CAJ | 학술논문

目的：研究妊娠期糖尿病(GDM)巨大儿的相关因素。方法选择2013年3月~2014年5月北京市昌平区中医医院收治的124例GDM患者，根据娩出胎儿是否为巨大儿将其分为巨大儿组(观察组，36例)和非巨大儿组(对照组，88例)。回顾性分析两组患者的一般情况、血糖水平、治疗开始孕龄、糖化血红蛋白、接受治疗情况、治疗方案和血糖控制的满意度。结果观察组患者的新生儿体重[(4389.2±369.6)g]显著高于对照组[(3367.1±386.3)g]，差异有高度统计学意义(t =13.539，P<0.01)；两组产次及巨大儿分娩史比较，差异均有统计学意义(χ2=7.525、4.969，均P<0.05)。两组患者OGTT 2 h血糖的水平及治疗开始孕龄比较，差异无统计学意义(t=0.475、0.357，均P>0.05)，但是观察组糖化血红蛋白水平[(6.78±0.87)%]明显高于对照组[(5.21±0.97)%]，差异有高度统计学意义(t=8.421，P<0.01)。观察组患者接受治疗率(55.56%)显著低于对照组(78.41%)，差异有统计学意义(u=6.587，P<0.05)。观察组患者的治疗方案主要是饮食调节，对照组则是在饮食调节下进行胰岛素治疗，差异有高度统计学意义(χ2=7.264，P<0.01)。对照组的血糖控制满意度(92.05%)显著高于观察组(72.22%)，差异有高度统计学意义(u=2.901，P<0.01)。结论妊娠期糖尿病巨大儿的发生与多种因素相关，为此孕妇在产前应进行严格的产检，当确诊GDM后应当积极配合治疗，随时保持血糖处于理想水平的状态，有利于降低巨大儿的发生率。
목적：연구임신기당뇨병(GDM)거대인적상관인소。방법선택2013년3월~2014년5월북경시창평구중의의원수치적124례GDM환자，근거면출태인시부위거대인장기분위거대인조(관찰조，36례)화비거대인조(대조조，88례)。회고성분석량조환자적일반정황、혈당수평、치료개시잉령、당화혈홍단백、접수치료정황、치료방안화혈당공제적만의도。결과관찰조환자적신생인체중[(4389.2±369.6)g]현저고우대조조[(3367.1±386.3)g]，차이유고도통계학의의(t =13.539，P<0.01)；량조산차급거대인분면사비교，차이균유통계학의의(χ2=7.525、4.969，균P<0.05)。량조환자OGTT 2 h혈당적수평급치료개시잉령비교，차이무통계학의의(t=0.475、0.357，균P>0.05)，단시관찰조당화혈홍단백수평[(6.78±0.87)%]명현고우대조조[(5.21±0.97)%]，차이유고도통계학의의(t=8.421，P<0.01)。관찰조환자접수치료솔(55.56%)현저저우대조조(78.41%)，차이유통계학의의(u=6.587，P<0.05)。관찰조환자적치료방안주요시음식조절，대조조칙시재음식조절하진행이도소치료，차이유고도통계학의의(χ2=7.264，P<0.01)。대조조적혈당공제만의도(92.05%)현저고우관찰조(72.22%)，차이유고도통계학의의(u=2.901，P<0.01)。결론임신기당뇨병거대인적발생여다충인소상관，위차잉부재산전응진행엄격적산검，당학진GDM후응당적겁배합치료，수시보지혈당처우이상수평적상태，유리우강저거대인적발생솔。
Objective To study the related factors of great children in patients with gestational diabetes. Methods 124 cases of patients with GDM from March 2013 to May 2014 in Changping Hospital of Traditional Chinese Medicine were selected, and they were divided into great children group (observation group, 36 cases) and non-great children group (control group, 88 cases) according to whether delivered a great children. The general condition, blood sugar levels, gestation age of begin treatment, glycosylated hemoglobin, situation of treatment acceptation, treatment regimens and satisfaction of glycolic control of two groups were retrospectively analyzed. Results The weight of newborn in the obser-vation group [(4389.2±369.6) g] was significant higher than that of the control group [(3367.1±386.3) g], the difference was statistically significant (t = 13.539, P < 0.01), production times and the history of great children between two groups had statistically significant differences (χ2=7.525, 4.969, all P<0.05). blood sugar levels at OGTT 2 h, gestation age of begin treatment of patients in two groups had no statistically significant difference (P> 0.05), but glycosylated hemoglobin of the observation group [(6.78±0.87)%] was significantly higher than that of the control group [(5.21±0.97)%], the difference was statistically significant (t=8.421, P<0.05); rate of treatment acceptation of patients in the observation group (78.41%) was significantly higher than that of the control group (55.56%), the difference was statisti-cally significant (u=6.5865, P<0.05); diet-regulated was the main therapy of the observation group, and insulin ther-apy assisted in regulation of diet was the main therapy of the control group, the difference was statistically significant (χ2=7.264, P< 0.01); satisfaction of blood glucose control in the control group (92.05%) was significantly higher than that of the observation group (72.22%), the difference was statistically significant (u=2.9014, P<0.01). Conclusion Many factors are relate to great children in patients with gestational diabetes, so pregnant women should carry out strict prenatal check-ups and actively cooperate with treatment when diagnosed with CDM, and to keep blood sugar in the ideal levels, which will help to reduce the incidence of great children.