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目的探讨妊娠期糖尿病(GDM)孕妇产后糖代谢变化。方法分别于产后42d和2年随访165例GDM孕妇(GDM组)和169例正常孕妇(对照组)的糖代谢相关指标。结果 GDM组产后42d和2年的空腹血糖、口服糖耐量试验2h血糖、空腹胰岛素、胰岛素抵抗指数及糖代谢异常率高于对照组(P<0.05或P<0.01),产后2年GDM组的腰臀比和舒张压高于对照组(P<0.01)。多因素分析提示,孕期使用胰岛素是导致GDM产后糖代谢异常的危险因素,而母乳喂养则是其保护因素。结论 GDM孕妇产后发生糖代谢异常的风险高于正常孕妇,应大力提倡母乳喂养并加强产后随访。
Objective To investigate the changes of postpartum glucose metabolism in pregnant women with gestational diabetes mellitus (GDM). Methods Totally 165 pregnant women with GDM (GDM group) and 169 normal pregnant women (control group) were followed up for glucose metabolism at 42d and 2years postpartum. Results The fasting blood glucose, fasting insulin, insulin resistance index and abnormal glucose metabolism rate of GDM group were higher than those of control group (P <0.05 or P <0.01) Waist-hip ratio and diastolic blood pressure were higher than those in the control group (P <0.01). Multivariate analysis suggested that the use of insulin during pregnancy was a risk factor for GDM postpartum glucose metabolism abnormalities, whereas breastfeeding was the protective factor. Conclusion The risk of abnormal glucose metabolism in postnatal GDM pregnant women is higher than that in normal pregnant women. Breastfeeding should be vigorously promoted and postpartum follow-up should be strengthened.