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目的:研究饮食指导对妊娠期糖尿病(GDM)及妊娠期糖耐量低减(G IGT)的妊娠女性孕期血脂水平的影响。方法:将2001年1月~2002年1月在北京妇产医院定期进行产前检查并分娩的113例妊娠女性分为3组:正常妊娠组64例,GDM组22例及G IGT组27例。3组分别于孕早中期(28周前)、孕晚期(32~42周)及哺乳期(产后2月)测定母亲的血脂水平,对所有指标进行秩和检验、单因素方差分析及两两比较。结果:随着妊娠的进展,各组的血脂水平均有所增加,经统计学检验,均有显著性差异,但GDM、GIGT和正常妊娠组之间的血脂水平在各阶段并无显著性差异。结论:高脂血症是妊娠期脂类代谢的特点之一。在糖代谢异常的患者中,由于胰岛素(INS)相对不足或缺乏,患GDM及G IGT的妊娠女性其脂代谢紊乱本应进一步加重,但经积极的饮食指导可延缓脂代谢紊乱的发生。
Objective: To study the effects of dietary guidance on serum lipids in pregnant women with gestational diabetes mellitus (GDM) and gestational impaired glucose tolerance (GIGT). Methods: One hundred and seventy pregnant women who had regular antenatal examination and delivery during January 2001 to January 2002 in Beijing Maternity Hospital were divided into three groups: 64 in normal pregnancy group, 22 in GDM group and 27 in GIGT group . The levels of serum lipids in the three groups were measured in the first trimester of pregnancy (28 weeks before pregnancy), the third trimester of pregnancy (32 to 42 weeks) and the second lactation (February of postpartum). All the indexes were tested by rank sum test, one-way ANOVA and two- Compare Results: With the progress of pregnancy, blood lipid levels increased in all groups, and there was significant difference by statistical test. However, there was no significant difference in blood lipid levels between GDM, GIGT and normal pregnancy groups at all stages . Conclusion: Hyperlipidemia is one of the characteristics of lipid metabolism during pregnancy. In patients with abnormal glucose metabolism, pregnant women suffering from GDM and G IGT should further aggravate their lipid metabolism disorder due to the relative insufficiency or deficiency of insulin (INS). However, active dietary counseling may delay the onset of lipid metabolism disorders.