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目的探讨妊娠期糖尿病(GDM)并发子痫前期(PE)的危险因素及其妊娠结局。方法选取2013年1月-2016年6月在该院及苏州大学附属第一人民医院分娩的50例单纯GDM患者为对照组,50例GDM并发PE患者为观察组,对比两组患者的体重指数(BMI)、甘油三酯(TG)、总胆固醇(TC)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、尿酸(UA)、脂质运载蛋白2(LCN-2)、同型半胱氨酸(Hcy)、乳酸脱氢酶(LDH)、碱性磷酸酶(ALP),并采用多元Logistic回归分析其危险因素,比较产后出血、剖宫产、早产、胎儿窘迫、胎膜早破、羊水量情况、新生儿体重和巨大儿发生率。结果观察组患者HbA1c、LDH及ALP与对照组比较,差异无统计学意义(P>0.05);观察组患者BMI、TG、TC、FPG、UA、LCN-2、Hcy水平均明显高于对照组(P<0.05),进一步多元Logistic回归分析显示,BMI、FPG及Hcy是GDM并发PE的危险因素(OR=1.051,1.234,1.117)。观察组患者的产后出血量、剖宫产、早产、胎儿窘迫及羊水量过少发生率明显高于对照组(P<0.05),而两组胎膜早破、新生儿体重及巨大儿发生率比较,差异无统计学意义(P>0.05)。结论 GDM并发PE患者的影响因素较多,其中BMI、FPG及Hcy是其危险因素,GDM并发PE可增加不良妊娠结局的发生率。
Objective To investigate the risk factors of gestational diabetes mellitus (GDM) complicated with preeclampsia (PE) and its pregnancy outcome. Methods Fifty patients with simple GDM in our hospital and the First People’s Hospital Affiliated to Soochow University from January 2013 to June 2016 were selected as the control group. Fifty patients with GDM complicated with PE were selected as observation group. Body mass index BMI, TG, TC, FPG, HbA1c, UA, LCN-2, homocysteine (Hcy), lactate dehydrogenase (LDH) and alkaline phosphatase (ALP) were measured. Risk factors were analyzed by multivariate logistic regression analysis. Postpartum hemorrhage, cesarean section, premature labor, fetal distress, premature rupture of membranes, amniotic fluid volume Condition, newborn weight and macrosomia. Results There was no significant difference in HbA1c, LDH and ALP between the observation group and the control group (P> 0.05). The levels of BMI, TG, TC, FPG, UA, LCN-2 and Hcy in the observation group were significantly higher than those in the control group (P <0.05). Further multivariate Logistic regression analysis showed that BMI, FPG and Hcy were risk factors of GDM complicated with PE (OR = 1.051,1.234,1.117). The incidence of postpartum hemorrhage, cesarean section, premature labor, fetal distress and amniotic fluid volume in the observation group were significantly higher than those in the control group (P <0.05). However, the incidence of premature rupture of membranes, The difference was not statistically significant (P> 0.05). Conclusions There are many influencing factors in patients with GDM complicated with PE, among which BMI, FPG and Hcy are the risk factors. Combined with PE, GDM can increase the incidence of adverse pregnancy outcomes.