【摘要】 目的:分析葡萄糖筛查阳性孕妇胰岛素抵抗与围产结局的关系。方法:对南京医科大学第一附属医院产科建卡的单胎孕妇(孕前有糖尿病的除外),先行50 g葡萄糖筛查试验(glucose challenge test,GCT),阳性者行75 g口服葡萄糖耐量试验(OGTT)及胰岛素释放试验。于孕24～28周选择葡萄糖筛查阳性孕妇,分为妊娠期糖尿病组(GDM组),妊娠期糖耐量受损组(IGT组)和无糖耐量受损组(NGT组),测定OGTT阶段血糖值和胰岛素值,用稳态模型评估胰岛素抵抗(HOMAinsulin resistance index,HOMA-IR)和胰岛β细胞功能(HOMA-β细胞功能),详细记录各组孕妇年龄、孕周、身高和体重,分娩时再次记录孕妇体重、围产结局、分娩方式等。结果:GDM孕妇年龄显著高于NGT和IGT组孕妇(P<0.05),IGT组孕妇血糖、胰岛素抵抗、出生体重、不良妊娠结局和剖宫产率都介于NGT组和GDM组之间,不良妊娠结局没有出现明显差别。结论:适时生育可降低GDM的发生,IGT组孕妇妊娠不良结局、剖宫产率和胰岛素抵抗水平都介于NGT和GDM之间。更多还原

【Abstract】 Objective: To analyze the relationship between insulin resistance and perinatal outcome in pregnant women with glucose screening positive. Methods: Women of singleton pregnancy( except for pre-pregnancy diabetes) in the First Affiliated Hospital of Nanjing Medical University were collected. Subjects underwent a 75 g oral glucose tolerance test( OGTT) and insulin release test after an abnormal result on a 50 g oral glucose challenge test( GCT). Women with glucose screening positive were chosen at 24 to 28 weeks of pregnancy and divided into 3 groups,such as gestational diabetes( GDM group),gestational impaired glucose tolerance group( IGT group)and without impaired glucose tolerance group( NGT group). During the OGTT,serum glucose and insulin level were tested,HOMA-IR,an index of insulin resistance and β-cell function index HOMA-IS of different time were assessed. Maternal age,gestational age,height and weight were recorded in detail in each group,when delivery,maternal weight,perinatal outcome,mode of delivery and so on were recorded again. Results: Age of women in GDM was significantly higher than that of in NGT and IGT group,the blood glucose,insulin resistance,birth weight,adverse pregnancy outcomes and cesarean section rate in IGT group were between NGT and GDM group,the adverse pregnancy outcomes had no significant difference. Conclusion: Timely birth can reduce the incidence of GDM,the adverse pregnancy outcomes,cesarean section rate and insulin resistance level of IGT fell between NGT and GDM groups.更多还原