【摘要】 目的:通过苏州地区妊娠期糖尿病(GDM)的筛查,了解妊娠期糖代谢异常的发病率及对妊娠的不良影响。方法:采用前瞻性的研究方法,2004年8月～2006年12月对苏州市各大医院及太仓市建卡的大部分孕妇采用50g葡萄糖负荷试验,共筛查孕妇4166例,阳性者再做75g葡萄糖耐量试验(OGTT)。设糖尿病组(GDM)及糖耐量异常组(IGT),以糖筛查正常的孕妇作对照组,对临床资料进行分析。结果:筛查4166例孕妇中GCT阳性者1394例(33.46%),总糖代谢异常率为6.29%,其中GDM150例(3.60%)、糖耐量异常(IGT)者为112例(2.69%)。GDM及IGT的发生率随孕妇年龄增大而显著升高(P<0.01)。新生儿出生体重GDM组和IGT组与对照组相比,有显著性差异(P<0.05),GDM孕妇巨大儿占19.33%。GDM孕妇中剖宫产76.67%,子痫前期9.33%、羊水过多7.33%,均明显高于对照组,早产4例,1例新生儿死亡。结论:妊娠期糖筛查有利于早期检出妊娠期糖代谢异常的孕妇,以便加强管理,减少对母儿的不良影响。更多还原

【Abstract】 Objective:To understand the incidence of abnormal glucose metabolism during pregnancy and its adverse effect on pregnancy by screening gestational diabetes mellitus (GDM) in Suzhou area.Methods:From August 2004 to December 2006,a prospective method was performed in Suzhou city and Taicang city,4 166 pregnant women were screened with 50 g glucose challenge test (GCT),then the positive pregnant women underwent 75 g oral glucose tolerance test (OGTT).The pregnant women were divided into GDM group,impaired glucose tolerance (IGT) group and control group,then the clinical data were analyzed.Results:The positive rate of GCT among 4 166 pregnant women was 33.46% (1 394 pregnant women),the abnormal rate of total glucose metabolism was 6.29%,including 150 GDM pregnant women (3.60%) and 112 IGT pregnant women (2.69%).The incidences of GDM and IGT increased with the ages of pregnant women (P <0.01),there was significant difference in birth weight among GDM group,IGT group and control group (P <0.05).The incidences of macrosomia,preeclampsia and polyhydramnios and the rate of cesarean section in GDM group were 19.33%,9.33%,7.33% and 76.67%,respectively,which were significantly higher than those in control group.4 premature infants and 1 neonatal death occurred in GDM group.Conclusion:Glucose screening during pregnancy is beneficial to early detection of women with abnormal glucose metabolism during pregnancy,in order to enhance management and reduce harmful effects to mothers and fetus.更多还原