本文選題：妊娠糖尿病 + 絲氨酸蛋白酶抑制劑　； 參考：《鄭州大學(xué)》2017年碩士論文

【摘要】：目的探討妊娠糖尿病(Gestational diabetes mellitus,GDM)孕婦孕前體質(zhì)指數(shù)(Body mass index,BMI)和孕期增重(Gestational weight gain,GWG)對(duì)初生嬰兒體格發(fā)育的影響以及GDM孕婦孕晚期血脂、絲氨酸蛋白酶抑制劑(Vaspin)和內(nèi)臟脂肪素(Visfatin)水平與初生嬰兒體格發(fā)育的關(guān)系。方法2015年11月~2016年5月在鄭州大學(xué)第二附屬醫(yī)院產(chǎn)科收集所有分娩的GDM孕婦308例和部分正常孕婦800例及其新生兒資料,并采集孕婦產(chǎn)前靜脈血清標(biāo)本227例(GDM孕婦血清96例,糖耐量正常孕婦血清131例),測(cè)定血清總膽固醇、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇、甘油三酯、Vaspin和Visfatin水平。將孕婦分為GDM組和正常對(duì)照組;根據(jù)孕前BMI將孕婦分為孕前消瘦組、正常組與超重/肥胖組;根據(jù)GWG將孕婦分為GWG不足組、適宜組和過(guò)多組。根據(jù)出生體重將新生兒分為低出生體重兒、正常體重兒和巨大兒。采用卡方檢驗(yàn)、t檢驗(yàn)、方差分析、二分類和多分類logistic回歸分析、Pearson或Spearman相關(guān)分析等方法,分析GDM組和正常對(duì)照組孕婦孕前BMI、GWG對(duì)新生兒出生體重、身長(zhǎng)、胸圍、頭圍和Ponderal指數(shù)的影響。比較孕晚期GDM組和正常對(duì)照組孕婦血脂、Vaspin和Visfatin水平,分析其與新生兒出生體重、身長(zhǎng)、胸圍、頭圍和Ponderal指數(shù)的關(guān)系。結(jié)果(1)GDM組新生兒的出生體重、胸圍、頭圍和Ponderal指數(shù)均大于正常對(duì)照組(P0.05)。(2)GDM是娩出巨大兒的危險(xiǎn)因素(OR=2.307,95%CI:1.470~3.622),易使新生兒出現(xiàn)較大Ponderal指數(shù)(OR=1.617,95%CI:1.117~2.341)。(3)GWG適宜的GDM孕婦,孕前BMI正常組新生兒的Ponderal指數(shù)小于孕前超重/肥胖組(P0.05)。GWG適宜的正常對(duì)照組內(nèi),孕前消瘦組新生兒的出生體重低于BMI正常組(P0.05)。GWG過(guò)多的正常對(duì)照組內(nèi),孕前消瘦組的新生兒的胸圍和頭圍均小于BMI正常組和超重/肥胖組(P0.05)。多分類logistic回歸分析中,孕前消瘦易使新生兒出現(xiàn)較短出生身長(zhǎng)(OR=2.214,95%CI:1.169~4.192)。孕前超重/肥胖是娩出巨大兒的危險(xiǎn)因素(OR=1.956,95%CI:1.145~3.342),易使新生兒出現(xiàn)較大Ponderal指數(shù)(OR=1.710,95%CI:1.094~2.671)。(4)孕前BMI正常的GDM組內(nèi),GWG不足組新生兒的出生體重和Ponderal指數(shù)均小于GWG過(guò)多組(P0.05);孕前BMI正常的正常對(duì)照組內(nèi),GWG不足組和適宜組新生兒的出生體重和胸圍均小于GWG過(guò)多組(P0.05)。多分類logistic回歸分析中,GWG不足易使新生兒出現(xiàn)較小出生頭圍(OR=1.888,95%CI:1.186~3.004)。(5)GDM組和正常對(duì)照組孕婦血TG水平與新生兒的胸圍呈正相關(guān)(r=0.203,P=0.047;r=0.288,P=0.001)。(6)孕晚期孕婦血清中Vaspin和Visfatin水平與新生兒出生體重、身長(zhǎng)、胸圍、頭圍和Ponderal指數(shù)均不相關(guān)(P0.05)。結(jié)論(1)GDM是娩出巨大兒的危險(xiǎn)因素,易使新生兒出現(xiàn)較大的Ponderal指數(shù),對(duì)新生兒的出生身長(zhǎng)和頭圍無(wú)影響。(2)孕前超重/肥胖是娩出巨大兒的危險(xiǎn)因素,易使新生兒出現(xiàn)較大Ponderal指數(shù)。孕前消瘦易使新生兒出現(xiàn)較短出生身長(zhǎng)。GWG不足易使新生兒出現(xiàn)較小出生頭圍。(3)孕晚期孕婦血甘油三酯水平與新生兒的胸圍呈正相關(guān),而Vaspin和Visfatin水平與新生兒的出生體重、身長(zhǎng)、胸圍、頭圍和Ponderal指數(shù)不相關(guān)。
[Abstract]:Objective to investigate the effect of pre pregnancy body mass index (Body mass index, BMI) and weight gain during pregnancy (Gestational weight gain, GWG) on the physical development of newborn infants and the level of blood lipid in the late pregnancy, the level of serine protease inhibitor and visceral fatty acid and newborn infant in Gestational diabetes mellitus (GDM). Methods the relationship between children's physical development was collected in November 2015 ~2016 ~2016 in the Second Affiliated Hospital of Zhengzhou University to collect all 800 cases of pregnant women and 800 cases of normal pregnant women and their newborns, and collect 227 cases of pre partum venous serum specimens (96 cases of GDM pregnant women, 131 cases of normal pregnant women with normal glucose tolerance), and determine the total bile of serum. Sterols, high-density lipoprotein cholesterol, low density lipoprotein cholesterol, triglyceride, triglyceride, Vaspin and Visfatin levels. The pregnant women were divided into GDM group and normal control group; pregnant women were divided into pre pregnancy emaciation group, normal group and overweight / obese group according to pre pregnancy BMI. According to GWG, pregnant women were divided into GWG deficiency group, suitable group and too many groups. According to birth weight, the new birth weight will be new. The children were divided into low birth weight infants, normal weight infants and giant infants. Using chi square test, t test, variance analysis, two classification and multiple classification logistic regression analysis, Pearson or Spearman correlation analysis, the birth weight, length, chest circumference, head circumference, and Ponderal index of newborn infants were analyzed by BMI and GWG in GDM group and normal control group. The relationship between the blood lipid, Vaspin and Visfatin levels in the GDM group and the normal control group was compared with the birth weight, length, circumference and Ponderal index of the newborn. Results (1) the birth weight, the chest circumference, the head circumference and the Ponderal index in the GDM group were all larger than the normal control group (P0.05). (2) GDM was a dangerous cause of childbirth. OR=2.307,95%CI:1.470~3.622 was easy to make a larger Ponderal index (OR=1.617,95%CI:1.117~2.341) for newborns. (3) the suitable GDM pregnant women with GWG, the Ponderal index in the normal BMI group before pregnancy was less than that in the normal control group of the overweight / obese group before pregnancy (P0.05).GWG (P0.05), and the birth weight of the newborn in the pre pregnancy emaciation group was lower than that of the BMI normal group (P0.) 05) in the normal control group, the chest circumference and head circumference of the pre pregnancy emaciation group were less than that of the BMI normal group and the overweight / obese group (P0.05). In the multi classification logistic regression analysis, the pre pregnancy emaciation was easy to make the newborn birth longer (OR=2.214,95%CI:1.169~4.192). The overweight / obesity before pregnancy was a risk factor for the childbirth of the giant infants (OR=1.). 956,95%CI:1.145~3.342), it is easy to make a larger Ponderal index (OR=1.710,95%CI:1.094~2.671) for newborns. (4) the birth weight and Ponderal index of newborns in GWG deficient group are less than those of the group of GWG (P0.05) before pregnancy, and the birth weight and chest in the normal normal pair group and the suitable group of newborn infants are in the normal normal pairs of GWG before pregnancy. The circumference was less than GWG group (P0.05). In the multi classification logistic regression analysis, the deficiency of GWG was easy to make newborns with smaller birth circumference (OR=1.888,95%CI:1.186~3.004). (5) the serum TG level of pregnant women in GDM and normal controls was positively correlated with the chest circumference of the newborn (r=0.203, P=0.047; r=0.288, P=0.001). (6) pregnant women in the late pregnancy Levels were not related to birth weight, body length, chest circumference, head circumference and Ponderal index (P0.05). Conclusion (1) GDM is a risk factor for childbirth. It is easy to make newborns with larger Ponderal index and no influence on the birth length and head circumference of the newborn. (2) overweight / obesity before pregnancy is a risk factor for childbirth. There is a larger Ponderal index. Pre pregnancy emaciation makes newborns less likely to have a shorter birth.GWG deficiency. (3) there is a positive correlation between the level of triglyceride in the late pregnancy and the chest circumference of the newborn, while the level of Vaspin and Visfatin is not related to the birth weight of the newborn, the length of the body, the chest circumference, the head circumference and the Ponderal index.

【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R714.256

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相關(guān)期刊論文 前1條

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相關(guān)博士學(xué)位論文 前1條

1 霍琰;脂肪因子Vaspin在妊娠期糖尿病中的作用[D];河北醫(yī)科大學(xué);2015年

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本文編號(hào)：1890850