妊娠期糖尿病母亲新生儿肾功能变化
发布时间：2018-08-23 07:50
【摘要】：研究背景及目的： 妊娠期糖尿病(gestational diabetes mellitus, GDM)指妊娠首次发生或发现的引起不同程度糖代谢异常的疾病。妊娠期糖尿病作为一种复杂的代谢紊乱性疾病,可对孕妇及胎儿产生严重不良影响,尤其是导致患儿生后出现一系列近远期并发症。妊娠期糖尿病对胎儿的影响为多器官功能的障碍,其中包括神经系统、心脏功能、呼吸系统以及骨骼系统等,对胎儿生后长期的生活质量造成严重的不良影响。随着围生医学的不断研究与进步,对糖尿病婴儿的研究越来越广泛,但国内外对妊娠期糖尿病母亲新生儿并发症的研究鲜有涉及肾功能方面,所以本文选择检测肾功能常用指标血清光抑素C (cystatin C, Cys-C)、β2微球蛋白(β2-microglobuLin,β2-MG)、尿素氮(Blood urea nitrogen, BUN)与血肌酐(Creati nine, CREA)作为衡量标准,探讨妊娠期糖尿病母亲新生儿肾功能变化,增加对妊娠期糖尿病母亲新生儿并发症的认识,从而提高妊娠期糖尿病母亲新生儿的生活质量。 对象与方法： 1.实验对象： 选取2009年3月-2011年9月山东大学附属省立医院新生儿科收治的妊娠期糖尿病母亲新生儿45例作为实验组,其中男23例,女22例,早产儿25例,足月儿20例,巨大儿20例,非巨大儿25例。选取同期出生的非妊娠期糖尿病母亲新生儿45例作为对照组,其中男21例,女24例；早产儿18例,足月儿27例,巨大儿22例,非巨大儿23例。两组之间的性别差异无统计学意义(P0.05)。所有研究对象均无严重感染、高胆红素血症、窒息及新生儿缺氧缺血性脑病等影响糖代谢、肾功能的疾病,且排除双肾器质性病变。 2.实验方法： 所有研究对象均于出生72h内采取空腹外周静脉血,应用广州OLYMPUS-AU5400全自动生化分析仪检测血清胱抑素C (Cys-C)、β2微球蛋白(p2-MG)尿素氮(BUN)、肌酐(CREA)值,观察各检测指标变化。 结果 1.妊娠期糖尿病母亲新生儿血清BUN、CREA与对照组相比无明显差异(P0.05),血清Cys-C、β2-MG水平较对照组升高(P0.05)； 2.妊娠期糖尿病母亲新生早产儿组、足月儿组血清Cys-C、β2-MG水平较对照组升高(P0.05),而妊娠期糖尿病母亲新生早产儿组、足月儿组之间血清Cy s-C、β2-MG水平比较无明显差异(P0.05)； 3.妊娠期糖尿病母亲新生巨大儿组、非巨大儿组血清Cys-C、β2-MG水平较对照组升高(P0.05),而妊娠期糖尿病母亲新生巨大儿组与非巨大儿组之间血清Cys-C、β2-MG水平无明显差异(P0.05)。 结论 1.妊娠期糖尿病母亲新生儿血清Cys-C与β2-MG水平较非妊娠期糖尿病母亲新生儿水平升高,推断妊娠期糖尿病母亲新生儿存在早期肾功能损害。 2.妊娠期糖尿病母亲新生儿早期肾功能损害不受胎龄、体质量影响。
[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.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R722.1
本文编号：2198360
[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.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R722.1
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