炎症因子水平在妊娠期糖尿病护理中的作用
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摘要
目的探讨炎症因子水平在妊娠期糖尿病(GDM)护理中的作用。方法选取2016年1月～2017年12月在我院行剖宫产的90例孕妇作为研究对象,其中60例为GDM患者,随机分为实验一组和实验二组,每组各30例,选择同期30例糖耐量正常者为对照组。实验一组通过饮食控制血糖理想,实验二组通过饮食控制血糖不理想需加用胰岛素治疗。比较三组孕妇的外周血中超敏C-反应蛋白(hs-CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、趋化素(Chemerin)、血糖及胰岛素水平;采用胰岛素稳态模型(HOMA-IR)评估胰岛素的敏感性。结果实验一组和二组孕妇血清中的hs-CRP、IL-6、TNF-α、Chemerin、血糖、胰岛素及HOMA-IR水平明显高于对照组,差异均有统计学意义(P<0.05);实验二组血清中的hs-CRP、IL-6、TNF-α、Chemerin、血糖、胰岛素及HOMA-IR水平与实验一组比较,差异无统计学意义(P>0.05)。结论检测孕妇hs-CRP、IL-6、TNF-α、Chemerin、血糖及胰岛素水平,可以及时发现GDM,对GDM的预防、控制、护理及预后都有着重要的意义,值得在临床中推广应用。
Objective To explore the role of inflammatory factors in the nursing of gestational diabetes mellitus(GDM).Methods Ninety pregnant women who underwent cesarean section in our hospital from January 2016 to December 2017 were selected as the study subjects, sixty of them were GDM patients, they were randomly divided into experimental group and experimental group, with 30 cases in each group, and 30 cases with normal glucose tolerance in the same period were selected as the control group. The control of blood sugar by diet in the experimental group was ideal, while the control of blood sugar by diet in the experimental group was unsatisfactory. Insulin therapy was needed in the experimental group. The levels of hypersensitive C-reactive protein(hs-CRP), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), chemerin, blood sugar and insulin in peripheral blood of three groups of pregnant women were compared, and insulin sensitivity was evaluated by insulin homeostasis model(HOMA-IR). Results The levels of hs-CRP,IL-6, TNF-α, Chemerin, blood sugar, insulin and HOMA-IR in the serum of pregnant women in the experimental group and the two groups were significantly higher than those in the control group, the differences were statistically significant(P<0.05). There was no significant difference in the levels of hs-CRP, IL-6, TNF-a, Chemerin, blood sugar,insulin and HOMA-IR between the experimental group and the experimental group(P>0.05). Conclusion Detecting the levels of hs-CRP, IL-6, TNF-α, Chemerin, blood sugar and insulin in pregnant women can detect GDM in time, which is of great significance to the prevention, control, nursing and prognosis of GDM, and is worthy of popularization and application in clinic.
Objective To explore the role of inflammatory factors in the nursing of gestational diabetes mellitus(GDM).Methods Ninety pregnant women who underwent cesarean section in our hospital from January 2016 to December 2017 were selected as the study subjects, sixty of them were GDM patients, they were randomly divided into experimental group and experimental group, with 30 cases in each group, and 30 cases with normal glucose tolerance in the same period were selected as the control group. The control of blood sugar by diet in the experimental group was ideal, while the control of blood sugar by diet in the experimental group was unsatisfactory. Insulin therapy was needed in the experimental group. The levels of hypersensitive C-reactive protein(hs-CRP), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), chemerin, blood sugar and insulin in peripheral blood of three groups of pregnant women were compared, and insulin sensitivity was evaluated by insulin homeostasis model(HOMA-IR). Results The levels of hs-CRP,IL-6, TNF-α, Chemerin, blood sugar, insulin and HOMA-IR in the serum of pregnant women in the experimental group and the two groups were significantly higher than those in the control group, the differences were statistically significant(P<0.05). There was no significant difference in the levels of hs-CRP, IL-6, TNF-a, Chemerin, blood sugar,insulin and HOMA-IR between the experimental group and the experimental group(P>0.05). Conclusion Detecting the levels of hs-CRP, IL-6, TNF-α, Chemerin, blood sugar and insulin in pregnant women can detect GDM in time, which is of great significance to the prevention, control, nursing and prognosis of GDM, and is worthy of popularization and application in clinic.
引文
[1]李会琴,刘云,任利容.妊娠期糖尿病的流行病学调查分析[J].中国妇幼保健,2015,30(11):1744-1746.
[2]关怀,尚丽新.妊娠期糖尿病流行现状[J].中国实用妇科与产科杂志,2015,31(1):91-94.
[3]张丹丹,高琴,白帆,等.妊娠期糖尿病孕妇产后血糖异常的影响因素调查[J].中国计划生育学杂志,2015,23(6):376-379.
[4]赵建峰,张华新,宋玉林.妊娠期糖尿病与胰岛素抵抗关系的临床研究[J].生殖医学杂志,2015,24(2):120-124.
[5]叶兰,王梅,杨祖菁.脂肪细胞因子瘦素、脂联素及趋化素与胰岛素抵抗及妊娠期糖尿病的关联研究[J].现代中西医结合杂志,2015,24(2):136-139.
[6]崔淑娟,张晶,马艳芬,等.血清GA、ADP、RBP4、Hcy与妊娠糖尿病胰岛素抵抗的相关性研究[J].疑难病杂志,2016,15(4):401-404.
[7]蒋新华.个体化营养膳食在妊娠期糖尿病中的应用[J].广东医学,2014,35(1):125-127.
[8]孙翀,刘淑霞.妊娠期糖尿病患者血糖控制效果对母婴结局影响的观察[J].中国糖尿病杂志,2014,22(5):401-403.
[9]吴佳秋.护理干预对妊娠期糖尿病患者母婴结局的影响研究[J].中国妇幼保健,2014,29(12):1845-1847.
[10]王雅萍,王红晔,徐友娣.妊娠期糖尿病最新诊断标准对妊娠结局的影响[J].山东医药,2014,54(4):68-70.
[11]侯雪晶,孙燕,陈秀英.妊娠期糖尿病与肥胖症、炎症因子、25-(OH)D3和胰岛素抵抗的关系[J].中国热带医学,2016,16(3):262-265.
[12]李小梅,任利容,卫炎星,等.新型脂肪因子对妊娠期糖尿病胰岛素抵抗的影响[J].河北医学,2011,17(6):794-796.
[13]金玲玲.妊娠期糖尿病发病的相关影响因素分析[J].中国妇幼保健,2014,29(30):4973-4975.
[14]霍琰,刘素新,冯静,等.内脂素在妊娠期糖尿病发病中的作用及其与胰岛素抵抗的关系[J].中华妇产科杂志,2014,49(8):584-587.
[15]潘宝龙,马润玫.血清脂肪因子omentin-1、chemerin的水平与妊娠期糖尿病的相关性[J].南方医科大学学报,2016,36(9):1231-1236.
[2]关怀,尚丽新.妊娠期糖尿病流行现状[J].中国实用妇科与产科杂志,2015,31(1):91-94.
[3]张丹丹,高琴,白帆,等.妊娠期糖尿病孕妇产后血糖异常的影响因素调查[J].中国计划生育学杂志,2015,23(6):376-379.
[4]赵建峰,张华新,宋玉林.妊娠期糖尿病与胰岛素抵抗关系的临床研究[J].生殖医学杂志,2015,24(2):120-124.
[5]叶兰,王梅,杨祖菁.脂肪细胞因子瘦素、脂联素及趋化素与胰岛素抵抗及妊娠期糖尿病的关联研究[J].现代中西医结合杂志,2015,24(2):136-139.
[6]崔淑娟,张晶,马艳芬,等.血清GA、ADP、RBP4、Hcy与妊娠糖尿病胰岛素抵抗的相关性研究[J].疑难病杂志,2016,15(4):401-404.
[7]蒋新华.个体化营养膳食在妊娠期糖尿病中的应用[J].广东医学,2014,35(1):125-127.
[8]孙翀,刘淑霞.妊娠期糖尿病患者血糖控制效果对母婴结局影响的观察[J].中国糖尿病杂志,2014,22(5):401-403.
[9]吴佳秋.护理干预对妊娠期糖尿病患者母婴结局的影响研究[J].中国妇幼保健,2014,29(12):1845-1847.
[10]王雅萍,王红晔,徐友娣.妊娠期糖尿病最新诊断标准对妊娠结局的影响[J].山东医药,2014,54(4):68-70.
[11]侯雪晶,孙燕,陈秀英.妊娠期糖尿病与肥胖症、炎症因子、25-(OH)D3和胰岛素抵抗的关系[J].中国热带医学,2016,16(3):262-265.
[12]李小梅,任利容,卫炎星,等.新型脂肪因子对妊娠期糖尿病胰岛素抵抗的影响[J].河北医学,2011,17(6):794-796.
[13]金玲玲.妊娠期糖尿病发病的相关影响因素分析[J].中国妇幼保健,2014,29(30):4973-4975.
[14]霍琰,刘素新,冯静,等.内脂素在妊娠期糖尿病发病中的作用及其与胰岛素抵抗的关系[J].中华妇产科杂志,2014,49(8):584-587.
[15]潘宝龙,马润玫.血清脂肪因子omentin-1、chemerin的水平与妊娠期糖尿病的相关性[J].南方医科大学学报,2016,36(9):1231-1236.