基于Logistic多因素回归分析糖尿病肾病患者发生贫血的影响因素分析及联合诊断模型构建

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目的 基于Logistic多因素回归分析探讨糖尿病肾病(DKD)患者发生贫血的独立影响因素,并构建诊断模型。方法 回顾性选取2020年1月—2025年8月我院收治的200例DKD患者,依据贫血发生情况,将患者分为贫血组(80例)与非贫血组(120例)。比较2组临床资料,采用Logistic多因素回归分析DKD患者发生贫血的影响因素,并构建DKD患者发生贫血的联合诊断模型。结果 贫血组糖尿病病程、肾病分期G3~G4患者占比、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、甘油三酯(TG)水平高于非贫血组,免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、白蛋白(ALB)、低密度脂蛋白胆固醇(LDL-C)水平低于非贫血组,差异有统计学意义(P<0.05);糖尿病病程(OR=1.723,95%CI:1.317~2.254)、肾病分期(OR=5.202,95%CI:2.338~11.573)、TNF-α(OR=2.861,95%CI:1.636~5.001)、hs-CRP(OR=2.073,95%CI:1.440~2.985)、IgM(OR=0.470,95%CI:0.331~0.667)、ALB(OR=0.533,95%CI:0.378~0.753)、TG(OR=3.016,95%CI:1.833~4.962)均为DKD患者发生贫血的影响因素,差异有统计学意义(P<0.05);基于Logistic回归分析构建联合诊断模型:Logit(P)=-0.218+0.544×糖尿病病程+1.649×肾病分期+1.051×TNF-α+0.729×hs-CRP+(-0.756)×IgM+(-0.629)×ALB+1.104×TG,经校准曲线和决策曲线检验显示,该模型诊断结果与实际预测结果具有较高一致性,且具有较高净获益。结论 糖尿病病程、肾病分期、TNF-α、hs-CRP、IgM、ALB、TG水平是DKD患者发生贫血的影响因素,临床应关注上述影响因素,以早期预防患者贫血的发生。

司美格鲁肽联合二甲双胍对2型糖尿病合并周围神经病变患者神经传导和炎症因子的影响

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目的:探讨司美格鲁肽联合二甲双胍对2型糖尿病合并周围神经病变(DPN)患者神经传导和炎症因子的影响。方法:选取64例DPN患者,分为研究组(n=32)和对照组(n=32)。对照组口服二甲双胍,研究组司美格鲁肽皮下注射联合口服二甲双胍。对比两组空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、腓总神经运动神经传导速度(CPN-MCV)、腓总神经感觉神经传导速度(CPN-SCV)、正中神经运动神经传导速度(MN-MCV)、正中神经感觉神经传导速度(MN-SCV)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及临床疗效。结果:治疗后,研究组FPG(7.47±1.16mmol/L vs. 8.20±1.22mmol/L)、2hPG(9.75±1.50mmol/L vs. 10.82±1.69mmol/L)及HbA1c(5.76±0.70% vs. 7.11±0.79%)较对照组降低(P<0.05)。研究组CPN-MCV(51.18±4.02m/s vs. 48.01±4.56m/s)、CPN-SCV(46.69±4.40m/s vs. 43.51±4.66m/s)、MN-MCV(46.79±3.53m/s vs. 43.42±4.68m/s)及(41.97±4.08m/s vs. 38.56±3.50m/s)较对照组升高(P<0.05)。研究组血清IL-6及TNF-α水平较对照组降低(P<0.05)。 研究组有效率高于对照组(96.87% vs. 78.12%,P<0.05)。结论:司美格鲁肽联合二甲双胍治疗DPN患者疗效确切,有助于改善神经传导功能,降低炎症因子表达。

脾肾阳虚型糖尿病肾病患者应用紫芪补肾汤联合达格列净治疗的效果及安全性分析

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目的 探讨紫芪补肾汤联合达格列净治疗脾肾阳虚型糖尿病肾病(DKD)患者的临床疗效,并分析其对糖代谢、肾功能的影响。方法 选取2024年9月~2025年9月于本院就诊的106例DKD患者为研究对象,按照随机数字表法将其分为对照组、研究组,各53例。对照组予以达格列净治疗,研究组予以紫芪补肾汤联合达格列净治疗,连续治疗2个月。统计对比两组临床疗效、不良反应及治疗前后中医证候积分、血糖及糖代谢指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、糖原合酶激酶-3β(GSK-3β)、缺氧诱导因子-1α(HIF-1α)]、肾功能相关指标[血尿素氮(BUN)、血肌酐(SCr)、尿微量白蛋白排泄率(UAER)、估算的肾小球滤过率(eGFR)、同型半胱氨酸(Hcy)、胱抑素C(CysC)、碳水化合物反应元件结合蛋白(ChREBP)]、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、肿瘤坏死因子1型受体(TNFR1)、趋化因子配体9(CXCL9)]、血管内皮功能[血管生成抑制蛋白-1(VASH-1)、血管内皮生长因子(VEGF)、内皮素-1(ET-1)、一氧化氮(NO)、血栓素B2(TXB2)]。结果 研究组总有效率为90.57%,明显高于对照组的73.58%(P<0.05);研究组治疗后中医证候积分低于对照组(P<0.05);研究组治疗后FPG、2 h PG、HbA1c、GSK-3β、HIF-1α水平低于对照组(P<0.05);研究组治疗后BUN、SCr、UAER、Hcy、CysC、ChREBP水平低于对照组,eGFR高于对照组(P<0.05);研究组治疗后血清TNF-α、IL-1β、TNFR1、CXCL9水平低于对照组(P<0.05);研究组治疗后VASH-1、NO水平高于对照组,VEGF、ET-1、TXB2水平低于对照组(P<0.05);两组不良反应比较无明显差异(P>0.05)。结论 紫芪补肾汤联合达格列净治疗DKD患者的疗效显著,可降低血糖水平,改善肾功能,抑制炎症反应,减轻血管内皮损伤,且具有一定安全性。

乙型肝炎病毒感染患者并发2型糖尿病风险因素分析

Analysis of Risk Factors for Type 2 Diabetes in Patients with Hepatitis B Virus Infection

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目的 分析乙型肝炎病毒(HBV)感染患者并发2型糖尿病(T2DM)相关风险因素。方法 研究收集2024年1月~2025年5月期间,于周口市传染病医院(周口市结核病防治所、周口市第五人民医院)接受治疗的HBV感染患者临床资料,共纳入患者95例,根据HBV感染后是否并发T2DM分组,合并T2DM患者纳入并发组(n=21),非合并T2DM患者纳入对照组(n=74),比较两组患者基线资料及实验室检查数据,逻辑回归分析HBV感染患者并发T2DM风险因素。结果 并发组年龄、体重指数(BMI)、甘油三酯(TG)高于对照组(P<0.05),年龄≥45岁、BMI肥胖、HBV感染时间≥6个月、TG≥1.7mmol/L、吸烟、乙型肝炎表面抗原(HBsAg)阳性及纤维化-4(FIB-4)指数≥2.67例数占比高于对照组(P<0.05)。年龄≥45岁[OR=21.599(95%CI:2.875-162.262)]、BMI(肥胖)[OR=16.729(95%CI:1.443-193.981)]、HBV感染时间≥6个月[OR=6.199(95%CI:1.101-34.904)]、吸烟[OR=9.429(95%CI:1.344-66.141)]、TG≥1.7mmol/L[OR=71.834(95%CI:7.060-730.897)]是HBV感染患者并发T2DM危险因素(P<0.05)。结论 HBV感染患者并发T2DM受人口学特征年龄、BMI、临床病程HBV感染时间、共病血脂异常及生活方式吸烟的共同影响。
Abstract: Objective To analyze risk factors associated with the development of type 2 diabetes mellitus (T2DM) in patients with hepatitis B virus (HBV) infection. Methods Clinical data were collected from HBV-infected patients treated at the Zhoukou City Infectious Disease Hospital (Zhoukou City Tuberculosis Prevention and Control Institute)between January 2024 and May 2025. A total of 95 patients were included in the study, Patients were grouped based on the presence or absence of T2DM following HBV infection. Patients with T2DM were included in the T2DM group (n=21), while those without T2DM were included in the control group (n=74). Baseline characteristics and laboratory test data were compared between the two groups, and logistic regression analysis was performed to identify factors associated with the development of T2DM in HBV-infected patients. Results The age, body mass index (BMI), and triglycerides (TG) in the intervention group were higher than those in the control group (P < 0.05); The proportion of cases with age ≥45 years, obese BMI, HBV infection duration ≥6 months, TG ≥1.7 mmol/L, smoking, hepatitis B surface antigen (HBsAg) positivity, and a FIB-4 score ≥2.67 was higher than that in the control group (P < 0.05). Age ≥ 45 years [OR = 21.599 (95% CI: 2.875–162.262)], BMI (obesity) [OR = 16.729 (95% CI: 1.443–193.981)], duration of HBV infection ≥ 6 months [OR = 6.199 (95% CI: 1.101–34.904)], smoking [OR=9.429 (95% CI: 1.344–66.141)], and TG ≥ 1.7 mmol/L [OR=71.834 (95% CI: 7.060–730.897)] were risk factors for T2DM in patients with HBV infection (P < 0.05). Conclusion The development of T2DM in patients with HBV infection is influenced by a combination of demographic factors (age and BMI), clinical course (duration of HBV infection), comorbid dyslipidemia, and lifestyle factors (smoking).

基于圆运动和五脏相关理论探讨2型糖尿病的病因病机与治疗

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2型糖尿病(T2DM)作为临床常见代谢性疾病,其病机阐释多从“阴虚燥热”立论,然临证所见,单纯养阴清热往往难收全功。本文尝试以彭子益圆运动理论“中气如轴,四维如轮,轴运轮行,轮运轴灵”为核心框架,结合五脏相关、气机升降、气化失常理论,重新阐释T2DM的病因病机:认为脾胃中气亏虚、枢机失运是发病之本,肝木失疏、肺金失降、心火失敛、肾水失藏为四维轮动失常之标,痰、湿、瘀、热为病理产物,共同导致“一气周流”失圆、精微不布、血糖失稳。治疗以复圆为纲,提出“运轴复轮、轴轮并调、标本同治”的核心治法,分阶段、分脏腑辨证施治,兼顾气机升降与气化功能,为T2DM的中医诊疗提供新的理论视角与临床思路。

基于圆运动和五脏相关理论探讨2型糖尿病的病因病机与治疗

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2型糖尿病(T2DM)作为临床常见代谢性疾病,其病机阐释多从“阴虚燥热”立论,然临证所见,单纯养阴清热往往难收全功。本文尝试以彭子益圆运动理论“中气如轴,四维如轮,轴运轮行,轮运轴灵”为核心框架,结合五脏相关、气机升降、气化失常理论,重新阐释T2DM的病因病机:认为脾胃中气亏虚、枢机失运是发病之本,肝木失疏、肺金失降、心火失敛、肾水失藏为四维轮动失常之标,痰、湿、瘀、热为病理产物,共同导致“一气周流”失圆、精微不布、血糖失稳。治疗以复圆为纲,提出“运轴复轮、轴轮并调、标本同治”的核心治法,分阶段、分脏腑辨证施治,兼顾气机升降与气化功能,为T2DM的中医诊疗提供新的理论视角与临床思路。
论著

残余胆固醇对糖尿病合并冠心病患者心力衰竭的预测价值

The predictive value of residual cholesterol for heart failure in patients with diabetes and coronary heart disease

:1745-1753
 
      目的   残余胆固醇(RC)是反映动脉粥样硬化性血脂异常的重要指标,其在糖尿病合并冠心病患者中的临床意义尚不明确。本研究旨在探讨RC水平对糖尿病合并冠心病患者心力衰竭风险的预测价值,并分析其相关性。方法   本研究为回顾性横断面研究,纳入2021年1月—2024年1月期间在鹤壁市人民医院接受诊治的292例糖尿病合并冠心病患者。根据是否存在心力衰竭分为心力衰竭组(128例)和无心力衰竭组(164例)。对基线特征进行比较,采用单因素和多因素Logistic回归分析RC与心力衰竭的相关性。同时,通过限制性立方样条(RCS)分析探讨RC与心力衰竭风险的线性关系,并通过受试者操作特征(ROC)曲线和曲线下面积(AUC)评估RC的预测价值。结果   心力衰竭组患者的男性比例、高血压患病率、RC水平等高于无心力衰竭组,而估算肾小球滤过率水平显著降低(P<0.05)。单因素分析显示,RC>0.7 mmol/L显著增加心力衰竭风险(OR=1.854,95%CI:1.161~2.960,P=0.010)。多因素Logistic回归分析中,全调整模型结果显示,RC作为分类变量时,RC>0.7 mmol/L的患者心力衰竭风险显著增加1.891倍(OR=1.891,95%CI:1.047~3.415,P=0.035);作为连续变量时,RC每增加1单位,心力衰竭风险增加2.464倍(OR=2.464,95%CI1.495~4.064,P<0.001);Log10RC的风险比为6.411(95%CI:2.246~18.302,P=0.001);标化RC的风险比为1.687(95%CI:1.262~2.255,P<0.001)。限制性立方样条分析表明RC与心力衰竭风险呈线性正相关,ROC分析显示RC预测心力衰竭的AUC为0.621(95%CI:0.555~0.687,P<0.001)。结论  RC水平与糖尿病合并冠心病患者心力衰竭风险显著相关,且呈线性正相关。RC具有一定的预测价值,可作为该人群心力衰竭风险评估的潜在指标。
       Objective  Residual cholesterol(RC)is  an important marker  reflecting  dyslipidemia  associated with atherosclerosis.Its clinical significance in patients with diabetes and coronary heart disease(CHD)remains unclear.To explore the predictive value of RC level for the risk of heart failure(HF)in patients with diabetes and CHD and analyze their association.Methods  This retrospective cross-sectional study included 292 patients with diabetes and CHD who were treated at Hebi People’s Hospital between January 2021 and January 2024.Patients were divided into the HF group(128 cases)and the non-HF group(164 cases)based on the presence of HF.Baseline characteristics were compared,and univariate and multivariate Logistic  regression analyses were performed to assess the association between RC and HF.Additionally,restricted cubic spline(RCS)analysis was used to explore the linear relationship between RC and HF risk,and the predictive value of RC was evaluated using receiveroperating characteristic(ROC)curves and the area under the curve(AUC).Results  The HF group had significantly higher proportions of males,hypertension prevalence and RC levels,while estimated glomerular filtration rate were significantly lower compared to the non-HF group(P<0.05).Univariate analysis showed that RC>0.7 mmol/L significantly increased the risk of HF(OR=1.854,95%CI:1.161–2.960,P=0.010).In the fully adjusted multivariate Logistic regression model,RC(RC>0.7 mmol/L)was associated with a 1.891-fold increased risk of HF as a categorical variable(OR=1.891,95%CI:1.047–3.415,P=0.035).As a continuous variable,each increased unit in RC was associated with a 2.464-fold increased risk of HF(OR=2.464,95%CI1.495–4.064,P<0.001).The odds ratios for Log10RC and standardized RC were 6.411(95%CI:2.246–18.302,P=0.001)and 1.687(95%CI:1.262–2.255,P<0.001),respectively.ROC analysis indicated a linear positive association between RC and HF risk(P=0.002).ROC analysis showed that RC had predictive value for HF,with an AUC of 0.621(95%CI:0.555–0.687,P<0.001).Conclusions  RC levels are significantly associated with the risk of HF in patients with diabetes and CHD,demonstrating a linear positive correlation.RC has potential predictive value and may serve as a useful indicator for assessing HFrisk in this population.
论著

妊娠期糖尿病患者 Apo-B、Apo-A1 水平在分娩巨大儿中的预测价值探讨

Predictive value of Apo-B and Apo-A1 levels on macrosomia delivery in patients with gestational diabetes mellitus

:1651-1655
 
      目的   探讨妊娠期糖尿病(GDM)患者载脂蛋白B(Apo-B)、载脂蛋白A1(Apo-A1)水平在分娩巨大儿中的预测价值。方法   选取2023年1月—2024年1月在珠海市第五人民医院建档并进行孕检、分娩的85例GDM患者,按照分娩的新生儿体质量情况分为分娩正常组55例(新生儿体质量<4 000 g)和分娩异常组30例(新生儿体质量≥4 000 g)。比较两组孕妇一般资料及孕早期的Apo-B、Apo-A1、Apo-B/Apo-A1比值,采用受试者操作特征(ROC)曲线分析Apo-B、Apo-A1、Apo-B/Apo-A1对GDM患者分娩巨大儿的预测价值。结果   分娩异常组Apo-B水平、Apo_B/Apo_A1比值(1.05±0.15)g/L、(0.81±0.23)]高于分娩正常组(0.95±0.12)g/L、(0.65±0.18)](t分别为3.357、3.544,P<0.05);Apo-A1水平[(1.29±0.26)g/L]低于分娩正常组[(1.47±0.23)g/L](t=3.292,P<0.05);ROC曲线显示,Apo-B、Apo-A1水平及Apo-B/Apo-A1比值预测GDM患者分娩巨大儿的曲线下面积(AUC)分别为0.705、0.660、0.709,灵敏度分别为63.33%、63.33%、66.67%,特异度分别为72.73%、74.55%、76.36%,其中Apo-B/Apo-A1比值预测效能最高(P<0.05)。结论  GDM患者分娩巨大儿与孕早期Apo-B升高、Apo-A1水平降低密切相关,监测患者孕早期的Apo-B、Apo-A1水平及Apo-B/Apo-A1比值有助于临床对分娩巨大儿进行预测。
      Objective  To explore the predictive value of apolipoprotein B(Apo-B)and apolipoprotein A1(Apo-A1)levels on delivery of macrosomia in patients with gestational diabetes mellitus(GDM).Methods  From January 2023 to January 2024,85 patients with GDM who were filed in the hospital and received pregnancy examination and delivery were selected.According to the neonatal body mass,the patients were divided into 55 cases in normal delivery group(newborn birth weight <4 000 g)and 30 cases in abnormal delivery group( newborn birth weight ≥4 000 g).The general data and levels of Apo-B,Apo-A1 and Apo-B/Apo-A1 in early pregnancy were compared between the two groups.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of Apo-B,Apo-A1 and Apo-B/Apo-A1 on delivery of macrosomia in GDM patients.Results  The Apo-B and Apo-B/Apo-A1 in abnormal delivery group were(1.05±0.15)g/L and(0.81±0.23),which were higher than(0.95±0.12)g/L and(0.65±0.18)in normal delivery group(t=3.357,3.544,P<0.05).While the level of Apo-A1 in abnormal delivery group,(1.29±0.26)g/L,was lower than(1.47±0.23)g/L in normal delivery group(t=3.292,P<0.05).ROC curve showed that the areas under the curve(AUC)of Apo-B,Apo-A1 and Apo-B/Apo-A1 in  predicting macrosomia in GDM patients were 0.705,0.660 and 0.709,and the sensitivities were 63.33%,63.33% and 66.67%,and the specificities were 72.73%,74.55% and 76.36%,respectively.Apo-B/Apo-A1 had the highest predictive efficiency(P<0.05).Conclusions  The delivery of macrosomia in GDM patients is closely related to the increase of Apo-B and the decrease of Apo-A1 in early pregnancy.Monitoring Apo-B,Apo-A1 and Apo-B/Apo-A1 in early pregnancy is helpful to predict the delivery of macrosomia.
论著

2 型糖尿病患者葡萄糖目标范围内时间与高尿酸血症的相关性研究

Study on the correlation between hyperuricemia and time in range of glucose in type 2 diabetes patients

:1519-1524
 
     目的   探讨2型糖尿病(T2DM)患者葡萄糖目标范围内时间(TIR)与高尿酸血症(HUA)的相关性。方法   纳入2021年10月—2024年10月厦门大学附属第一医院收治的110例T2DM合并HUA的患者,将其分为T2DM并HUA组,另选取同期110例单纯T2DM患者,分为单纯T2DM组,比较两组一般资料及实验室相关指标,采用Logistics回归模型分析T2DM患者HUA发生的影响因素。随后将110例T2DM合并HUA的患者依照其病情严重程度分为轻度组(58例)、中度组(37例)及重度组(15例),比较三组临床相关指标及TIR水平,分析临床相关指标及TIR水平与T2DM患者HUA严重程度的相关性。结果  T2DM并HUA组与单纯T2DM组患者体质指数(BMI)、糖化血红蛋白、总胆固醇、甘油三酯、血肌酐(Scr)、TIR对比差异有统计学意义(P<0.05);将具有统计学差异的指标纳入Logistics回归模型,以是否合并HUA作为因变量(合并HUA=1,未合并HUA=0),结果显示,BMI、糖化血红蛋白、总胆固醇、甘油三酯、Scr、TIR为T2DM患者HUA发生的重要影响因素(P<0.05);HUA不同严重程度患者临床相关指标及TIR水平对比发现,轻度组、中度组与重度组糖化血红蛋白、总胆固醇、甘油三酯、Scr水平对比差异无统计学意义(P>0.05),轻度组、中度组与重度组BMI、TIR对比差异显著(P<0.05),重度组BMI高于轻度组对比差异有统计学意义(P<0.05),重度组TIR低于轻度组和中度组对比差异有统计学意义(P<0.05);Spearman相关分析显示:BMI与HUA严重程度呈正相关,TIR与HUA严重程度呈负相关P<0.05)。结论  TIR降低为T2DM患者HUA发生的重要影响因素之一,且TIR水平与HUA严重程度密切相关。
        Objective  To explore the correlation between time in range(TIR)of glucose and hyperuricemia(HUA)in patients with type 2 diabetes mellitus(T2DM).Methods  From October 2021 to October 2024,110 patients with T2DM complicated with HUA admitted to our hospital were divided into T2DM with HUA group,and 110 patients with T2DM only in the same period were divided into T2DM group.The general data and laboratory related indicators of the two groups were compared,and the influencing factors of the occurrence of HUA in T2DM patients were analyzed by logistic regression model.Subsequently,110 patients with T2DM complicated with HUA were divided into mild group(58 cases),moderate group(37 cases),and severe group(15 cases)according to their severity.The clinical related indicators and TIR levels of the three groups were compared,and the correlation between clinical related indicators and TIR levels and the severity of HUA in T2DM patients was analyzed.Results  Body mass index(BMI),glycosylated hemoglobin,total cholesterol,triglyceride,and blood creatinine(Scr)between T2DM with HUA group and T2DM group were significantly different(P<0.05).The indicators with statistical differences were included in the logistics regression model to determine whether to merge HUA as the dependent variable(with HUA=1,without HUA=0).The results showed that,BMI,glycosylated hemoglobin,total cholesterol,triglycerides,Scr,and TIR were important influencing factors for the occurrence of HUA in T2DM patients(P<0.05).Comparison of clinical indicators and TIR levels in patients with different degrees of HUA revealed no significant differences in glycosylated hemoglobin,total cholesterol,triglycerides,and Scr levels among the mild,moderate,and severe groups(P>0.05),while there were significant differences in BMI and TIR levels among the mild,moderate,and severe groups(P<0.05).The difference between the severe group and the mild group was statistically significant(P<0.05),and the difference between the severe group and the moderate group was statistically significant(P<0.05).The Spearman correlation analysis  results showed that BMI was positively correlated with the severity of HUA,while TIR was negatively correlated with the severity of HUA(P<0.05).Conclusions  The decrease of TIR is one of the important influencing factors of HUA in T2DM patients,and the level of TIR is closely related to the severity of HUA.
论著

产时超声管理妊娠期糖尿病初产妇产程的临床研究

A clinical study of intrapartum ultrasound in the management of labor in primiparous women with gestational diabetes mellitus

:1423-1427
 
目的 探讨产时超声管理妊娠期糖尿病产妇产程的应用价值。方法 选择2022年1月1日—2023年12月31日在佛山市高明区人民医院妇产科分娩的妊娠期糖尿病初产妇共100例。患者签署知情同意书后, 按照1∶1比例采用随机数字表法分为对照组和研究组各50例。对照组采用阴道指诊检查判断产程和分娩方式。研究组采用经腹联合会阴超声测量检查判断产程及分娩方式。收集两组初产妇血糖、血常规、分娩方式、产后24 h出血量以及切口情况, 新生儿Apgar评分。结果 研究组阴道分娩率高于对照组(88.0% vs 72.0%, P<0.05), 而阴道检查次数(4.18±0.8 vs 6.82±0.8, P<0.05)少于对照组、不良事件发生率(4% vs 16%, P<0.05)低于对照组。相对于对照组,研究组血红蛋白水平较高(104.10±5.25 vs 100.30±4.78, P<0.05)、而白细胞计数(11.40±1.49 vs 12.04±1.66, P<0.05)以及中性粒细胞百分比较低(72.79±4.04 vs 75.01±5.53, P<0.05)。结论 通过产时超声监测判断妊娠期糖尿病初产妇产程,能够降低阴道操作引起的感染等风险,提高阴道分娩率,有效降低产妇感染,提高产妇分娩满意度以及舒适度,改善母婴结局。
Objective To explore the application value of intrapartum ultrasound for labor management of pregnant women with gestational diabetes mellitus.Methods A total of 100 primiparous women with gestational diabetes mellitus who gave birth in the Obstetrics and Gynecology Department of Foshan Gaoming District People’s Hospital from January 1, 2022 to December 31, 2023 were selected.After signing the informed consent form, the patients were randomly divided into a control group and a study group with 50 cases in each group according to a ratio of 1∶1, using a random number table method.The control group underwent vaginal digital examination to assess the labor process and delivery method.For the study group, the labor process and delivery mode were determined using transabdominal ultrasound measurement.Blood glucose level,routine blood test results, delivery methods, 24-hour postpartum bleeding volume and incision conditions of two groups of primiparas, as well as the Apgar score of newborns were collected.Results The study group demonstrated a significantly higher vaginal delivery rate than the control group(88.0% vs 72.0%, P<0.05), with fewer vaginal examinations(4.18±0.80 vs 6.82±0.80, P<0.05)and a lower incidence of adverse events(4% vs 16%, P<0.05).Compared to the control group, the study group exhibited higher hemoglobin levels([104.10±5.25]g/L vs [100.30±4.78] g/L, P<0.05), but lower white blood cell counts([11.40±1.49]×109/L vs [12.04±1.66]×109/L, P<0.05)and reduced neutrophil percentages([72.79±4.04]% vs [75.01±5.53]%, P<0.05).Conclusions Intrapartum ultrasound monitoring for assessing labor progression in primiparas with gestational diabetes mellitus reduces infection risks associated with vaginal procedures, increases vaginal delivery rates, effectively decreases maternal infections, enhances maternal satisfaction and comfort during delivery,and improves maternal-neonatal outcomes.
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