孕母糖代谢状况对早产儿早期胰岛功能的影响

发布时间：2018-06-24 03:06

本文选题：妊娠期糖尿病 + 早产儿　；参考：《天津医科大学》2014年硕士论文

【摘要】：目的： 1.分析孕母糖代谢异常对早产儿头围、身长、体质量等指标的影响。 2.分析孕母糖代谢异常对早产儿血糖、胰岛素原、胰岛素和C-肽等胰岛功能指标影响,并探讨监测早产儿胰岛功能的敏感指标。 3.通过血糖、胰岛素原、胰岛素和C-肽评估孕母糖代谢异常早产儿胰岛功能。方法：将2012年3月至12月住新生儿重症监护病房的82例早产儿分为两组：母亲孕期糖代谢异常组(35例)和母亲孕期糖代谢正常组(47例),分别测量两组早产儿的体格发育指标(头围、身长和体质量)和监测相关胰岛功能的指标(空腹血糖FPG、胰岛素、C-肽和胰岛素原),并比较胰岛β细胞功能(胰岛素抵抗指数insulin resistance index IR、空腹β细胞功能指数fasting β-cell function index FBCI和胰岛素敏感指数insulin sensitivity index IAI)。结果： 1.正常组和异常组早产儿母亲的孕前和产前体质量指数(BMI)比较显示：异常组母亲的孕前和产前BMI均高于正常组母亲(P0.05),但母亲孕期增加体质量的差异无统计学意义(P0.05)； 2.正常组和异常组早产儿的体格发育指标比较显示：异常组早产儿出生时体质量和头围及生后7天的体质量均高于正常组,差异有统计学意义(P0.05),但出生时两组早产儿胎龄和身长的差异无统计学意义； 3.正常组和异常组早产儿生化指标比较显示：异常组早产儿出生时和生后7天胰岛素原及生后7天C-肽水平均高于正常,差异有统计学意义(P0.05)；两组早产儿出生时和生后7天的血糖、胰岛素及出生时C-肽水平的差异无统计学意义(P0.05)； 4.正常组和异常组早产儿出生时和生后7天的IR、FBCI和IAI比较显示,两组结果差异无统计学意义(P0.05)。 5.母亲孕期血糖、早产儿FBCI与相关指标的相关性和多元回归分析显示：母亲孕期血糖与母亲孕前BMI、产前BMI、早产儿出生时胰岛素、C-肽和FBCI,呈正相关性(P0.05),其中母亲产前BMI和早产儿出生时胰岛素为独立危险因素。早产儿FBCI与母亲血糖呈正相关性,与母亲孕前BMI和产前BMI无相关性,母亲血糖为FBCI的独立危险因素。 6.早产儿出生时胰岛素原与其出生时胎龄、体重、头围和身长无相关性；早产儿胰岛β细胞功能与早产儿出生时胎龄、体重、头围和身长无相关性；早产儿胰岛素原与其胰岛β细胞无相关性；早产儿血糖与母亲孕前BMI、产前BMI和孕期血糖无相关性；结论： 1.母亲孕期血糖异常组与正常组相比,早产儿出生时和生后7天的胰岛素原较正常组增高,表明母亲血糖异常组的早产儿存在不同程度的胰岛β细胞功能损伤,提示异常组早产儿日后可能发生不同程度的糖耐量损伤。 2.母亲孕期血糖与母亲孕前BMI、产前BMI、早产儿C-肽、胰岛素和FBCI呈显著正相关性,产前BMI和早产儿胰岛素为其独立危险因素,提示母亲需控制体重、合理体重增长,否则易发生糖耐量受损,影响胎儿宫内胰岛细胞功能。 3.早产儿胰岛β细胞功能中FBCI与母亲孕期血糖呈显著正相关性,母亲血糖为其独立危险因素,提示母亲孕期血糖异常已在宫内影响早产儿的FBCI,故对整个孕期均需合理控制血糖,以免使胎儿胰岛细胞功能早期受损,乃至造成日后的异常。
[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 .
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R722.6

【参考文献】