新診斷標(biāo)準(zhǔn)下GDM危險(xiǎn)因素調(diào)查及CRP與GDM的相關(guān)性
發(fā)布時(shí)間：2018-08-03 13:08
【摘要】：目的：探討新診斷標(biāo)準(zhǔn)下妊娠期糖尿病(gestational diabetes mellitus,GDM)發(fā)病的危險(xiǎn)因素及炎癥因子C反應(yīng)蛋白(C-reactive protein,CRP)與GDM發(fā)病的相關(guān)性，為臨床通過(guò)對(duì)GDM的危險(xiǎn)因素進(jìn)行早期干預(yù)，以預(yù)防GDM及遠(yuǎn)期并發(fā)癥提供一定的循證學(xué)依據(jù)，順應(yīng)中醫(yī)“治未病”理念，為創(chuàng)建具有中醫(yī)特色的圍產(chǎn)保健模式提供參考。 方法：本課題采用橫斷面調(diào)查的研究方法，對(duì)2013年4月～2014年2月在河南中醫(yī)學(xué)院第一附屬醫(yī)院建卡并定期行圍產(chǎn)保健檢查的孕28周內(nèi)的單胎孕婦進(jìn)行抽樣調(diào)查。選出符合GDM診斷標(biāo)準(zhǔn)的孕婦91例作為觀察組，并采用單純隨機(jī)抽樣法從179份完整問(wèn)卷中選出同期圍產(chǎn)保健的健康孕婦91例作為對(duì)照組。對(duì)調(diào)查對(duì)象采用GDM流行病學(xué)調(diào)查表(見(jiàn)附錄1)進(jìn)行調(diào)查，將調(diào)查結(jié)果錄入SPSS并建立數(shù)據(jù)庫(kù)。采用SPSS18.0統(tǒng)計(jì)軟件用χ2檢驗(yàn)對(duì)計(jì)數(shù)資料進(jìn)行分析，采用t檢驗(yàn)對(duì)計(jì)量資料進(jìn)行分析，對(duì)于計(jì)量資料首先進(jìn)行正態(tài)分布檢驗(yàn)，采用單樣本k-s檢驗(yàn)法，若為正態(tài)分布，則進(jìn)行兩獨(dú)立樣本的t檢驗(yàn)法進(jìn)行分析，反之則進(jìn)行兩獨(dú)立樣本的非參數(shù)檢驗(yàn)法進(jìn)行分析。對(duì)于多因素的研究采用Logistic回歸分析法。 結(jié)果：①觀察組和對(duì)照組在飲食偏嗜，孕前體重指數(shù)，本次妊娠年齡，初次妊娠年齡，OGTT時(shí)體重增幅，糖尿病家族史，GDM史，不良孕產(chǎn)史，妊娠次數(shù)，巨大兒或羊水過(guò)多分娩史，多囊卵巢綜合征病史，本次妊娠胎兒大于孕周或羊水過(guò)多等方面存在有顯著性統(tǒng)計(jì)學(xué)差異(P＜0.05)。②觀察組和對(duì)照組CRP水平具有顯著性統(tǒng)計(jì)學(xué)差異(P＜0.05)。③觀察組與對(duì)照組在職業(yè)，教育文化程度，產(chǎn)次，分娩方式，乙肝病毒表面抗原攜帶，反復(fù)性假絲酵母菌感染史等方面的組間比較中差異無(wú)統(tǒng)計(jì)學(xué)意義(P＞0.05)。④經(jīng)多因素Logistic回歸分析，孕前體重指數(shù)，本次妊娠年齡，妊娠次數(shù)，不良孕產(chǎn)史，巨大兒或羊水過(guò)多分娩史，多囊卵巢綜合征病史，CRP七個(gè)危險(xiǎn)因素均進(jìn)入回歸模型，各影響回歸系數(shù)分別為1.334,0.520,-0.813,1.580,1.709,1.513,0.262。 結(jié)論：①多因素Logistic回歸結(jié)果顯示：孕前體重指數(shù)，妊娠年齡，不良孕產(chǎn)史，，巨大兒或羊水過(guò)多分娩史，多囊卵巢綜合征病史是新診斷標(biāo)準(zhǔn)下GDM的獨(dú)立危險(xiǎn)因素。②CRP水平與新診斷標(biāo)準(zhǔn)下GDM的發(fā)病呈正相關(guān)性，有一定的早期預(yù)測(cè)作用。③飲食偏嗜，初次妊娠年齡，GDM史，糖尿病家族史，本次妊娠胎兒大于孕周或羊水過(guò)多等因素未能進(jìn)入回歸模型，可能是GDM的混雜因素。
[Abstract]:Objective: to investigate the risk factors of (gestational diabetes mellitusus in gestational diabetes mellitus (GDM) under the new diagnostic criteria, and the correlation between C-reactive and GDM, so as to provide early intervention for the risk factors of GDM. In order to prevent GDM and long-term complications to provide a certain evidence-based basis, comply with the concept of "cure disease", for the establishment of traditional Chinese medicine characteristics of perinatal health care model to provide a reference. Methods: a cross-sectional investigation was carried out on pregnant women with single pregnancy during 28 weeks of pregnancy during the first affiliated Hospital of Henan College of traditional Chinese Medicine from April 2013 to February 2014, with regular perinatal health care examination. 91 pregnant women who met the diagnostic criteria of GDM were selected as observation group, and 91 healthy pregnant women in the same period of perinatal care were selected as control group from 179 complete questionnaires. The subjects were investigated by GDM epidemiological questionnaire (see Appendix 1). The results were recorded in SPSS and database was established. SPSS18.0 statistical software was used to analyze the counting data by 蠂 2 test, the measurement data was analyzed by t test, the normal distribution test was carried out for the measurement data, and the single sample k-s test method was used, if it was normal distribution, Then the t-test method of two independent samples and the non-parametric test method of two independent samples are carried out. Logistic regression analysis was used to study the multiple factors. Results in the observation group and control group, the diet preference, body mass index (BMI) before pregnancy, age of pregnancy, weight increase of OGTT at the first gestational age, family history of diabetes mellitus (GDM), history of bad pregnancy and delivery, pregnancy times, macrosomia or amniotic fluid excess delivery history were observed in the observation group and the control group. History of polycystic ovary syndrome, There was significant difference in CRP level between the observation group and the control group (P < 0. 05). 3 there was significant difference between the observation group and the control group in the level of occupation, education and culture, and there was significant difference between the pregnancy group and the control group in the aspects of fetal excess or amniotic fluid excess (P < 0. 05). There was no significant difference in delivery times, delivery mode, HBV surface antigen carrying, history of repeated Candida cerevisiae infection among groups (P > 0. 05). 4. By multivariate Logistic regression analysis, the body mass index before pregnancy, gestational age, and so on were not significantly different (P > 0. 05). Seven risk factors, including the frequency of pregnancy, the history of bad pregnancy and labor, the history of macrosomia or amniotic fluid, and the history of polycystic ovary syndrome (PCOS) were all included in the regression model, and the regression coefficients were 1.334n0.520- 0.8131.580- 1.709U 1.513130.262. Conclusion the results of multivariate Logistic regression showed that: body mass index (BMI), age of pregnancy, history of bad pregnancy and labor, history of macrosomia or amniotic fluid overproduction. The history of polycystic ovary syndrome (PCOS) is an independent risk factor of GDM under the new diagnostic criteria. The level of CRP is positively correlated with the onset of GDM under the new diagnostic criteria. In the family history of diabetes, the factors such as gestational excess or amniotic fluid were not included in the regression model, which may be the mixed factor of GDM.
【學(xué)位授予單位】：河南中醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R714.256
本文編號(hào)：2161842
[Abstract]:Objective: to investigate the risk factors of (gestational diabetes mellitusus in gestational diabetes mellitus (GDM) under the new diagnostic criteria, and the correlation between C-reactive and GDM, so as to provide early intervention for the risk factors of GDM. In order to prevent GDM and long-term complications to provide a certain evidence-based basis, comply with the concept of "cure disease", for the establishment of traditional Chinese medicine characteristics of perinatal health care model to provide a reference. Methods: a cross-sectional investigation was carried out on pregnant women with single pregnancy during 28 weeks of pregnancy during the first affiliated Hospital of Henan College of traditional Chinese Medicine from April 2013 to February 2014, with regular perinatal health care examination. 91 pregnant women who met the diagnostic criteria of GDM were selected as observation group, and 91 healthy pregnant women in the same period of perinatal care were selected as control group from 179 complete questionnaires. The subjects were investigated by GDM epidemiological questionnaire (see Appendix 1). The results were recorded in SPSS and database was established. SPSS18.0 statistical software was used to analyze the counting data by 蠂 2 test, the measurement data was analyzed by t test, the normal distribution test was carried out for the measurement data, and the single sample k-s test method was used, if it was normal distribution, Then the t-test method of two independent samples and the non-parametric test method of two independent samples are carried out. Logistic regression analysis was used to study the multiple factors. Results in the observation group and control group, the diet preference, body mass index (BMI) before pregnancy, age of pregnancy, weight increase of OGTT at the first gestational age, family history of diabetes mellitus (GDM), history of bad pregnancy and delivery, pregnancy times, macrosomia or amniotic fluid excess delivery history were observed in the observation group and the control group. History of polycystic ovary syndrome, There was significant difference in CRP level between the observation group and the control group (P < 0. 05). 3 there was significant difference between the observation group and the control group in the level of occupation, education and culture, and there was significant difference between the pregnancy group and the control group in the aspects of fetal excess or amniotic fluid excess (P < 0. 05). There was no significant difference in delivery times, delivery mode, HBV surface antigen carrying, history of repeated Candida cerevisiae infection among groups (P > 0. 05). 4. By multivariate Logistic regression analysis, the body mass index before pregnancy, gestational age, and so on were not significantly different (P > 0. 05). Seven risk factors, including the frequency of pregnancy, the history of bad pregnancy and labor, the history of macrosomia or amniotic fluid, and the history of polycystic ovary syndrome (PCOS) were all included in the regression model, and the regression coefficients were 1.334n0.520- 0.8131.580- 1.709U 1.513130.262. Conclusion the results of multivariate Logistic regression showed that: body mass index (BMI), age of pregnancy, history of bad pregnancy and labor, history of macrosomia or amniotic fluid overproduction. The history of polycystic ovary syndrome (PCOS) is an independent risk factor of GDM under the new diagnostic criteria. The level of CRP is positively correlated with the onset of GDM under the new diagnostic criteria. In the family history of diabetes, the factors such as gestational excess or amniotic fluid were not included in the regression model, which may be the mixed factor of GDM.
【學(xué)位授予單位】：河南中醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R714.256
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