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目的:探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)妇女在孕晚期的血糖值对基础胎心率等各项参数的影响。方法:选取50例GDM妇女进行前瞻性研究,研究对象均为单胎、妊娠36～40周、无胎儿发育异常、既往无糖尿病史。在妊娠晚期用系统胎心监护仪进行60min以上的监护,同时在监护前即刻、监护进行后30min和60min分别抽取外周血检测血糖值,取3点的血糖平均值。结果:18例GDM妇女(36%)平均血糖值≥6.7mmol/L,平均基础胎心率为(141.7±17.6)bpm;32例GDM妇女(64%)平均血糖值<6.7mmol/L,平均基础胎心率为(128.2±19.1)bpm,两者之间有显著差异(P=0.015)。研究发现胎儿基础胎心率与孕妇血糖值呈明显正相关(P=0.0001,r=0.574);系统胎心监护所示的短程变异与孕妇血糖值呈明显负相关(P=0.003,r=-0.466)。系统胎心监护所示的其它指标与孕妇血糖值没有明显相关性。结论:GDM妇女孕晚期的血糖升高可使胎儿基础胎心率加快。
Objective: To investigate the effect of gestational diabetes mellitus (GDM) on the parameters of basal fetal heart rate in the third trimester of pregnancy. Methods: Fifty cases of GDM women were prospectively studied. All the subjects were singletons and had no history of fetal development from 36 to 40 weeks of gestation. In the third trimester of pregnancy with fetal heart rate monitor for more than 60min, while monitoring immediately before the care and 30min and 60min respectively, blood samples were drawn to detect blood glucose, blood sugar at 3:00 average. Results: The average blood glucose of 18 women with GDM (36%) was 6.7 mmol / L and the average fetal heart rate was (141.7 ± 17.6) bpm. The mean blood glucose of 32 women with GDM (64%) was <6.7 mmol / Basal fetal heart rate was (128.2 ± 19.1) bpm, a significant difference between the two (P = 0.015). The fetal fetal heart rate was significantly positively correlated with the blood glucose level of pregnant women (P = 0.0001, r = 0.574). The short - term variation of fetal fetal heart rate showed negative correlation with the blood glucose level of pregnant women (P = 0.003, r = 0.466). Other indicators of fetal heart rate monitoring showed no significant correlation with blood glucose levels in pregnant women. Conclusion: GDM women in the third trimester of pregnancy can increase the fetal heart rate fetal heart rate.