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目的探讨妊娠期糖尿病(GDM)母亲所生新生儿肾功能的变化,加强对GDM母亲所生新生儿并发症的认识,从而提高GDM母亲所生新生儿的生活质量。方法选取2009年3月-2010年9月山东大学附属省立医院新生儿科收治的GDM母亲所生新生儿45例作为观察组。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GDM母亲所生新生儿45例作为对照组。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。研究对象均于出生72 h内采集空腹外周静脉血,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(β2-MG)、BUN、肌酐(CREA)水平,观察各检测指标变化。结果观察组BUN、CREA水平与对照组比较均无统计学差异(Pa>0.05),血清Cys-C、β2-MG均较对照组升高(Pa<0.05);观察组早产儿、足月儿Cys-C、β2-MG水平均较对照组显著升高(Pa<0.05),而观察组早产儿和足月儿间Cys-C、β2-MG水平比较均无统计学差异(Pa>0.05);观察组巨大儿和非巨大儿Cys-C、β2-MG水平均较对照组升高(Pa<0.05),观察组巨大儿与非巨大儿间Cys-C、β2-MG水平均无统计学差异(Pa>0.05)。结论 GDM母亲所生新生儿较非GDM母亲所生新生儿血清Cys-C与β2-MG水平升高,GDM母亲所生新生儿可能存在早期肾功能损害,且不受胎龄、体质量影响。
Objective To explore the changes of renal function in newborn infants with gestational diabetes mellitus (GDM) and to enhance the understanding of neonatal complications of GDM mothers so as to improve the quality of life of neonates born of GDM mothers. Methods From March 2009 to September 2010, 45 newborns born to GDM mothers admitted to neonatology department of Shandong Provincial Affiliated Provincial Hospital were selected as the observation group. 23 males and 22 females; 25 preterm children, 20 full-term infants; macrosomia in 20 cases, non-macrosomia in 25 cases. Forty-five neonates born from non-GDM mothers born in the same period were selected as the control group. There were 21 males and 24 females, 18 premature children and 27 full-term children, 22 macrosomia and 23 non-macrosomia children. Fasting peripheral venous blood was collected within 72 hours of birth in all subjects. Serum levels of cystatin C (Cys-C), β2 microglobulin (β2-MG), BUN and creatinine were detected by Guangzhou OLYMPUS-AU5400 automatic biochemistry analyzer CREA) levels were observed changes in the detection indicators. Results The levels of BUN and CREA in the observation group were not significantly different from those in the control group (P> 0.05), while the levels of Cys-C and β2-MG in the observation group were higher than those in the control group (P <0.05) Cys-C, β2-MG levels were significantly higher than those in the control group (P <0.05), while there was no significant difference in the Cys-C and β2-MG levels between the observation group and the term infants . The levels of Cys-C and β2-MG in the macrosomia and non-macrosomia groups in the observation group were higher than those in the control group (P0.05). There was no statistical difference in the levels of Cys-C and β2-MG between the macrosomia and non- Difference (Pa> 0.05). Conclusion The serum levels of Cys-C and β2-MG in neonates born to GDM mothers are higher than those in non-GDM mothers. Neonates born to GDM mothers may have early renal impairment and are not affected by gestational age or body weight.