| 摘要: |
| 目的 探讨孕期血糖管理对妊娠期糖尿病胎盘超微结构的影响,为优化孕期管理提供科学佐证。方法 将2013年1月至2014年12月于南通市第一人民医院常规产检至分娩的妊娠期糖尿病孕妇,根据血糖控制情况分为血糖控制满意组及血糖控制不满意组;同期产检的正常孕妇为对照组。检测3组孕妇的血糖水平并采用透射电镜观察相应的胎盘超微结构。结果 (1)经整个孕期的管理及追踪,最终共有57例孕妇纳入研究。妊娠期糖尿病孕妇占56.14%(32/57),其中血糖控制满意组占35.09%(20/57),血糖控制不满意组占21.05%(12/57);对照组孕妇占43.86%(25/57)。(2)3组孕妇的年龄、口服葡萄糖耐量试验(OGTT)检查时孕周、分娩时孕周、血压及体质量指数差异均无统计学意义(P>0.05)。(3)经孕期血糖管理,3组孕妇的空腹血糖差异无统计学意义(P=0.099);血糖控制满意组与对照组的餐后2 h血糖、夜间血糖及糖化血红蛋白差异均无统计学意义(P>0.05);血糖控制不满意组的餐后2 h血糖、夜间血糖及糖化血红蛋白均高于血糖控制满意组及对照组,差异有统计学意义(P<0.01)。(4)血糖控制满意组与对照组的胎盘超微结构有改变者所占比例差异无统计学意义(P>0.05),血糖控制不满意组的胎盘超微结构有改变者所占比例与血糖控制满意组、对照组相比差异均有统计学意义(P<0.01)。结论 高血糖是胎盘超微结构改变的危险因素,孕期需加强血糖管理,减少或避免妊娠期糖尿病孕妇胎盘超微结构的改变,减少不良妊娠结局的发生。 |
| 关键词: 妊娠糖尿病 胎盘 超微结构 血糖 |
| DOI：10.16781/j.0258-879x.2016.05.0645 |
| 投稿时间：2015-09-29修订日期：2015-11-15 |
| 基金项目:江苏省妇幼保健科研项目(F201329),江苏省卫生和计划生育委员会青年科研课题(Q201512),南通市卫生和计划生育委员会科技项目(WQ2015015). |
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| Effect of plasma glucose management during pregnancy on placental ultrastructure in pregnant women with gestational diabetes mellitus |
| ZHENG Yan-li1*,HAN Yun1,WU Ai-min1,HAN Yu-wen1,LIU Hong-bin2,LU Xiao-yan1 |
(1. Department of Obstetrics and Gynecology, First People's Hospital of Nantong, Nantong 226001, Jiangsu, China;
2. Department of Pathology, First People's Hospital of Nantong, Nantong 226001, Jiangsu, China
*Corresponding author) |
| Abstract: |
| Objective To explore the effect of plasma glucose management on placental ultrastructure in pregnant women with gestational diabetes mellitus, so as to provide scientific evidence for optimizing the management during pregnancy. Methods Pregnant women with gestational diabetes mellitus were divided into satisfied glucose control group and dissatisfied glucose control group; meanwhile, normal pregnant women were taken as controls. All the participants received antenatal care until delivery in the First People's Hospital of Nantong from January 2013 to December 2014. Plasma glucose levels of the three groups were examined and the placental ultrastructure was observed by transmission electron microscopy. Results (1) Finally 57 pregnant women were included in this study. There were 32 pregnant women with gestational diabetes mellitus (56.14%, 32/57) and 25 with normal glucose (43.86%, 25/57). The proportions of pregnant women with satisfied and dissatisfied glucose control were 35.09% (20/57) and 21.05% (12/57), respectively. (2) There were no significant differences in the age, gestational weeks of oral glucose tolerance test (OGTT), gestational weeks of labor, blood pressure or body mass index between the three groups (P>0.05). (3) After plasma glucose management, there was no significant difference in fasting blood glucose between the three groups (P=0.099). And no significant differences were found in 2 h postprandial blood glucose, nocturnal blood glucose, or glycosylated hemoglobin between satisfied glucose control group and healthy control group (P>0.05). The 2 h postprandial blood glucose, nocturnal blood glucose and glycosylated hemoglobin in the dissatisfied glucose control group were significantly higher than those in the other two groups (P<0.01). (4) There was no significant difference in the placental ultrastructure changes between the satisfied glucose control group and control group (P>0.05). The proportions of participants with placental ultrastructure changes in the dissatisfied glucose control group were significantly different from those of the other two groups (P<0.01). Conclusion Hyperglycemia is a risk factor for placental ultrastructure change in pregnant women with gestational diabetes mellitus; the management of plasma glucose should be strengthened during pregnancy, so as to avoid the placental ultrastructure change and to reduce adverse pregnancy. |
| Key words: gestational diabetes placenta ultrastructure blood glucose |
