个体化营养干预对妊娠期糖尿病(GDM)并发高血压患者有效性Meta分析

Meta-Analysis of Effectiveness of Individualized Nutrition Intervention on Hypertensive Patients with Gestational Diabetes Mellitus (GDM)

摘要: 目的：评价分析个体化营养干预对妊娠期糖尿病(GDM)并发高血压孕妇患者的有效性。方法：检索Cochrane Library、PubMed、Embase、中国知网、万方数据库、维普数据库中个体化营养护理对妊娠期糖尿病并发妊娠期高血压孕妇影响的随机对照试验(RCT)文献，检索时间为1995年1月1日~2021年6月30日。实验组接受个体化营养护理，对照组接受常规护理。采用RevMan5.3软件进行统计分析。结果：本研究共纳入17篇文献、3157例孕妇患者，Meta分析结果显示实验组与对照组相比较：对照组发生不良反应的可能性是实验组的0.27倍，差异有统计学意义(固定效应模型，RR = 0.27，95% CI (0.22~0.33)，P < 0.00001)；实验组能明显降低患者餐后血糖(FBG/FBG)、餐后2小时血糖(2 hPG)、收缩压(SBP)、舒张压(DBP)，差异均有统计学意义(FBG/FPG：随机效应模型，WMD = −2.22，95% CI (−2.89~−1.56)，P < 0.00001；2 hPG：随机效应模型，WMD = −2.20，95% CI (−3.22~−1.18)，P < 0.00001；SBP：随机效应模型，WMD = −14.10，95% CI (−17.74~−10.46)，P < 0.00001；DBP：随机效应模型，WMD = −8.24，95% CI (−10.85~−5.63)，P < 0.00001)。结论：个体化营养干预能明显降低妊娠期糖尿病(GDM)并发高血压孕妇患者的餐后血糖(FBG/FPG)、餐后2小时血糖(2 hPG)、收缩压(SBP)、舒张压(DBP)水平以及减少不良反应的发生。

Abstract: Objective: To evaluate the effectiveness of individualized nutrition intervention on pregnant women with gestational diabetes mellitus (GDM) complicated with hypertension. Methods: The randomized controlled trial (RCT) literature on the effect of individualized nutrition care on pregnant women with gestational diabetes mellitus complicated with gestational hypertension in Cochrane Library, PubMed, Embase, CNKI, Wanfang database and VIP database was searched from January 1, 1995 to June 30, 2021. The experimental group received individualized nutrition nursing, while the control group received routine nursing. Statistical analysis was carried out by RevMan5.3 software. Results: A total of 17 literatures and 3157 pregnant women were included in this study. Meta-analysis showed that compared with the control group, the possibility of adverse reactions in the control group was RR = 0.27 times higher than that in the experimental group, and the difference was statistically significant (fixed effect model, RR = 0.27, 95% CI (0.22~0.33), P < 0.00001). The experimental group can significantly reduce postprandial blood glucose (FBG/FBG), postprandial blood glucose (2 hPG), systolic blood pressure (SBP) and diastolic blood pressure (DBP), with statistical significance (FBG/FPG: random effect model, WMD = −2.22, 95% CI (−2.89~−1.56)) 2 hPG: random effect model, WMD = −2.20, 95% CI (−3.22~−1.18), P < 0.00001; SBP: random effect model, WMD = −14.10, 95% CI (−17.74~−10.46), P < 0.00001; DBP: random effect model, WMD = −8.24, 95% CI (−10.85~−5.63), P < 0.00001). Conclusion: Individualized nutrition intervention can significantly reduce postprandial blood glucose (FBG), postprandial 2-hour blood glucose (2 hPG), systolic blood pressure (SBP), diastolic blood pressure (DBP) and adverse reactions in pregnant women with gestational diabetes mellitus (GDM) complicated with hypertension.