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目的:探讨妊娠期糖代谢异常与妊娠期高血压疾病的关系。方法:回顾分析2003年至2007年在我院住院分娩的6748例孕妇的临床资料,分析不同程度糖代谢异常孕妇妊娠期高血压疾病的发生情况;将妊娠期糖代谢异常并发高血压疾病(PHD)患者分为妊娠期高血压组(Ⅰ组)、轻度子痫前期组(Ⅱ组)和重度子痫前期组(Ⅲ组),比较3组孕妇不同糖负荷后血糖水平(GCT、OGTT)、糖化血红蛋白水平及胰岛素抵抗指数的差异。结果:(1)6748例孕妇发生PHD252例,发生率3.7%(252/6748),妊娠期糖代谢异常孕妇1402例,发生率20.8%(1402/6748);妊娠期糖代谢异常孕妇82例并发PHD,发生率5.8%(82/1402);糖代谢正常孕妇PHD发生率为3.2%(170/5346),差异有统计学意义(P<0.001);(2)82例妊娠期糖代谢异常并发PHD患者中,糖尿病合并妊娠(DM)、妊娠期糖尿病(GDM)、妊娠期糖耐量降低(GIGT)、妊娠期50g葡萄糖筛查(GCT)(+)的PHD发生率分别为8.5%(12/141),7.9%(45/571),3.4%(9/265),3.8%(16/425);DM、GDM组与GIGT、GCT(+)组的差异有统计学意义(P=0.010、0.001);DM组与GDM组的差异无统计学意义(P=0.805);GIGT组与GCT(+)组相比及两组与糖代谢正常组的差异无统计学意义(P=0.801、0.535)。(3)82例妊娠期糖代谢异常并发PHD患者,妊娠期高血压(Ⅰ组)27例、轻度子痫前期(Ⅱ组)24例、重度子痫前期(Ⅲ组)31例,3组血糖(GCT、OGTT)、糖化血红蛋白水平及胰岛素抵抗指数无统计学差异。结论:妊娠期糖代谢异常的孕妇更易发生妊娠期高血压疾病;随糖代谢异常程度加重,妊娠期高血压疾病发病率呈增加趋势。
Objective: To investigate the relationship between abnormal glucose metabolism during pregnancy and hypertensive disorder complicating pregnancy. Methods: The clinical data of 6748 pregnant women hospitalized in our hospital from 2003 to 2007 were analyzed retrospectively. The incidence of gestational hypertension in pregnant women with different degrees of glucose metabolism was analyzed. The abnormal glucose metabolism in pregnancy complicated with hypertension (PHD ) Patients were divided into hypertensive pregnancy group (group Ⅰ), mild preeclampsia group (group Ⅱ) and severe preeclampsia group (group Ⅲ). The levels of glucose and glucose (GCT, OGTT) , Glycosylated hemoglobin level and insulin resistance index difference. Results: (1) The incidence of PHD in 6748 pregnant women was 252 (3.7% (252/6748)). There were 1402 pregnant women with abnormal glucose metabolism in pregnancy, the incidence rate was 20.8% (1402/6748). 82 pregnant women with abnormal glucose metabolism during pregnancy PHD, the incidence of 5.8% (82/1402); normal glucose metabolism rate of PHD in pregnant women was 3.2% (170/5346), the difference was statistically significant (P <0.001); (2) 82 cases of abnormal glucose metabolism during pregnancy complicated Among PHD patients, the incidence of PHD in diabetic patients with DM, gestational diabetes mellitus (GDM), gestational glucose tolerance (GIGT) and gestational 50g glucose screening (GCT) (+) were 8.5% (P = 0.010, P <0.01). The difference between the GDM group and the GIGT group was statistically significant (P = 0.010, P <0.01) 0.001). There was no significant difference between DM group and GDM group (P = 0.805). There was no significant difference between GIGT group and GCT (+) group and normal glucose metabolism group (P = 0.801, 0.535 ). (3) There were 27 cases with gestational hypertension (group Ⅰ), 24 cases with mild preeclampsia (group Ⅱ), 31 cases with severe preeclampsia (group Ⅲ), 3 cases with severe preeclampsia (group Ⅲ) and 82 cases with abnormal glucose metabolism during pregnancy. Blood glucose (GCT, OGTT), glycosylated hemoglobin and insulin resistance index no significant difference. Conclusion: Pregnant women with abnormal glucose metabolism during pregnancy are more likely to develop hypertensive disorder complicating pregnancy. With the aggravation of abnormal glucose metabolism, the prevalence of hypertensive disorder complicating pregnancy is increasing.