中华围产医学杂志
中華圍產醫學雜誌
중화위산의학잡지
CHINESE JOURNAL OF PERINATAL MEDICINE
2012年
12期
705-709
,共5页
王婧%陈卓%马润玫%杨明晖%尹蓉%孙永虎%孙倩%张兰
王婧%陳卓%馬潤玫%楊明暉%尹蓉%孫永虎%孫倩%張蘭
왕청%진탁%마윤매%양명휘%윤용%손영호%손천%장란
孕妇%血红蛋白类%红细胞计数%血细胞比容%糖尿病,妊娠
孕婦%血紅蛋白類%紅細胞計數%血細胞比容%糖尿病,妊娠
잉부%혈홍단백류%홍세포계수%혈세포비용%당뇨병,임신
Pregnant women%Hemaglobins%Erythrocyte count%Hematocrit%Diabetes,gestational
目的 探讨昆明地区非贫血孕妇妊娠早期母体血红蛋白(hemaglobin,Hb)浓度、红细胞计数(red blood cell count,RBC)和红细胞压积(hematocrit,HCT)对妊娠晚期发生妊娠期糖尿病(gestational diabetes mellitus,GDM)的预测作用. 方法 本研究为前瞻性研究.2008年1月1日至2009年12月31日在昆明医科大学第一附属医院产科门诊行产前检查的昆明地区单胎妊娠妇女1189例在妊娠14周前进行首次产前检查时接受血液细胞学分析.应用四分位数法分别将这些研究对象按Hb、RBC及HCT水平依次分为4组,比较每项指标的各四分位组孕妇妊娠晚期GDM发生率的差异.用Kolmogorov-Smirnov法分别对妊娠14周Hb、RBC和HCT总体样本进行正态分布检验,比较各组率的差异用x2检验；采用Logistic回归分析筛选GDM发病的独立危险因素. 结果 随着妊娠14周前Hb、RBC、HCT四分位数组别的增高,妊娠晚期GDM的发生率相应地逐渐升高.Hb≥75th组GDM发生率与＜25th、25th～、50th～组的GDM发生率相比,均明显增高,差异有统计学意义[分别为13.1％ (34/259)、5.9％(18/304)、9.2％ (30/326)、9.3％ (28/300),x2=8.53、4.18、3.96,P＜0.05].RBC 50th～及≥75th组的GDM发生率分别较RBC＜25th及25th～组的GDM发生率明显增高,差异有统计学意义[50th～组与＜25th组:11.7％(34/290)与6.3％(19/304),x2 =5.30;50th～组与25th～组:11.7％ (34/290)与7.0％ (21/298),x2=3.93;≥75th组与＜25th组:12.1％(36/297)与6.3％ (19/304),x2=6.49;≥75th组与25th～组:12.1％(36/297)与7.0％(21/298),x2=3.85;P＜0.05].HCT 25th～、50th～及≥75th组的GDM发生率分别较HCT＜25th 组增高,差异有统计学意义[分别为9.3％(29/311)、10.8％(31/287)和11.8％(34/288)与5.3％(16/303),x2=7.04、3.93和6.49,P＜0.05].Logistic回归分析显示,妊娠14周前Hb(OR=1.031,95％CI:1.010～1.052]、RBC(OR =2.286,95％ CI:1.318～3.963)和HCT(OR=1.106,95％CI:1.037～1.179)均是妊娠晚期GDM发生的独立危险因素(P均＜0.05). 结论 妊娠早期Hb、RBC及HCT水平升高可作为预测昆明地区孕妇GDM发生的重要指标.
目的 探討昆明地區非貧血孕婦妊娠早期母體血紅蛋白(hemaglobin,Hb)濃度、紅細胞計數(red blood cell count,RBC)和紅細胞壓積(hematocrit,HCT)對妊娠晚期髮生妊娠期糖尿病(gestational diabetes mellitus,GDM)的預測作用. 方法 本研究為前瞻性研究.2008年1月1日至2009年12月31日在昆明醫科大學第一附屬醫院產科門診行產前檢查的昆明地區單胎妊娠婦女1189例在妊娠14週前進行首次產前檢查時接受血液細胞學分析.應用四分位數法分彆將這些研究對象按Hb、RBC及HCT水平依次分為4組,比較每項指標的各四分位組孕婦妊娠晚期GDM髮生率的差異.用Kolmogorov-Smirnov法分彆對妊娠14週Hb、RBC和HCT總體樣本進行正態分佈檢驗,比較各組率的差異用x2檢驗；採用Logistic迴歸分析篩選GDM髮病的獨立危險因素. 結果 隨著妊娠14週前Hb、RBC、HCT四分位數組彆的增高,妊娠晚期GDM的髮生率相應地逐漸升高.Hb≥75th組GDM髮生率與＜25th、25th～、50th～組的GDM髮生率相比,均明顯增高,差異有統計學意義[分彆為13.1％ (34/259)、5.9％(18/304)、9.2％ (30/326)、9.3％ (28/300),x2=8.53、4.18、3.96,P＜0.05].RBC 50th～及≥75th組的GDM髮生率分彆較RBC＜25th及25th～組的GDM髮生率明顯增高,差異有統計學意義[50th～組與＜25th組:11.7％(34/290)與6.3％(19/304),x2 =5.30;50th～組與25th～組:11.7％ (34/290)與7.0％ (21/298),x2=3.93;≥75th組與＜25th組:12.1％(36/297)與6.3％ (19/304),x2=6.49;≥75th組與25th～組:12.1％(36/297)與7.0％(21/298),x2=3.85;P＜0.05].HCT 25th～、50th～及≥75th組的GDM髮生率分彆較HCT＜25th 組增高,差異有統計學意義[分彆為9.3％(29/311)、10.8％(31/287)和11.8％(34/288)與5.3％(16/303),x2=7.04、3.93和6.49,P＜0.05].Logistic迴歸分析顯示,妊娠14週前Hb(OR=1.031,95％CI:1.010～1.052]、RBC(OR =2.286,95％ CI:1.318～3.963)和HCT(OR=1.106,95％CI:1.037～1.179)均是妊娠晚期GDM髮生的獨立危險因素(P均＜0.05). 結論 妊娠早期Hb、RBC及HCT水平升高可作為預測昆明地區孕婦GDM髮生的重要指標.
목적 탐토곤명지구비빈혈잉부임신조기모체혈홍단백(hemaglobin,Hb)농도、홍세포계수(red blood cell count,RBC)화홍세포압적(hematocrit,HCT)대임신만기발생임신기당뇨병(gestational diabetes mellitus,GDM)적예측작용. 방법 본연구위전첨성연구.2008년1월1일지2009년12월31일재곤명의과대학제일부속의원산과문진행산전검사적곤명지구단태임신부녀1189례재임신14주전진행수차산전검사시접수혈액세포학분석.응용사분위수법분별장저사연구대상안Hb、RBC급HCT수평의차분위4조,비교매항지표적각사분위조잉부임신만기GDM발생솔적차이.용Kolmogorov-Smirnov법분별대임신14주Hb、RBC화HCT총체양본진행정태분포검험,비교각조솔적차이용x2검험；채용Logistic회귀분석사선GDM발병적독립위험인소. 결과 수착임신14주전Hb、RBC、HCT사분위수조별적증고,임신만기GDM적발생솔상응지축점승고.Hb≥75th조GDM발생솔여＜25th、25th～、50th～조적GDM발생솔상비,균명현증고,차이유통계학의의[분별위13.1％ (34/259)、5.9％(18/304)、9.2％ (30/326)、9.3％ (28/300),x2=8.53、4.18、3.96,P＜0.05].RBC 50th～급≥75th조적GDM발생솔분별교RBC＜25th급25th～조적GDM발생솔명현증고,차이유통계학의의[50th～조여＜25th조:11.7％(34/290)여6.3％(19/304),x2 =5.30;50th～조여25th～조:11.7％ (34/290)여7.0％ (21/298),x2=3.93;≥75th조여＜25th조:12.1％(36/297)여6.3％ (19/304),x2=6.49;≥75th조여25th～조:12.1％(36/297)여7.0％(21/298),x2=3.85;P＜0.05].HCT 25th～、50th～급≥75th조적GDM발생솔분별교HCT＜25th 조증고,차이유통계학의의[분별위9.3％(29/311)、10.8％(31/287)화11.8％(34/288)여5.3％(16/303),x2=7.04、3.93화6.49,P＜0.05].Logistic회귀분석현시,임신14주전Hb(OR=1.031,95％CI:1.010～1.052]、RBC(OR =2.286,95％ CI:1.318～3.963)화HCT(OR=1.106,95％CI:1.037～1.179)균시임신만기GDM발생적독립위험인소(P균＜0.05). 결론 임신조기Hb、RBC급HCT수평승고가작위예측곤명지구잉부GDM발생적중요지표.
Objective To investigate the role of hemoglobin (Hb),red blood cell count (RBC) and hematocrit (HCT) during the first trimester in predicting the occurrence of gestational diabetes mellitus (GDM) in the third trimester in nonanemic women in Kunming.Methods A prospective study was carried out.Routine blood tests were performed in 1189 nondiabetic singleton pregnant Chinese women at their initial prenatal healthcare before 14 gestational weeks in the First Affiliated Hospital of Kunming Medical University from January 1,2008 to December 31,2009.They were divided into four groups by quartiles of Hb,RBC and HCT levels respectively.Differences of GDM incidence at the third trimester were compared among groups.Kollmogorov Smirnov test was used to detect normal distribution of Hb,RBC and HCT results.Differences between rates of groups were detected by Chi-square test.Independent risk factors of GDM were screened by Logistic regression analysis.Results The incidence of GDM at the third trimester increased as quartile categories of Hb,RBC and HCT ascended.The GDM incidence (13.1 ％,34/259) of ≥75th Hb group was higher than that of ＜ 25th group (5.9 ％,18/304,x2 =8.53,P＜ 0.0 1),25th ～ group (9.2 ％,30/326,x2=4.18,P＜0.05) and 50th～ group (9.3％,28/300,x2=3.96,P＜0.05).The GDM incidence (11.7 ％,34/290) of 50th～ RBC group (RBC≥4.44 × 1012/L) was higher than that of ＜25th group (6.3％,19/304,x2=5.30,P＜0.05),25th～ group (7.0％,21/298,x2 =3.93,P＜0.05); and the GDM incidence (12.1％,36/297) of ≥75th group was also higher than that of ＜25th group (6.3％,19/304,x2 =6.49,P＜0.05),25th～ group (7.0％,21/298,x2=3.85,P＜0.05).The GDM incidence of ＜25th HCT group (5.3％,16/303) was lower than that of 25th～ group (9.3％,29/311,x2=7.04,P＜0.01),50th～ group (10.8％,31/287,x2=3.93,P＜0.05) and ≥75th group (11.8％,34/288,x2=6.49,P＜0.05).Logistic regression analysis showed that Hb (OR=1.031,95％ CI:1.010-1.052),RBC (OR=2.286,95％CI:1.318-3.963) and HCT (OR=1.106,95％ CI:1.037-1.179) were independent risk factors of GDM (all P＜0.05).Conclusions High maternal Hb,RBC and HCT levels in the first trimester could be used in predicting GDM in pregnant women in Kunming area.
