摘要
目的探讨妊娠期糖尿病患者血脂、游离脂肪酸(FFA)水平与新生儿动脉血气、血乳酸(LAC)、心肌酶水平的变化。方法选取2019年7月至2020年7月在西安高新区医院定期体检与分娩且确诊的妊娠期糖尿病患者102例作为研究组,选取同期在本院进行定期体检的健康孕妇102名作为对照组,回顾性分析2组人群的资料。对2组人群的血脂、FFA、新生儿出生1h内的动脉血气指标、血乳酸、心肌酶相关指标进行检测。比较2组人群体质量指数、糖代谢指标、血常规、生化指标、新生儿动脉血气指标、LAC水平、心肌酶相关指标、生化指标情况。主要包括:谷草转氨酶(AST)、谷丙转氨酶(ALT)、血红蛋白(Hb)、白蛋白、肌酐、尿酸、尿素氮、纤维蛋白原(FIB)。分娩前对2组人群的糖代谢指标进行检测,主要有FFA、高密度脂蛋白胆固醇(HDL-C)、极低密度脂蛋白胆固醇(VLDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、总胆固醇(TC)、糖化血红蛋白(HbA1c);血钙(Ca)、血乳酸、二氧化碳分压(PaCO_(2))、动脉血pH值、血糖、剩余碱、氧分压,对新生儿对生化指标进行检测,主要有尿素氮、AST、ALT、ALB、Hb;同时对心肌酶相关指标进行检测,主要有乳酸脱氢酶(LDH)、肌酸激酶同工酶MB(CK-MB)、肌酸激酶(CK)。结果研究组体质量指数、HDL-C、VLDL-C、TG、TC、FFA、HbA1c高于对照组(P<0.05),研究组LDL-C小于对照组(P<0.05);研究组AST、ALT、红细胞压积(HCT)、血小板计数(PLT)、Hb、白蛋白(ALB)、肌酐(Cr)、尿酸(UA)、尿素氮(BUN)、FIB水平高于对照组(P<0.05);研究组新生儿出生体质量、血乳酸(LAC)、PaCO_(2)高于对照组(P<0.05),研究组新生儿1min Apgar评分、剩余碱、血糖、氧分压(PaO_(2))、pH值小于对照组新生儿(P<0.05);研究组新生儿CK、CK-MB、LDH、白蛋白、ALT、尿素氮、AST、Hb高于对照组新生儿(P<0.05),研究组Ca低于对照组新生儿(P<0.05)。结论妊娠期糖尿病患者存在糖代谢异常现象,且会对新生儿的物质代谢产生影响,会使新生儿的血乳酸水平发生变化,且存在潜在的心肌损伤。
Objective To investigate the changes in blood lipids,free fatty acid(FFA)in pregnant women with gestational diabetes and profiles of arterial blood gas,lactic acid(LAC)and myocardial enzymes in the newborns.Methods A total of 102 women with gestational diabetes diagnosed during regular checkup or delivery in Xi′an hightech hospital between July 2019 and July 2020 were enrolled as the study group.Another 102 healthy preg-nant women who underwent regular checkup in our hospital during the same period were enrolled as the control group.Demographic data in the two groups were retrospectively analyzed.The two groups were investigat-ed for levels of blood lipids,FFA,as well as arterial blood gas indicators,blood LAC,and myocardial enzymes in the newborn within one hour after birth.Comparisons were performed between the two groups on body mass in-dex(BMI),glucose metabolism,blood routine test,biochemistry,as well as the neonatal arterial blood gas index,LAC level,myocardial enzymes and biochemical indices that chiefly included aspartate aminotransferase(AST),alanine aminotrans(ALT),hemoglobin(Hb),albumin(ALB),creatinine(Cr),uric acid(UA),blood urea nitrogen(BUN),and fibrinogen(FIB).Before delivery,the glucose metabolism and blood lipids indicators tested for the two groups were FFA,high-density lipoprotein cholesterol(HDL-C),very low density lipoprotein cholesterol(VLDL-C),low density lipoprotein cholesterol(LDL-C),triglycerides(TG),total cholesterol(TC),gycated hemoglobin(HbA1c),blood calcium(Ca),LAC,partial pressure of carbon dioxide(PaO_(2)),arterial pH,blood sugar(GLU),alkaline sur-plus(BE),and oxygen partial pressure(PaO_(2));the biochemical indicators tested chiefly included BUN,AST,ALT,ALB,and Hb;the myocardial enzymes tested were lactate dehydrogenase(LDH),creatine kinase isoenzyme MB(CK-MB),and creatine kinase(CK).Results Compared with the control group,the study group showed higher values of BMI,HDL-C,VLDL-C,TG,TC,FFA,and HbA1c(P<0.05),lower LDL-C level(P<0.05),higher levels of AST,ALT,HCT,PLT,Hb,ALB,Cr,UA,BUN,and FIB(P<0.05).The newborn birth weight,LAC,and PaCO_(2) were higher in the study group than those in the control group(P<0.05).The Apgar score at 1 min,BE,GLU,PaO2,and pH were lower in the study group than those in the control group(P<0.05).The study group also had higher levels of CK,CK-MB,LDH,ALB,ALT,BUN,AST,and Hb compared with the control group(P<0.05).The Ca level in the study group was lower than that in the control group(P<0.05).Conclusion Abnormal glucose metabolism is present in patients with gestational diabetes.This can interfere with neonatal metabolism,leading to change in blood lactic acid levels and potential myocardial damage of the newborns.
作者
陈璐
张西艺
李维玲
陈媛媛
Chen Lu;Zhang Xiyi;Li Weiling;Chen Yuanyuan(Department of Obstetrics and Gynecology,Xi′an Hightech Hospital,Shaanxi 710075,China)
出处
《中国药物与临床》
CAS
2022年第2期123-126,共4页
Chinese Remedies & Clinics
关键词
糖尿病
妊娠
血脂异常
脂肪酸类
血气分析
婴儿
新生
Diabetes,gestational
Dyelipidemias
Fatty acids
Blood gas analysis
Infant,newboyn
