本文選題：妊娠期糖尿病 + 早產(chǎn)兒　； 參考：《天津醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的： 1.分析孕母糖代謝異常對早產(chǎn)兒頭圍、身長、體質(zhì)量等指標(biāo)的影響。 2.分析孕母糖代謝異常對早產(chǎn)兒血糖、胰島素原、胰島素和C-肽等胰島功能指標(biāo)影響,并探討監(jiān)測早產(chǎn)兒胰島功能的敏感指標(biāo)。 3.通過血糖、胰島素原、胰島素和C-肽評估孕母糖代謝異常早產(chǎn)兒胰島功能。 方法： 將2012年3月至12月住新生兒重癥監(jiān)護病房的82例早產(chǎn)兒分為兩組：母親孕期糖代謝異常組(35例)和母親孕期糖代謝正常組(47例),分別測量兩組早產(chǎn)兒的體格發(fā)育指標(biāo)(頭圍、身長和體質(zhì)量)和監(jiān)測相關(guān)胰島功能的指標(biāo)(空腹血糖FPG、胰島素、C-肽和胰島素原),并比較胰島β細(xì)胞功能(胰島素抵抗指數(shù)insulin resistance index IR、空腹β細(xì)胞功能指數(shù)fasting β-cell function index FBCI和胰島素敏感指數(shù)insulin sensitivity index IAI)。 結(jié)果： 1.正常組和異常組早產(chǎn)兒母親的孕前和產(chǎn)前體質(zhì)量指數(shù)(BMI)比較顯示：異常組母親的孕前和產(chǎn)前BMI均高于正常組母親(P0.05),但母親孕期增加體質(zhì)量的差異無統(tǒng)計學(xué)意義(P0.05)； 2.正常組和異常組早產(chǎn)兒的體格發(fā)育指標(biāo)比較顯示：異常組早產(chǎn)兒出生時體質(zhì)量和頭圍及生后7天的體質(zhì)量均高于正常組,差異有統(tǒng)計學(xué)意義(P0.05),但出生時兩組早產(chǎn)兒胎齡和身長的差異無統(tǒng)計學(xué)意義； 3.正常組和異常組早產(chǎn)兒生化指標(biāo)比較顯示：異常組早產(chǎn)兒出生時和生后7天胰島素原及生后7天C-肽水平均高于正常,差異有統(tǒng)計學(xué)意義(P0.05)；兩組早產(chǎn)兒出生時和生后7天的血糖、胰島素及出生時C-肽水平的差異無統(tǒng)計學(xué)意義(P0.05)； 4.正常組和異常組早產(chǎn)兒出生時和生后7天的IR、FBCI和IAI比較顯示,兩組結(jié)果差異無統(tǒng)計學(xué)意義(P0.05)。 5.母親孕期血糖、早產(chǎn)兒FBCI與相關(guān)指標(biāo)的相關(guān)性和多元回歸分析顯示：母親孕期血糖與母親孕前BMI、產(chǎn)前BMI、早產(chǎn)兒出生時胰島素、C-肽和FBCI,呈正相關(guān)性(P0.05),其中母親產(chǎn)前BMI和早產(chǎn)兒出生時胰島素為獨立危險因素。早產(chǎn)兒FBCI與母親血糖呈正相關(guān)性,與母親孕前BMI和產(chǎn)前BMI無相關(guān)性,母親血糖為FBCI的獨立危險因素。 6.早產(chǎn)兒出生時胰島素原與其出生時胎齡、體重、頭圍和身長無相關(guān)性；早產(chǎn)兒胰島β細(xì)胞功能與早產(chǎn)兒出生時胎齡、體重、頭圍和身長無相關(guān)性；早產(chǎn)兒胰島素原與其胰島β細(xì)胞無相關(guān)性；早產(chǎn)兒血糖與母親孕前BMI、產(chǎn)前BMI和孕期血糖無相關(guān)性； 結(jié)論： 1.母親孕期血糖異常組與正常組相比,早產(chǎn)兒出生時和生后7天的胰島素原較正常組增高,表明母親血糖異常組的早產(chǎn)兒存在不同程度的胰島β細(xì)胞功能損傷,提示異常組早產(chǎn)兒日后可能發(fā)生不同程度的糖耐量損傷。 2.母親孕期血糖與母親孕前BMI、產(chǎn)前BMI、早產(chǎn)兒C-肽、胰島素和FBCI呈顯著正相關(guān)性,產(chǎn)前BMI和早產(chǎn)兒胰島素為其獨立危險因素,提示母親需控制體重、合理體重增長,否則易發(fā)生糖耐量受損,影響胎兒宮內(nèi)胰島細(xì)胞功能。 3.早產(chǎn)兒胰島β細(xì)胞功能中FBCI與母親孕期血糖呈顯著正相關(guān)性,母親血糖為其獨立危險因素,提示母親孕期血糖異常已在宮內(nèi)影響早產(chǎn)兒的FBCI,故對整個孕期均需合理控制血糖,以免使胎兒胰島細(xì)胞功能早期受損,乃至造成日后的異常。
[Abstract]:Purpose :

1 . Analysis of the effects of maternal sugar metabolism on the head circumference , body length and body mass of premature infants .

2 . To analyze the effects of maternal glucose metabolism on the function indexes of insulin , insulin , C - peptide and other pancreatic islets in preterm infants , and to explore the sensitive index of monitoring the function of pancreatic islets in preterm infants .

3 . Evaluate the pancreatic function of preterm infants with abnormal metabolism of maternal blood glucose , insulin , insulin and C - peptide .

Method :

82 preterm infants in the neonatal intensive care unit from March to December 2012 were divided into two groups : maternal glucose metabolism disorder group ( 35 cases ) and mother ' s normal glucose metabolism group ( 47 cases ) , the physical development index ( head circumference , body length and body mass ) of two groups of premature infants were measured and the indexes of related islet function ( fasting plasma glucose FPG , insulin , C - peptide and insulin original ) were measured , and the function of pancreatic 尾 cell ( insulin resistance index IR , fasting 尾 cell function index fasting 尾 - cell function index FBCI and insulin sensitivity index IAI ) were compared .

Results :

1 . The pre - pregnancy and prenatal mass index ( BMI ) of the mother of the normal and abnormal groups showed that the pre - pregnancy and pre - natal BMI were higher in the abnormal group than in the normal group ( P0.05 ) .


2 . The physical development index of preterm infants in the normal group and abnormal group showed that the mass of the body mass and the body mass were higher in the abnormal group than in the normal group ( P0.05 ) , but there was no statistical significance between the gestational age and the body length of the two groups at birth .


3 . The biochemical indexes of preterm infants in the normal group and the abnormal group showed that the levels of C - peptide were higher in the abnormal group and 7 days after the birth and 7 days after the birth , respectively ( P0.05 ) .
There was no significant difference in plasma glucose , insulin and C - peptide levels in both groups at birth and 7 days after birth ( P0.05 ) .


4 . The IR , FBCI and IAI of both normal and abnormal groups were compared with IR , FBCI and IAI of 7 days after birth , and there was no statistical difference between the two groups ( P0.05 ) .

The relationship between maternal blood sugar and maternal BMI , pre - birth BMI , insulin , C - peptide and FBCI were positively correlated ( P0.05 ) . There was a positive correlation between maternal blood sugar and maternal blood sugar , and there was no correlation between maternal blood sugar and maternal blood sugar , and maternal blood glucose was independent risk factor of FBCI .

6 . There was no correlation between the gestational age , body weight , head circumference and body length in preterm infants .
There was no correlation between 尾 - cell function and gestational age , body weight , head circumference and body length in preterm infants .
There was no correlation between insulin in preterm infants and its pancreatic 尾 cells .
There was no correlation between the blood glucose of preterm infants and maternal BMI , pre - natal BMI and maternal blood glucose ;


Conclusion :

1 . Compared with the normal group , the abnormal group of insulin in maternal blood glucose group was higher than that in the normal group , indicating that the preterm infants in the abnormal blood sugar group had different degrees of pancreatic 尾 - cell function injury , suggesting that the abnormal group may have different degrees of glucose tolerance after preterm infants .

2 . There was a positive correlation between maternal blood glucose and maternal BMI , pre - natal BMI , C - peptide , insulin and FBCI , pre - natal BMI and premature infant insulin as independent risk factors , suggesting that mothers need to control body weight and increase the reasonable weight gain , otherwise , impaired glucose tolerance can occur , affecting the function of fetal intrauterine device .

3 . There was a positive correlation between FBCI and maternal blood glucose in preterm infants with 尾 - cell function , and maternal blood glucose was independent risk factor , suggesting that maternal blood glucose abnormality has affected the FBCI of preterm infants during pregnancy . Therefore , it is necessary to control blood sugar rationally during pregnancy , so as to avoid the early damage of fetal pancreatic islet cell function , and even cause abnormality in the future .
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R722.6

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本文編號：2059721