妊娠合并糖尿病患者分娩结局及其与糖化血红蛋白的关系探讨

陈瑞妍

[摘要]目的 探討妊娠合并糖尿病患者糖化血红蛋白对其分娩结局的影响，为临床疾病治疗提供依据。方法 选取2014年9月～2017年9月在我院就诊的妊娠合并糖尿病患者90例作为观察组，另选取同期我院行健康产检的健康孕妇50例为对照组。按照观察组患者入院后血糖控制治疗1周后再次测量血糖分为血糖达标组（A组）和血糖未达标组（B组）。测量不同治疗阶段三组糖化血红蛋白水平，随诊产妇直至分娩，观察所有孕妇分娩结局，分析其与糖化血红蛋白含量的关系，并进行统计学分析。结果 观察组入院时糖化血红蛋白量明显高于对照组，差异有统计学意义（P<0.05）。观察组不良分娩结局发生率显著高于对照组，差异有统计学意义（P<0.05）。糖化血红蛋白含量≥6.5%患者不良分娩结局发生率显著高于糖化血红蛋白含量<6.5%患者，差异有统计学意义（P<0.05）。结论 高糖化血红蛋白与妊娠合并糖尿病患者不良分娩结局成正相关，孕期积极有效地监测并控制血糖可显著改善产妇分娩结局。

[关键词]妊娠；糖尿病；糖化血红蛋白；分娩结局

[中图分类号] R714.256 [文献标识码] A [文章编号] 1674-4721（2018）5（b）-0101-03

Relationship between the glycated hemoglobin levels and pregnancy outcome of pregnant women pregnancy associated with diabetes

CHEN Rui-yan

Department of Gynecology and Obstetrics，People′s Hospital of Fengkai County，Guangdong Province，Fengkai 526400，China

[Abstract]Objective To explore relationship between the glycosylated hemoglobin levels and pregnancy outcome of pregnant women pregnancy associated with diabetes and provide the basis for clinical treatment.Methods All of 90 cases of pregnant women pregnancy associated with diabetes from September 2014 to September 2017 treated in our hospital were observation group.Besides，50 pregnant women who were adopted healthy examination during the same period were selected as control group.After 1 week treatment in the observation gorup，the patients were divied group A and group B according to blood glucese normal or not normal.Measuring the different stages of observation group and control group in patients with glycosylated hemoglobin levels，follow-up until delivery，maternal observation all pregnant women delivery end，analyze its relationship with glycosylated hemoglobin content，and statistical analysis.Results The hemoglobin content of the patients in the observation group was significantly higher than that in the control group，the difference was statistically significant by statistical analysis （P<0.05）.The incidence of adverse childbirth outcomes in the observation group was significantly higher than that in the control group，and statistically significant difference was found （P<0.05）.The incidence of adverse childbirth outcomes was significantly higher in patients with glycated hemoglobin than that of 6.5% percent of the patients with glycated hemoglobin <6.5%，the difference was significant （P<0.05）.Conclusion High glycosylated hemoglobin is positively correlated with the outcome of adverse childbirth outcomes in patients with gestational diabetes mellitus.Active and effective monitoring and control of blood glucose during pregnancy can significantly improve the outcome of maternal childbirth.

[Key words]Pregnancy；Diabetes；Glycated hemoglobin；Delivery outcome

妊娠合并糖尿病是临床妇产科最常見的产妇合并症之一，且多发生于高龄产妇，其发生率可达5%以上[1-2]，近年来随着生活水平的提高，临床发病率有增高的趋势[3]。由于妊娠期机体的特殊及药物运用的限制，给临床治疗带来一定的难度[4]。研究表明孕期母体的高糖状态对母体及胎儿的健康影响与血糖控制程度密切相关[5]，而对于孕前即使用胰岛素治疗的糖尿病患者妊娠期若不合理调整用量，极易造成妊娠期严重低血糖及糖尿病严重并发症的发生，进一步影响妊娠结局[6]。本研究探讨妊娠合并糖尿病对患者分娩结局的影响及其与母体糖化血红蛋白含量的关系，现报道如下。

1资料与方法

1.1一般资料