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目的观察应用地塞米松促胎肺成熟对糖耐量异常孕产妇及围生儿的影响。方法将1999年3月至2004年8月北京大学第四临床医院66例糖耐量异常的孕产妇根据是否应用地塞米松分为观察组(32例)和对照组(34例)。观察用药前后血糖、尿糖及尿酮体和胎心监护的变化,以及两组新生儿窒息、新生儿高胆红素血症的发生情况。结果孕妇在应用地塞米松3餐后2h血糖及尿糖均有明显升高(P<0·01),尿酮体于晚餐后及21时增多(P<0·01)。应用地塞米松期间12例出现胎心监护改变,停药后全部恢复正常。观察组新生儿高胆红素血症的发生率(50·00%)高于对照组(20·59%)(P<0·05)。结论地塞米松导致的糖代谢紊乱,可能对糖耐量异常孕产妇及围生儿产生不良影响,应用时必须加强监护。
Objective To observe the effect of dexamethasone on the development of fetal lung and fetal malnutrition in infants with impaired glucose tolerance. Methods From March 1999 to August 2004, 66 pregnant women with impaired glucose tolerance in the Fourth Clinical Hospital of Peking University were divided into observation group (32 cases) and control group (34 cases) according to whether dexamethasone was used or not. The changes of blood sugar, urine sugar, urine ketone bodies and fetal heart monitoring before and after treatment were observed, and the incidence of neonatal asphyxia and neonatal hyperbilirubinemia in both groups were observed. Results The levels of blood glucose and urine sugar in pregnant women were significantly increased 2 h after dexmethasone administration (P <0.01), and urine ketone bodies increased after dinner and 21 hrs (P <0.01). Dexamethasone during the application of 12 cases of fetal heart rate monitoring changes, all returned to normal after stopping. The incidence of neonatal hyperbilirubinemia in the observation group (50.00%) was higher than that in the control group (20.59%) (P <0.05). Conclusion Dexamethasone-induced glucose metabolism disorders may have adverse effects on impaired pregnant women and perinatals, and their monitoring must be strengthened.