文档介绍：预测妊娠期糖尿病孕妇加用胰岛素治疗的相关因素分析
吴琦嫦孙丽许亚松苏彩治
【摘要】目的通过分析单纯饮食治疗的妊娠期糖尿病(gestational diabetes mellitus,GDM)孕妇的新生儿出生体重和餐后2h血糖值,探讨影响GDM孕妇单纯饮食治疗成败需要加用胰岛素治疗的相关因素。方法选择2006年1月-2010年6月单纯饮食治疗的GDM孕妇294例,通过单因素和多因素回归分析,分析对新生儿出生体重及治疗后平均餐后2h血糖值有影响的相关因素,分析影响GDM孕妇单纯饮食治疗成败的有关因素,探讨可预测GDM孕妇需要加用胰岛素治疗的相关因素。结果空腹血糖>≤,P<。对新生儿出生体重有影响的因素是治疗后平均餐后2h血糖值(95%~,)、75gOGTT空腹血糖值(95%~,)以及孕前体重(95%~,),P<。对治疗后平均餐后2h血糖值有影响的因素是产时体重,95%~,,P<。受试者工作特征曲线(ROC曲线)分析结果提示,75gOGTT空腹血糖值≥,预测新生儿出生体重≥%,%,平均餐后2h血糖值≥,预测新生儿出生体重≥%,%。结论影响妊娠期糖尿病孕妇单纯饮食治疗成败的主要因素是孕妇饮食治疗后的餐后2h血糖水平,GDM孕妇确诊时的空腹血糖水平、孕前体重、孕期体重增长及胎儿的腹围对决定是否尽快使用胰岛素治疗具有预测价值。
【关键词】妊娠;糖尿病;饮食治疗;胰岛素;体重;新生儿
[Abstract] Objective Through the analysis of the newborn weight and 2-hour postprandial plasma glucose level about gestational diabetes mellitus(GDM) women with diet controlled alone,to determine the factors associated with the effect about diet controlled alone in GDM A retrospective analysis on medical records of 294 cases with GDM on diet controlled alone from January 2006 to June 2010,in which the effective factors on newborn weight and 2-hour postprandial plasma glucose level were The newborn weight in women with fasting glucose at or below were significantly different from the women with fasting glucose level above associated with newborn weight were 2-hour postprandial plasma glucose level (odds ratio,;95%CI,~),fasting values of 75gOGTT (odds ratio,;95%CI,~) and pre-pregnant maternal weight (odds ratio,; 95%CI,~1,13).Factors associated with 2-hour postprandial plasma glucose level was maternal weight at birth (odds ratio,; 95%CI,1.
04~).Receiver operating characteristic (ROC) analysis found that fasting values of 75gOGTT at or above ,the sensi