【摘要】 【目的】探讨妊娠合并糖尿病对新生儿脐血C肽(C-peptide)、胰岛素(insulin)以及胰高血糖素(gluca-gons)质量浓度的影响。【方法】选择34例妊娠合并糖尿病的孕妇(妊娠期糖代谢异常17例,糖尿病合并妊娠7例)及其新生儿为观察对象,同时随机收集同期分娩的51例糖代谢正常孕妇及其新生儿作为对照组。抽取两组新生儿的脐静脉血,分离血清。采用放射免疫方法测定C肽、胰岛素、胰高血糖素。采用多因素Logistic回归分析探讨脐血C肽水平的影响因素。【结果】观察组脐血C肽、胰岛素以及胰高血糖素的质量浓度及生后1 h末梢血糖分别为(1.87±1.41)μg/L,(24.94±22.91)mU/L,(176.24±72.90)ng/L,(2.63±0.71)mmol/L;对照组分别为(1.33±0.68)μg/L,(17.93±15.32)mU/L,(161.75±47.38)ng/L,(3.23±0.69)mmol/L;两组脐血C肽水平差异有显著性,观察组显著高于对照组(P<0.05),胰岛素及胰高血糖素水平组间比较差异无显著性;观察组新生儿生后1 h末梢血糖显著低于对照组(P<0.01)。此外,观察组孕妇年龄及分娩时体重均大于对照组(P值均<0.05),观察组新生儿的外父母患糖尿病、心脑血管疾病者显著多于对照组(P<0.01)。多因素Logistic回归分析显示新生儿外父母患糖尿病、心脑血管疾病家族史对其脐血C肽水平有重要影响,其风险比值为11.30。【结论】妊娠合并糖尿病母亲的新生儿脐血C肽水平升高。对具有糖尿病高危因素的新生儿应早期开始追踪观察及时发现其潜在的代谢综合征的表现。更多还原

【Abstract】 【Objective】 To investigate the changes of umbilical insulin,C-peptide and glucagons levels in newborns of pregnancy women with diabetes mellitus. 【Methods】 34 pregnancy women with diabetes mellitus as observation group and 51 controls of normal glucose tolerance(NGT) pregnancies were selected into this stady.Insulin,C-peptide and glucagons concentrations were qualified in the umbilical vein serum with radioimmunoassay methods.Capillary blood glucose was measured at the first hour after delivery.Associated high risk factors of umbilical C-peptide levels were determined by multiple logistic regression analysis. 【Results】 Umbilical C-peptide level in observation group was higher than that in control group [(1.87±1.41)μg/L vs.(1.33±0.68)μg/L,P<0.05],and mean blood glucose level was significantly lower in observation group [(2.63±0.71) mmol/L vs.(3.23 ±0.69)mmol/L,P<0.01].No significant difference was found between the two groups either in umbilical insulin level or in glucagons level.History of diabetes and cardio-cerebrovascular disease of maternal grandparent had an important influence on umbilical C-peptide level(OR=11.30,P<0.05). 【Conclusions】 Umbilical serum levels of C-peptide are elevated in newborns of mothers with diabetes mellitus.Follow-up study should be given to high-risk newborns of diabetes so as to determine the early sign of metabolic syndrome in children and prevent the developing of cardio-cerebrovascular diseases in adult.更多还原