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目的:探讨非贫血孕妇妊娠早期红细胞参数与妊娠糖尿病(GDM)发生的相关性,为临床早期预测妊娠糖尿病提供有效的参考手段。方法:采用前瞻性研究方法,选择2012年7月1日-2012年12月31日在本院完成产前检查并住院分娩且资料完整符合条件的1 342例妊娠妇女作为研究对象,所有孕妇在初次产检时登记其妊娠5-13+6周之间血常规检查的红细胞参数值,于妊娠24-28周产检时进行75 g糖耐量试验(OGTT),根据妊娠14周前血红蛋白(Hb)第25、50、75位百分位数水平将孕妇分为4组:A组(≤P25)、B组(P25-P50)、C组(P50-P75)以及D组(≥P75),分析GDM与孕妇妊娠14周前血红蛋白(Hb)、红细胞计数(RBC)、红细胞压积(HCT)之间的关系;并研究导致GDM的独立相关危险因素。结果:D组GDM发生率明显高于其他3组(P<0.05);而RBC中C组与D组GDM发生率分别高于A组、B组,差异均有统计学意义(P<0.05);HCT中GDM发生率:B组、C组以及D组3组明显高于A组(P<0.05),但是B组、C组以及D组组间无统计学差异(P>0.05)。Logistic回归分析发现妊娠期14周前Hb(β=0.028,OR=1.032)、RBC(β=0.743,OR=2.286)和HCT(β=0.089,OR=1.107)水平是导致GDM发生的独立危险因素。结论:妊娠14周前不同红细胞参数水平与GDM发生率密切相关,随着Hb、RBC、HCT水平增加,GDM发生率也有增加;且Hb、RBC、HCT是导致GDM的独立危险因素,临床上可以作为GDM的早期预测指标。
Objective: To investigate the correlation between erythrocyte parameters and gestational diabetes mellitus (GDM) in non-anemic pregnant women in early pregnancy and to provide an effective reference for the early prediction of gestational diabetes. METHODS: A prospective study was conducted to select 1 342 pregnant women who completed prenatal examinations, hospitalized and delivered in our hospital from July 1, 2012 to December 31, 2012 and were fully qualified. All pregnant women were enrolled At the time of initial check-up, the erythrocyte parameter values of blood routine examination during 5-13 + 6 weeks of gestation were registered. The 75-g glucose tolerance test (OGTT) was performed at the time of 24-28 weeks gestation. According to the hemoglobin (Hb) At the level of 50, 50 and 75 percentiles, pregnant women were divided into 4 groups: group A (≤ P25), group B (P25-P50), group C (P50-P75) and group D (≥P75) And pregnant women 14 weeks before pregnancy hemoglobin (Hb), red blood cell count (RBC), hematocrit (HCT) the relationship between and to study the independent risk factors leading to GDM. Results: The incidence of GDM in group D was significantly higher than that in the other three groups (P <0.05). However, the incidence of GDM in group C and group D was higher than that in group A and group B, respectively (P <0.05) The incidence of GDM in HCT group was significantly higher than that in group A (P <0.05), but there was no significant difference between group B, group C and group D (P> 0.05). Logistic regression analysis showed that the levels of Hb (β = 0.028, OR = 1.032), RBC (β = 0.743, OR = 2.286) and HCT (β = 0.089, OR = 1.107) 14 weeks after gestation were the independent risk factors for GDM . CONCLUSIONS: The levels of different erythrocyte parameters before 14 weeks gestation are closely related to the incidence of GDM. With the increase of Hb, RBC and HCT levels, the incidence of GDM also increases. Hb, RBC and HCT are independent risk factors for GDM. Clinically, As an early predictor of GDM.