【摘要】：研究背景及目的： 妊娠期糖尿病(gestational diabetes mellitus, GDM)指妊娠首次發(fā)生或發(fā)現(xiàn)的引起不同程度糖代謝異常的疾病。妊娠期糖尿病作為一種復(fù)雜的代謝紊亂性疾病,可對孕婦及胎兒產(chǎn)生嚴(yán)重不良影響,尤其是導(dǎo)致患兒生后出現(xiàn)一系列近遠(yuǎn)期并發(fā)癥。妊娠期糖尿病對胎兒的影響為多器官功能的障礙,其中包括神經(jīng)系統(tǒng)、心臟功能、呼吸系統(tǒng)以及骨骼系統(tǒng)等,對胎兒生后長期的生活質(zhì)量造成嚴(yán)重的不良影響。隨著圍生醫(yī)學(xué)的不斷研究與進(jìn)步,對糖尿病嬰兒的研究越來越廣泛,但國內(nèi)外對妊娠期糖尿病母親新生兒并發(fā)癥的研究鮮有涉及腎功能方面,所以本文選擇檢測腎功能常用指標(biāo)血清光抑素C (cystatin C, Cys-C)、β2微球蛋白(β2-microglobuLin,β2-MG)、尿素氮(Blood urea nitrogen, BUN)與血肌酐(Creati nine, CREA)作為衡量標(biāo)準(zhǔn),探討妊娠期糖尿病母親新生兒腎功能變化,增加對妊娠期糖尿病母親新生兒并發(fā)癥的認(rèn)識,從而提高妊娠期糖尿病母親新生兒的生活質(zhì)量。 對象與方法： 1.實驗對象： 選取2009年3月-2011年9月山東大學(xué)附屬省立醫(yī)院新生兒科收治的妊娠期糖尿病母親新生兒45例作為實驗組,其中男23例,女22例,早產(chǎn)兒25例,足月兒20例,巨大兒20例,非巨大兒25例。選取同期出生的非妊娠期糖尿病母親新生兒45例作為對照組,其中男21例,女24例；早產(chǎn)兒18例,足月兒27例,巨大兒22例,非巨大兒23例。兩組之間的性別差異無統(tǒng)計學(xué)意義(P0.05)。所有研究對象均無嚴(yán)重感染、高膽紅素血癥、窒息及新生兒缺氧缺血性腦病等影響糖代謝、腎功能的疾病,且排除雙腎器質(zhì)性病變。 2.實驗方法： 所有研究對象均于出生72h內(nèi)采取空腹外周靜脈血,應(yīng)用廣州OLYMPUS-AU5400全自動生化分析儀檢測血清胱抑素C (Cys-C)、β2微球蛋白(p2-MG)尿素氮(BUN)、肌酐(CREA)值,觀察各檢測指標(biāo)變化。 結(jié)果 1.妊娠期糖尿病母親新生兒血清BUN、CREA與對照組相比無明顯差異(P0.05),血清Cys-C、β2-MG水平較對照組升高(P0.05)； 2.妊娠期糖尿病母親新生早產(chǎn)兒組、足月兒組血清Cys-C、β2-MG水平較對照組升高(P0.05),而妊娠期糖尿病母親新生早產(chǎn)兒組、足月兒組之間血清Cy s-C、β2-MG水平比較無明顯差異(P0.05)； 3.妊娠期糖尿病母親新生巨大兒組、非巨大兒組血清Cys-C、β2-MG水平較對照組升高(P0.05),而妊娠期糖尿病母親新生巨大兒組與非巨大兒組之間血清Cys-C、β2-MG水平無明顯差異(P0.05)。 結(jié)論 1.妊娠期糖尿病母親新生兒血清Cys-C與β2-MG水平較非妊娠期糖尿病母親新生兒水平升高,推斷妊娠期糖尿病母親新生兒存在早期腎功能損害。 2.妊娠期糖尿病母親新生兒早期腎功能損害不受胎齡、體質(zhì)量影響。
[Abstract]:Background & AIM: gestational diabetes mellitus (gestational diabetes mellitus, GDM) is a disease of different degrees of abnormal glucose metabolism that occurs or is discovered for the first time in pregnancy. Gestational diabetes mellitus (GDM), as a complex metabolic disorder, can cause severe adverse effects on pregnant women and fetuses, especially leading to a series of short-term and long-term complications. The effect of gestational diabetes mellitus on fetal function is a multi-organ dysfunction, including nervous system, heart function, respiratory system and skeletal system, which has a serious adverse effect on the long-term quality of life of the fetus after birth. With the continuous research and progress of perinatal medicine, the research on diabetic infants is more and more extensive. However, the research on neonatal complications of gestational diabetic mothers rarely involves renal function at home and abroad. Therefore, serum photostatin (C (cystatin C, Cys-C), 尾 2 microglobulin (尾 2-MG), urea nitrogen (Blood urea nitrogen, BUN) and serum creatinine (Creati nine, CREA) were selected as the criteria to evaluate the changes of renal function in newborns with gestational diabetes mellitus (GDM). To improve the quality of life of newborns with gestational diabetes mellitus. Object and method: 1. Participants: from March 2009 to September 2011, 45 newborns with gestational diabetes mellitus were selected as experimental group, including 23 males, 22 females and 25 premature infants. There were 20 term infants, 20 macrosomia and 25 non-macrosomia. Forty-five newborns with non-gestational diabetes mellitus were selected as control group, including 21 males and 24 females, 18 premature infants, 27 term infants, 22 macrosomia and 23 non-macrosomia. There was no statistical difference between the two groups (P0.05). No severe infection, hyperbilirubinemia, asphyxia and neonatal hypoxic-ischemic encephalopathy were found to affect glucose metabolism and renal function. Methods: all subjects were given fasting peripheral venous blood within 72 hours. Serum cystatin C (Cys-C), 尾 2 microglobulin (p2-MG) urea nitrogen (BUN), creatinine (CREA) were measured by Guangzhou OLYMPUS-AU5400 automatic biochemical analyzer. Observe the change of each index. Result 1. There was no significant difference in serum BUNA CREA between gestational diabetic mothers and control group (P0.05). The serum levels of Cys-Cand 尾 2-MG were higher than those of control group (P0.05). The serum levels of Cys-Cand 尾 2-MG in pregnant women with diabetes mellitus were higher than those in control group (P0.05), while the levels of Cy s-C and 尾 2-MG in pregnant women with diabetes mellitus were not significantly different from those in term infants (P0.05). The serum levels of Cys-Cand 尾 2-MG in gestational diabetic mothers with neonatal macrosomia group and non-macrosomia group were higher than those in control group (P0.05), but there was no significant difference in serum Cys-Cand 尾 2-MG levels between gestational diabetes mellitus mother newborn macrosomia group and non-macrosomia group (P0.05). Conclusion 1. The levels of serum Cys-C and 尾 2-MG in newborns with gestational diabetes mellitus were higher than those of non-gestational diabetic mothers. It was inferred that early renal function damage existed in newborns with gestational diabetes mellitus. 2. The early renal function damage of gestational diabetic mothers was not affected by gestational age and body mass.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R722.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 瞿美琴;李紅新;;血、尿β_2—微球蛋白測定在窒息新生兒中的臨床意義[J];工企醫(yī)刊;2002年02期

2 李琮輝 ,周世菊 ,萬衛(wèi)紅;檢測腎小球濾過功能的新方法——血清巰基蛋白酶抑制肽C[J];貴州醫(yī)藥;2003年01期

3 孫琴;劉杰波;鄧笑梅;;脂肪因子對妊娠期糖尿病胰島素抵抗及新生兒影響的研究進(jìn)展[J];臨床合理用藥雜志;2009年12期

4 王合麗;孫學(xué)梅;孫正蕓;王娜;林霞;;妊娠期糖尿病母親新生兒T細(xì)胞亞群及NK細(xì)胞活性的變化及其與血糖相關(guān)的研究[J];山東大學(xué)學(xué)報(醫(yī)學(xué)版);2011年04期

5 王娜;孫正蕓;王合麗;林霞;劉彥娥;;妊娠糖尿病母親新生兒及健康巨大兒血糖、胰島素和皮質(zhì)醇水平的變化[J];山東大學(xué)學(xué)報(醫(yī)學(xué)版);2011年06期

6 劉雪舫;;血清胱抑素2、肝細(xì)胞生長因子與新生兒窒息合并腎損傷的關(guān)系[J];山東醫(yī)藥;2011年17期

7 漆洪波,胡麗娜,吳味辛,卞度宏;妊娠期糖尿病母兒血清瘦素水平和胎盤瘦素表達(dá)及其與胰島素的關(guān)系[J];實用婦產(chǎn)科雜志;2005年01期

8 陳t$;陳惠金;錢龍華;陳冠儀;;不同血糖水平對缺氧缺血新生大鼠腦病理改變的影響[J];實用兒科臨床雜志;2006年14期

9 孫藝;;糖尿病腎病發(fā)病機(jī)理與臨床的新認(rèn)識[J];沈陽醫(yī)學(xué)院學(xué)報;2006年02期

10 徐麗珍,符玉亭;妊娠期糖尿病胎盤微絨毛體視學(xué)初探[J];實用醫(yī)學(xué)雜志;2000年10期

相關(guān)碩士學(xué)位論文 前1條

1 陳元元;妊娠期糖尿病診斷孕周和糖化血紅蛋白水平與圍產(chǎn)結(jié)局的關(guān)系[D];浙江大學(xué);2010年

，

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