中文摘要：

目的探讨个体化医学营养治疗对妊娠期糖尿病（GDM）患者脂代谢的影响。方法选择2013年1月至2013年12月在常州市妇幼保健院128例参加GDM筛查的单胎孕妇,试验组为妊娠期糖尿病组共68例,按患者自愿原则分为G1组33例,给予个体化医学营养治疗（MNT）,G2组35例,给予一般饮食指导;对照组为正常组（N组）60例。比较试验组和对照组孕中期和分娩前的血脂变化。结果孕中期G1、G2组治疗前血脂水平总胆固醇（TC）、甘油三脂（TG）、高密度脂蛋白胆固醇（HDLC）、低密度脂蛋白胆固醇（LDL-C）、游离脂肪酸（FFA）、载脂蛋白A/B（APO-A、APO-B）均无明显差异（t值分别为0.10、1.29、1.13、0.22、0.39、1.84、2.35,均P〉0.05）,而G1、G2组的TC、TG、LDL-C、FFA水平均较对照组高,差异有统计学意义（t值分别为3.26/3.42,5.63/4.29,2.25/2.55,3.29/3.80,均P〈0.05）。在分娩前,G1组血TC、LDL-C、FFA、APO-A、APO-B均比G2组低,差异有统计学意义（t值分别为2.55、2.15、2.26、2.53、3.05,均P〈0.05）;G1组与对照组相比,TC、TG、HDL-C无显著性差异（t值分别为0.90、0.50、1.02,均P〉0.05）,LDL-C、FFA、APO-A、APO-B均显著增高（t值分别为2.55、2.46、5.63、5.04,均P〈0.05）;G2组与对照组相比,TC、TG、LDL-C、APO-A均显著增高（t值分别为3.83、2.58、4.37、2.85,均P〈0.05）。结论个体化MNT能显著改善妊娠期糖尿病患者脂代谢紊乱,对孕妇自身及胎儿围产结局大有裨益。

英文摘要：

Objective To investigate the effect of individual medical nutrition therapy（ MNT） on lipid metabolism of patients with gestational diabetes mellitus（ GDM）. Methods Totally 128 singleton pregnant women who participated in GDM screening were selected in Changzhou Maternity and Children Health Care Hospital from January to December in 2013. Test group including 68 cases of GDM was divided into G1 group（ 33 cases） with individual MNT and G2 group（ 35 cases） with general diet guidance. Control group was normal group（ N Group） with 60 cases. Blood lipid changes in the test group and control group were compared in the second trimester stage and before delivery phase. Results During the second trimester,there was no significant difference in TC,TG,HDL-C,LDL-C,FFA and A /B（ APO-A、APO-B） between G1 and G2 groups before treatment（ t value was 0. 10,1. 29,1. 13,0. 22,0. 39,1. 84 and 2. 35,respectively,all P〈0. 05）. And in G1 and G2 groups,the serum levels of TC,TG,LDL-C and FFA were higher than those in the control group with statistically significant differences（ t value was 3. 26 /3. 42,5. 63 /4. 29,2. 25 /2. 55 and 3. 29 /3. 80,respectively,all P〈0. 05）. Before delivery,the serum levels of TC,LDL-C,FFA,APO-A and APO-B in G1 group were lower than those in G2 group,and the differences were statistically significant（ t value was 2. 55,2. 15,2. 26,2. 53 and 3. 05,respectively,all P〈0. 05）. There was no significant difference in serum levels of TC,TG and HDL-C between G1 and N group（ t value was 0. 90,0. 50 and 1. 02,respectively,all P〈0. 05）,but the serum levels of LDL-C,FFA,APO-A and APO-B in G1 group were higher than those in N group（ t value was 2. 55,2. 46,5. 63 and 5. 04,respectively,all P〈0. 05）. The serum levels of TC,TG,LDL-C and APO-A of G2 group were higher than those of N group,and the differences were statistically significant（ t value was 3. 83,2. 58,4. 37 and 2. 85,respectively,all P〈0. 05）.Conclusion Individual MNT for GDM patients can effectively re