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目的探讨妊娠合并糖尿病与肾功能损害的关系。方法住院待产单胎妊娠孕妇645例分为五组:正常妊娠孕妇(A组,100例),妊娠期糖尿病(GDM)(B组,247例),糖尿病合并妊娠(C组,36例),子痫前期合并GDM(D组,82例),子痫前期(E组,180例)。检测并比较五组孕妇的血清肌酐(SCr)、尿素氮(BUN)、尿酸(UA)和肾小球滤过率(GFR)。结果 E组、D组的UA、SCr高于其他三组,GRF低于其他三组(P<0.05);C组的UA高于B组和A组(P<0.05)。E组、D组出现肾功能损害(GFR<90ml·min-1·1.73m-2)的发生率高于其他三组(P<0.05);E组BUN异常的发生率高于其他四组(P<0.05)。结论妊娠期肾功能的损害主要源于子痫前期,而非糖尿病。UA和GFR是临床监测肾功能较为敏感的指标。
Objective To investigate the relationship between pregnancy complicated with diabetes and renal dysfunction. Methods One hundred and sixty-five pregnant women with singleton pregnancy were divided into five groups: normal pregnant women (group A, n = 100), gestational diabetes mellitus (group B, 247), diabetes mellitus complicated with pregnancy (group C, n = 36) Preeclampsia with GDM (D group, 82 cases), preeclampsia (E group, 180 cases). The serum creatinine (SCr), blood urea nitrogen (BUN), uric acid (UA) and glomerular filtration rate (GFR) of five pregnant women were detected and compared. Results The UA and SCr of group E and group D were higher than those of the other three groups, while the GRF was lower than the other three groups (P <0.05). The UA of group C was higher than that of group B and group A (P <0.05). The incidence of renal dysfunction (GFR <90ml · min-1 · 1.73m-2) in group E and group D was higher than that in the other three groups (P <0.05). The incidence of abnormal BUN in group E was higher than that in the other four groups P <0.05). Conclusion The damage of renal function in pregnancy mainly comes from preeclampsia, but not diabetes. UA and GFR are clinical indicators of renal function more sensitive.