国际妇产科学杂志

国际妇产科学杂志 ›› 2011, Vol. 38 ›› Issue (2): 158-160.

• 论著 • 上一篇    下一篇

血糖筛查异常的妊娠妇女胰岛β细胞功能评价

张志坤 陈 叙 常 颖   

  1. 300052 天津医科大学总医院妇产科(张志坤); 天津市中心妇产科医院(张志坤,陈 叙,常 颖)
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2011-04-15 发布日期:2011-04-15

Evaluate the Function of the β-cell in the Pregnant Women with Abnormal Glucose Challenge Test

ZHANG Zhi-kun，CHEN Xu， CHANG Ying   

  1. Department of Obstetrics Gynecology, Tianjin Medical University General Hospital, Tianjin 300052, China（ZHANG Zhi-kun）；Tianjin Central Obstetrics and Gynecology Hospital, Tianjin 300100, China（ZHANG Zhi-kun, CHEN Xu, CHANG Ying）
  • Received:1900-01-01 Revised:1900-01-01 Published:2011-04-15 Online:2011-04-15

PDF (PC)

4936

摘要：
【摘 要】 目的：了解妊娠中期糖尿病筛查异常妊娠妇女的胰岛β细胞功能及其临床意义。方法：对门诊常规进行产前检查的149例妊娠24～28周的妇女行50 g葡萄糖负荷试验，结果＞7.8 mmol/L者进行75 g糖耐量检查，按美国糖尿病协会（ADA）标准诊断妊娠糖尿病（GDM）、糖耐量低减（GIGT）和正常（NP）3组，对其进行β细胞功能评价。结果：①GIGT组、NP组的稳态模型评价β细胞功能（HOMA-β）均高于GDM组，差别有统计学意义（P ＜0.000 1）。NP组、GIGT组稳态模型评价胰岛素抵抗（HOMA-IR）均低于GDM组，差别具有统计学意义（P ＜0.000 1）。②GDM组和GIGT组中空腹血糖正常者间HOMA-β和HOMA-IR差异无统计学意义，2组空腹血糖异常者间差异也无统计学意义。GDM组、GIGT组中空腹血糖正常者和异常者间比较HOMA-β差别无统计学意义，HOMA-IR差别有统计学意义。结论：GIGT妊娠妇女虽未诊断为糖尿病，但其β细胞功能已受损，应予以重视。对空腹血糖升高的妊娠妇女需进行合理干预，以改善其妊娠结局，降低或延缓其日后发生2型糖尿病。

关键词: 糖尿病, 妊娠, 多相筛查, 葡糖耐量试验, 胰岛素分泌细胞, 胰岛素抗药性

Abstract: Objective: To evaluate the function of the β-cell in the pregnant women with abnormal GCT and its clinical significance. Methods: A glucose challenge test（GCT） was carried out in all regular examined pregnant women, from 24 to 28 pregnant weeks. If the report was abnormal, they would be required to undergo the oral glucose tolerance test（OGTT）. Then according to the standard of ADA, they were divided into three groups including GDM, GIGT and normality. Then the evaluation of the function of the β-cell was carried out on them. Results: ①HOMA-β of GIGT and NP group were higher than the GDM group, the difference was statistically significant（P <0.0001）. HOMA-IR of NP and GIGT group were lower than the GDM group, the difference was statistically significant（P <0.0001）.②Compared those patients with normal fasting blood glucose between GDM group and GIGT group on the HOMA-β and HOMA-IR, there was no significant difference between the 2 groups. Between GDM group and GIGT group with normal and abnormal fasting blood glucose that the HOMA-β were no significant differences, but HOMA-IR difference was statistically significant. Conclusions: β-cell dysfunction of GIGT women has existed. We must pay attention to these women, especially to the women of fasting glucose impaired. We should provide them rational interventions, reducing the complication of pregnancy and the incidence of T2DM.

Key words: Diabetes, gestational, Multiphasic screening, Glucose tolerance test, Insulin-secreting cells, Insulin resistance