妊娠糖尿病的发病原理和治疗研究进展.pdfVIP

国外医学妇幼保健分册2005 年第 16 卷第 3 期 153 妊娠糖尿病的发病机理和治疗研究进展 祝 　群 , 戈敏娟 , 马向华 (南京医科大学第一附属医院内分泌科 ,江苏 南京 210029) [ 摘 　要 ]妊娠糖尿病是妊娠妇女较常见的围产期并发症之一 , 其发病机制涉及遗传易感、胰岛素抵抗和分泌缺陷、 慢性炎症反应、代谢紊乱等。妊娠糖尿病的诊断方法和标准尚未统一 , 临床上以两步法诊断和美国国家糖尿病数据组及 W HO 的诊断标准应用尤为广泛。胰岛素治疗是妊娠糖尿病药物治疗的首选, 近年的研究显示超短效胰岛素类似物同 样具有安全、有效的治疗作用。另外 , 虽然有报道优降糖等口服降糖药物治疗妊娠糖尿病较为安全, 但其有效性和安全 性尚待进一步证实。 [ 关键词]妊娠糖尿病; 发病机制; 诊断; 治疗 [ 中图分类号] R 714 . 147; R587 . 1 　　　[ 文献标识码]A 　　　[ 文章编号](2005) Progress in diagnosis and treatment of gestational diabetes mellitus ZHU Qun , GE Mingjuan , MA Xian ghua ( Department of Endocrinology , The First Af f iliated Hospital of Nanjin g Medical University , J iangsu Nanjin g 210029 , China) [ Abstract] Gestational diabetes mellitus( GDM) is one of the common complications of pregnancy in perinatal period. The pathogenesis of GDM involves multiple factors , such as genetics , insulin resistance and defects in insulin secretion , chronic inflammation and metabolic disorder. There are no agreements on diagnostic method and criteria for GDM yet now. Twostep diagnosis and the diagnostic criteria of the US National Diabetes Data Group (NDD G) and the WHO are widely used. Insulin therap y is the first choice amid medical therapies for the disease. Recent study have showed that rapidacting insulin analogues is efficacious and can be safely used for the treatment of women with gestational diabetes too. In addition , although it has been reported that oral antihyperglycaemic agents such as glybulide can be safely used for the patients , their safety and efficacy still should be confirmed further. [ Key words] gestational diabetes mellitus ; p at ho genesis ; dia