目的探讨妊娠合并糖尿病与肾功能损害的关系。方法住院待产单胎妊娠孕妇645例分为五组:正常妊娠孕妇(A组,100例),妊娠期糖尿病(GDM)(B组,247例),糖尿病合并妊娠(C组,36例),子痫前期合并GDM(D组,82例),子痫前期(E组,180例)。检测并比较五组孕妇的血清肌酐(SCr)、尿素氮(BUN)、尿酸(UA)和肾小球滤过率(GFR)。结果 E组、D组的UA、SCr高于其他三组,GRF低于其他三组(P〈0.05);C组的UA高于B组和A组(P〈0.05)。E组、D组出现肾功能损害(GFR〈90ml·min^-1·1.73m^-2)的发生率高于其他三组(P〈0.05);E组BUN异常的发生率高于其他四组(P〈0.05)。结论妊娠期肾功能的损害主要源于子痫前期,而非糖尿病。UA和GFR是临床监测肾功能较为敏感的指标。
Objective To analyze the relationship between renal impairment and pregnancy associated with diabetes. Methods A total of 645 pregnant women with single pregnancy was assigned into 5 groups of A(with normal pregnancy, 100 cases),B(with gestational diabetes mellitus, 247 cases) ,C(with diabetes mellitus associated with pregnancy, 36 cases) ,D(with gestational diabetes mellitus and preeclampsia, 82 cases) and E (with preeclampsia, 180 cases). Serum creatinine (SCr), blood urea nitrogen(BUN), uric acid(UA) and glomerular filtration rate(GFR) were detected and compared. Results UA and SCr were higher,but GFR was lower, in groups of D and E than those in groups of A, B and C(P〈0.05). UA was higher in group C than that in groups of B and A (P〈0. 05). The incidence rate of GFR〈90 ml·min^-1·1.73m^-2was higher in groups of E and D than that in groups of A,B and C(P〈0. 05). The incidence rate of abnormal BUN was higher in group E than that in the other 4 groups(P〈0. 05). Conclusion Renal impairment in pregnancy is mainly due to preeclampsia, but not from diabetes mellitus. UA and GFR are the sensitive indicators for evaluating the renal function.