孕妇糖代谢指标对原因不明的小于胎龄儿预测价值的分析

发布时间：2019-06-27 16:03

【摘要】：第一部分原因不明的SGA相关因素的临床分析研究目的：研究原因不明的SGA胎儿的相关因素以及与母体血糖的关系。材料和方法：收集2008年1月至2014年2月于珠海市人民医院分娩并且孕期规律产检的孕妇病历资料，根据新生儿的出生体重，分为SGA组和AGA组。结果： 1.两组孕妇的产次，，身高，孕期增重没有统计学意义(P＞0.05)，孕妇的年龄，孕次，孕前的BMI有统计学意义(P0.05)。两组学历构成比较：x2=7.218，P＞0.05。两组新生儿一般情况均没有统计学意义(P＞0.05)。 2.两组孕妇OGTT血糖结果可见：空腹血糖有统计学意义(P0.05)，OGTT1小时、2小时血糖没有统计学意义(P＞0.05)。结论： 1.孕妇孕前BMI较低和曾经多次妊娠因种种原因未生育的孕妇更易发生SGA； 2.空腹血糖较低的孕妇容易影响胎儿的生长发育。第二部分原因不明的SGA孕妇胰岛素敏感性变化及SGA的预测研究目的：探讨孕妇的部分糖代谢指标和原因不明的SGA之间可能存在的关系，并且评估这些参数与对SGA的预测能力并建立预测模型。材料和方法： 1.研究对象选定为不明原因SGA的孕妇，按照1：1的比例随机抽取同时期出生的体重符合孕周的胎儿归为AGA组； 2.检测两组孕妇OGTT血糖水平和各时相胰岛素水平，并计算QUICKI和OGIS数值。结果： 1. SGA组和AGA组的空腹血糖和空腹胰岛素有明显的统计学意义（P0.05），而口服葡萄糖后1小时、2小时的血糖和胰岛素都没有统计学意义（P＞0.05），胰岛素敏感性指标QUICKI和OGIS均有统计学意义（P0.05）。 2. Bayes判别方程：Y1=3.951（OGIS）+5.777(QUICKI)-6.863(空腹胰岛素)-1.746（2小时胰岛素）+2.458（空腹血糖）-11.097，Y2=1.401（OGIS）+3.691(QUICKI)-3.823(空腹胰岛素)-1.383（2小时胰岛素）+3.971（空腹血糖）-8.218 结论： 1、胰岛素敏感性增加似乎是造成不明原因的SGA的因素之一； 2、根据本研究建立的预测模型，对妊娠结局预测价值较高。
[Abstract]:Clinical Analysis of SGA-related Factors with Unknown Cause study entry : The related factors of the SGA fetus with unknown cause of the study and the maternal blood glucose . Material. and the method comprises the following steps of: collecting the data of the medical record of the pregnant woman who is delivered by the people's hospital in Zhuhai from January 2008 to February 2014 and the regular production test of the pregnant woman, and dividing the medical record information into the SGA group according to the birth weight of the newborn; and AG Group A. Results:1. There was no significant difference between the two groups of pregnant women (P> 0.05), the age of the pregnant women, the gestational age, and the BMI before the pregnancy. Significance (P0.05). Comparison of two groups of academic qualifications: x2 = 7.2 18, P> 0.05. There was no statistical difference between the two groups. (P> 0.05).2. The results of OGTT blood glucose in two groups were found to be statistically significant (P0.05). the significance of study (P> 0.05). Conclusion:1. The pre-pregnancy BMI of pregnant women is lower than that of previous pregnancies. The reason that SGA is more likely to occur in unproductive pregnant women;2. Fasting blood Pregnant women with lower sugar can easily influence the growth and development of the fetus. The second part is unknown. SGA pregnant women Objective: To study the relationship between the partial sugar metabolism index of pregnant women and the SGA with unknown causes, and to study the relationship between the changes of insulin sensitivity and the prediction of SGA. these parameters are evaluated and set up a predictive model for the prediction of SGA. Materials and methods:1. The study object is selected as a pregnant woman with a SGA of unknown origin, in accordance with 1:1 The weight of the born in the same period was randomly selected according to the proportion, and the fetus in the same period was classified as the AGA group;2. The OGTT blood of the two groups of pregnant women was detected. sugar level Results:1. The fasting blood glucose and fasting insulin in the SGA group and the AGA group were statistically significant (P0.05). The blood glucose and insulin in 2 hours were not statistically significant (P> 0.05). The insulin sensitivity index QUICKI and OGIS were both statistically significant (P0.05).2. The Bayes discriminant equation: Y1 = 3.951 (OGIS) + 5.777 (QUICKI)-6.863 (fasting insulin)-1.746 (2-hour insulin) + 2.458 (fasting blood glucose)-11.097, Y2 = 1.401 (OGIS) + 3.691 (QUICKI)-3.823 (fasting insulin )- 1.383 (2-hour insulin) + 3.971 (fasting blood glucose)-8 .218 Conclusion:1. The increase in insulin sensitivity appears to be a result of not
【学位授予单位】：暨南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714

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