【摘要】 目的:对妊娠血糖分布及影响妊娠血糖水平的因素进行描述和分析,为妊娠期糖尿病的防治提供基础资料。方法:对2003年4~10月参加围产保健的孕妇进行空腹血浆血糖(FPG)测定和问卷调查。通过计算妊娠血糖的均数和标准误对妊娠血糖的分布进行描述;通过单因素和多元线性回归分析,考察可能影响血糖的因素及其对妊娠空腹血糖水平的影响;评价危险因素得分与妊娠血糖水平的关系。结果:空腹妊娠血糖呈对称分布,范围为1.78~10.0 mmol/L,平均(4.37±0.02)mmol/L;与孕前BM I<25 kg/m2妇女的FPG(4.340.03 mmol/L)相比,孕前BM I≥25 kg/m2的妇女FPG(4.55±0.08 mmol/L)较高,差别有统计学意义(t=2.821,P<0.01);与妊娠年龄<30岁妇女的FPG(4.34±0.03 mmol/L)相比,≥30岁的妇女具有较高的FPG(4.52±0.06 mmol/L),差别具有统计学意义(t=2.66,P<0.01)。危险因素得分为2分和≥3分的两组妇女与0得分组相比,FPG相差2.1~2.6 mmol/L,经M ann-W h itney检验,差别有统计学意义(z=-2.753,P=0.006;z=-2.167,P=0.003)。结论:①在我国利用FPG筛检GDM的临床实践和研究较少,有必要进一步积累资料;②妊娠期间多次糖筛查以及在妊娠的不同时期采用不同切点进行筛检的必要性和可行性值得研究;③提示根据高危因素进行选择性筛检的可行性以及加强30岁及以上年龄组和孕前BM I较高妇女孕期血糖监测的必要性;④提示在我国对国际筛检GDM的标准进行适用性研究的必要性。更多还原

【Abstract】 Objective:To provide baseline data for gestational diabetic mellitus(GDM) treatment and prevention through describing the distribution of gestational fasting plasma glucose level and role of potential influential factors.Methods:Women were recruited at Weifang Institute of Maternal and Child Health Care from April to October,2003 when women came for prenatal health care.Fasting plasma glucose(FPG) was tested and questionnaire was administered for eligible women.Mean and standard error were calculated to describe the distribution of FPG.Both univariate and multiple linear regression methods were administered to analyze how potential influential factors influenced the FPG.Results:FPG were obtained from 1 130 pregnant women whose mean age was 27.3±0.1 years old in the range of 21 to 41 years old.57% women were in the 25 to 29 years old age group.The FPG presented a symmetric distribution with range from 1.78 to 10.0 mmol/L and mean of 4.37±0.02 mmol/L.Women whose BMI before pregnancy were equal to or greater than 25 kg/m~2 had higher FPG(4.52±0.06 mmol/L)compared to women whose BMI were less than 25 kg/m~2(4.34±0.03 mmol/L)(t=2.821,P<0.01).Women whose ages at pregnancy were equal to or greater than 30 years old had higher FPG(4.52±0.06 mmol/L)compared to women who were younger than 30 years old at pregnant(4.34±0.03 mmol/L)(t=2.66,P<0.01).Women whose risk scores were two or greater than those had higher FPG compared to women without considered risk factors.The differences of FPG were between 2.1~2.6 mmol/L and statistically significant according to Mann-Whitney test(z=-2.753,P=0.006;z=-2.167,P=0.003).Conclusion:①It is important to cumulate data to evaluate the use of FPG for the detection of GDM in China.②It is important to study the needs and feasibility of repeated gestational glucose measurement and appropriate cut point at various gestational ages.③Selective screening is supported basing risk evaluation.Glucose test is recommended for women at high risk group. ④ It is necessary to research and develop guidelines for GDM screening in China.更多还原