| 许翔,刘新秀,陈玲,曾锦树,叶新鲜,黄小花,魏凌琳,包中涛.妊娠期糖尿病对孕妇产前及产后血管内皮功能影响的纵向研究[J].中国医学影像技术,2020,36(6): |
| 妊娠期糖尿病对孕妇产前及产后血管内皮功能影响的纵向研究 |
| Effect of gestational diabetes mellitus on endothelial function in antenatal and postpartum patients: A longitudinal study |
| 投稿时间：2019-09-13 修订日期：2020-06-15 |
| DOI： |
| 中文关键词: 妊娠期糖尿病 内皮功能 内皮依赖性血管扩张 |
| 英文关键词:Gestational diabetes mellitus Endothelium function Endothelium dependent vasodilatation |
| 基金项目:福建省卫生和计划生育委员会中青年骨干人才培养项目（2017-ZQN-49） |
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| 中文摘要: |
| 目的 探讨妊娠期糖尿病对孕妇产前及产后血管内皮功能的影响。 方法 2016年11月至2019年6月期间在我院产检并分娩,并分别在孕前、孕24-28周和产后12周后进行右侧肱动脉内皮依赖性血流介导血管扩张(flow-mediated dilation,FMD)检测的34名正常妊娠孕妇(对照组)和29名妊娠期糖尿病(Gestational diabetes mellitus,GDM)孕妇(研究组)纳入本次研究。对不同组间或同一组内不同时间点的FMD值差异性比较采用重复测量方差分析；不同组间相关指标的差异性比较采用独立样本T检验；对研究组FMD值变化趋势影响因素进行主成分分析。结果 两个组别组内不同时间点FMD值差异有统计学意义(P<0.05),呈先降后升趋势。两个组别间三个时间点FMD值总体水平差异有统计学意义(P<0.001)。不同组别各时间点患者的FMD值组间比较孕前基线水平差异无统计学意义(P>0.05),在晚孕期和产后12周两个时间点,对照组的FMD值和研究组的FMD值差异有统计学意义(P<0.05)。主成分分析显示,空腹血糖、服糖后2h血糖和舒张压对研究组FMD值变化趋势影响因素最大。 结论 妊娠期糖尿病对于血管内皮功能损伤很可能是不可逆性的；妊娠期糖尿病孕妇产后定期评估FMD值的变化可以作为筛查心脑血管病高危人群的重要手段。 |
| 英文摘要: |
| Objective To investigate the effect of gestational diabetes mellitus(GDM) on endothelial function in antenatal and postpartum patients. Methods From November 2016 to June 2019, 34 normal pregnant women (control group) and 29 gestational diabetes mellitus pregnant women (research group) examined by flow-mediated dilation (FMD) of the right brachial artery before pregnancy, during 24-28 weeks of gestation and after 12 weeks postpartum were included in this study. Repeated measurement variance analysis was used to compare the differences of FMD values between different groups or at different time points in the same group. Independent sample T test was used to compare the differences of related indicators between different groups. Principal component analysis was used to analyze the influencing factors of the change trend of FMD values in the study group. Results There were significant differences in FMD values between the two groups at different time points (P < 0.05), showing a trend of first decreasing and then rising. There was significant difference in FMD between the two groups at three time points (P < 0.001). There was no significant difference in FMD values between groups at different time points before pregnancy (P > 0.05). At Sthird trimester and 12 weeks after delivery, there was significant difference in FMD values between the control group and the study group (P < 0.05). Principal component analysis showed that fasting plasma sugar, 2 hours glucose during OGTT and diastolic blood pressure had the greatest influence on the change trend of FMD value in the study group. Conclusion Gestational diabetes mellitus may be irreversible for vascular endothelial dysfunction. Periodic assessment of FMD changes in pregnant women with gestational diabetes mellitus after delivery can be an important means of screening high-risk population of cardiovascular and cerebrovascular diseases. |
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