不同生化指标对妊娠糖尿病临床结局的预测意义

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摘要目的探讨孕中期血小板反应蛋白1(TSP-1)、人新饱食分子蛋白-1(Nesfatin-1)、脂联素(ADP)、超敏C反应蛋白(Hs-CRP)与妊娠期糖尿病(GDM)及母婴结局的相关性。方法 2015年2月—2017年10月期间在我院就诊的孕16~20周孕妇162例,入组后在孕24～28周进行GDM筛查后分为GDM组和正常妊娠组;采用Logistic回归模型评价Nesfatin-1、ADP、TSP-1、Hs-CRP与GDM和母婴结局的预测意义,同时ROC曲线分析TSP-1对GDM、母婴不良结局的预测临界值。结果随访期间确诊GDM 73例作为研究组,正常妊娠89例作为对照组,GDM组胎膜早破、剖宫产、产后出血、产后感染、轻度子痫前期、围生儿早产、巨大儿、低出生体重儿、新生儿窒息、高胆红素血症、新生儿低血糖、新生儿肺炎比例均高于对照组(P<0.05),TSP-1对妊娠糖尿病、孕母不良结局、新生儿不良结局的预测临界值分别为110.6 ng/ml、112.6 ng/ml、115.4 ng/ml,Logistic回归分析表明,Nesfatin>2.1 μg/L(OR=2.01)、TSP-1>110.6 ng/ml (OR=1.01)、ADP<8.5 ng/L (OR=1.76)、Hs-CRP>1.5 mg/L(OR=2.35)对GDM有预测意义;Nesfatin>2.1 μg/L (OR=1.72)、TSP-1>112.6 ng/ml (OR=3.12)、Hs-CRP>1.5 mg/L (OR=2.04)对孕母不良妊娠结局有预测意义;TSP-1>115.4 ng/ml (OR=2.98)、Hs-CRP>1.5 mg/L (OR=1.41)对新生儿不良结局有预测意义。结论孕中期TSP-1水平升高是GDM及不良母婴结局发生的预测因素,临床上可结合Nesfatin-1、ADP、Hs-CRP进行综合判断。

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	何云

关键词 ：血小板反应蛋白1, 妊娠糖尿病, 孕中期, 母婴结局

收稿日期: 2018-06-26

通讯作者: 何云(zpy329603@163.com)

引用本文:

何云. 不同生化指标对妊娠糖尿病临床结局的预测意义[J]. 中国生育健康杂志, 2019, 30(3): 266-269.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2019/V30/I3/266

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