临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
2014年
19期
1608-1610
,共3页
妊娠期糖尿病%骨代谢%钙%磷%治疗方案
妊娠期糖尿病%骨代謝%鈣%燐%治療方案
임신기당뇨병%골대사%개%린%치료방안
Gestational diabetes%Bone metabolism%Calcium%Phosphorus%Treatment programs
目的：探讨妊娠期糖尿病（ GDM）患者骨代谢的变化及适宜的治疗方案。方法选择104例孕妇，包括GDM患者52例，正常对照52例。GDM患者随机为A、B两组，自孕中期（24~26周）开始，A组服用1片碳酸钙D3，B组服用2片碳酸钙D3，直至分娩。比较GDM与对照组血钙、尿钙、血磷代谢变化及治疗前后钙磷代谢和碱性磷酸酶（ALP）及25（OH）D变化。结果治疗前，GDM组24 h尿钙水平显著高于对照组（ P <0.001），血钙水平略高于对照组，但无统计学差异（ P >0.05）。GDM患者产后血钙与对照组水平接近，血磷水平则基本无明显变化。A、B两种方案血钙水平治疗后均降低，无统计学差异，两组血ALP和25（ OH）D水平治疗后均显著增高，其中B方案治疗后血ALP水平较A方法低（ P <0.05）。B方案治疗的患者24尿钙水平显著降低（ P =0.002）。结论妊娠中晚期尿钙丢失增加，应及时补充钙剂。GDM患者尿钙丢失更多，采取B方案可增加对钙剂的补充，更适合GDM患者。
目的：探討妊娠期糖尿病（ GDM）患者骨代謝的變化及適宜的治療方案。方法選擇104例孕婦，包括GDM患者52例，正常對照52例。GDM患者隨機為A、B兩組，自孕中期（24~26週）開始，A組服用1片碳痠鈣D3，B組服用2片碳痠鈣D3，直至分娩。比較GDM與對照組血鈣、尿鈣、血燐代謝變化及治療前後鈣燐代謝和堿性燐痠酶（ALP）及25（OH）D變化。結果治療前，GDM組24 h尿鈣水平顯著高于對照組（ P <0.001），血鈣水平略高于對照組，但無統計學差異（ P >0.05）。GDM患者產後血鈣與對照組水平接近，血燐水平則基本無明顯變化。A、B兩種方案血鈣水平治療後均降低，無統計學差異，兩組血ALP和25（ OH）D水平治療後均顯著增高，其中B方案治療後血ALP水平較A方法低（ P <0.05）。B方案治療的患者24尿鈣水平顯著降低（ P =0.002）。結論妊娠中晚期尿鈣丟失增加，應及時補充鈣劑。GDM患者尿鈣丟失更多，採取B方案可增加對鈣劑的補充，更適閤GDM患者。
목적：탐토임신기당뇨병（ GDM）환자골대사적변화급괄의적치료방안。방법선택104례잉부，포괄GDM환자52례，정상대조52례。GDM환자수궤위A、B량조，자잉중기（24~26주）개시，A조복용1편탄산개D3，B조복용2편탄산개D3，직지분면。비교GDM여대조조혈개、뇨개、혈린대사변화급치료전후개린대사화감성린산매（ALP）급25（OH）D변화。결과치료전，GDM조24 h뇨개수평현저고우대조조（ P <0.001），혈개수평략고우대조조，단무통계학차이（ P >0.05）。GDM환자산후혈개여대조조수평접근，혈린수평칙기본무명현변화。A、B량충방안혈개수평치료후균강저，무통계학차이，량조혈ALP화25（ OH）D수평치료후균현저증고，기중B방안치료후혈ALP수평교A방법저（ P <0.05）。B방안치료적환자24뇨개수평현저강저（ P =0.002）。결론임신중만기뇨개주실증가，응급시보충개제。GDM환자뇨개주실경다，채취B방안가증가대개제적보충，경괄합GDM환자。
Objective To explore the changes of bone metabolism in patients with gestational diabetes mellitus( GDM). Methods A to-tal of 104 pregnant women in this hospital were enrolled,including 52 patients with GDM,and 52 cases of normal controls. GDM patients were randomly divided into A and B groups. From the beginning of second trimester(24~26 weeks),patients in A group were given with 1 tablet of calcium carbonate D3. Patients in B group were administrated with two tablets of calcium carbonate D3 entil to delivery. Changes in serum calci-um,urinary calcium,phosphorus metabolism were detected,and changes in calcium and phosphorus metabolism and alkaline phosphatase( ALP) and 25(OH)D were tested before and after treatment in GDM groups and control group. Results Levels of 24 h urinary calcium(24~26W)in GDM groups were significantly higher than those of control group( t =4. 590,P <0. 001). Serum level of calcium was slightly higher,but there was no significant difference( P >0. 05)between them. Serum level of calcium was near to normal and serum level of phosphate had no obvious change in patients with GDM after postpartum. Serum levels of calcium were decreased in A,B programs,but their difference was not significant. Serum levels of ALP and 25( OH)D after treatment were significantly increased in both 2 groups and serum level of ALP in B group was slightly lower than that of A group. Levels of 24 urinary calcium were significantly lower in B group after treatment( t =4. 892,P =0. 002). Conclusion In the third trimester of pregnancy,loss of urinary calcium is increased,hence calcium should be replenished for pregnant women. Loss of urina-ry calcium is more significant in GDM patients than normal controls. Program B can increase supplemental calcium,and it is more suitable for pa-tients with GDM.
