level, increase serum adiponectin level, control blood glucose level and improve pregnancy outcome in patients with GDM, which has a good clinical application prospect.