TPOAb、HbA1c、PLGF及血脂水平对妊娠期糖尿病孕妇妊娠结局的影响

doi:10.3969/j.issn.1004-583X.2021.01.011

摘要/Abstract

摘要：

目的探讨妊娠期糖尿病(GDM)孕妇抗甲状腺过氧化物酶抗体(TPOAb)、糖化血红蛋白(HbA₁c)、胎盘生长因子(PLGF)、血脂等水平及意义。方法选取在南京市妇幼保健院治疗的GDM患者180例为观察组;选取同期在南京市妇幼保健院产检的健康产妇180例为对照组。于妊娠24~27周,采集空腹静脉血,检测TPOAb、HbA₁c、PLGF及血脂指标,对比两组上述指标水平;记录GDM患者妊娠结局,分析妊娠结局不良患者与妊娠结局正常患者TPOAb、HbA₁c、PLGF及血脂指标。结果观察组TPOAb、HbA₁c、甘油三酯(TG)水平高于对照组,PLGF水平低于对照组(P<0.05);观察组TPOAb阳性率高于对照组(χ ²=12.394,P<0.01);观察组发生妊娠结局不良56例(31.11%),妊娠结局正常124例(68.89%);妊娠结局不良患者TPOAb、HbA₁c、TG水平高于妊娠结局正常患者,PLGF水平低于妊娠结局正常患者(P<0.05);妊娠结局不良患者TPOAb阳性率高于妊娠结局正常患者(χ ²=5.762,P=0.016)。结论 GDM孕妇TPOAb、HbA₁c、PLGF及TG与健康孕妇存在明显差异,可能对妊娠结局产生不良影响。

关键词: 糖尿病, 妊娠, 过氧化物酶类, 血红蛋白类, 糖基化, 胞间信号肽类和蛋白质类, 血脂异常, 妊娠结局

Abstract:

Objective To investigate the levels and significance of antithyroid peroxidase antibody(TPOAb), hemoglobin A1c(HbA₁c), placental growth factor(PLGF) and blood lipid in pregnant women with gestational diabetes mellitus(GDM). Methods A total of 180 GDM patients in Nanjing Maternity and Child Health Care Hospital were selected as observation group. A total of 180 healthy pregnant women who were examined in the above hospital during the same period were selected as control group. Fasting venous blood was collected at 24-27 weeks of gestation, and TPOAb, HbA₁c PLGF and lipid indexes were detected and compared between two groups. The pregnancy outcomes of GDM patients were recorded, and TPOAb, HbA₁c, PLGF and blood lipid indexes between patients with poor pregnancy outcomes and those with normal pregnancy outcomes were analyzed. Results TPOAb, HbA₁c, TG in observation group were higher than those in control group, while PLGF was lower than that in control group (P<0.05); TPOAb positive rate in observation group was higher than that in control group (χ²=12.394, P<0.01); there were 56 patients(31.11%) with poor pregnancy outcomes and 124 patients(68.89%) with normal pregnancy outcomes in observation group. TPOAb, HbA₁c, TG in patients with poor pregnancy outcome were higher than those in patients with normal pregnancy outcome, while PLGF was lower than that in patients with normal pregnancy outcome (P<0.05); TPOAb positive rate of patients with poor pregnancy outcome was higher than that of normal pregnancy outcome (χ²=5.762, P=0.016).Conclusion There were significant differences in TPOAb, HbA₁c, PLGF and TG between GDM pregnant women and healthy pregnant women, which may have some adverse influence on pregnancy outcomes.

Key words: diabetes, gestational, peroxidases, hemoglobins, glycosylated, intercellular signaling peptides and proteins, dyslipidemia, pregnancy outcome

中图分类号:

R587.1

尤牧, 蔡满红. TPOAb、HbA₁c、PLGF及血脂水平对妊娠期糖尿病孕妇妊娠结局的影响[J]. 临床荟萃, 2021, 36(1): 54-57.

You Mu, Cai Manhong. Effect of TPOAb, HbA₁c, PLGF and lipid level on pregnancy outcome in pregnant women with gestational diabetes mellitus[J]. Clinical Focus, 2021, 36(1): 54-57.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2021.01.011

https://huicui.hebmu.edu.cn/CN/Y2021/V36/I1/54

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参考文献 20

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组别	例数	年龄(岁)	孕次	产次	孕前BMI	分娩孕周
观察组	180	26.93±3.89	1.73±0.38	1.51±0.27	22.48±1.33	37.89±2.52
对照组	180	26.48±3.75	1.79±0.32	1.47±0.31	22.65±1.21	38.14±2.68
t值		1.117	1.620	1.305	1.268	0.912
P值		0.265	0.106	0.193	0.205	0.363

组别	例数	年龄(岁)	孕次	产次	孕前BMI	分娩孕周
观察组	180	26.93±3.89	1.73±0.38	1.51±0.27	22.48±1.33	37.89±2.52
对照组	180	26.48±3.75	1.79±0.32	1.47±0.31	22.65±1.21	38.14±2.68
t值		1.117	1.620	1.305	1.268	0.912
P值		0.265	0.106	0.193	0.205	0.363

组别		例数		TPOAb(U/ml)		HbA₁c(%)		PLGF(pg/ml)		TG(mmol/L)		TC(mmol/L)
观察组		180		43.66±11.36		5.57±0.63		69.68±19.74		2.31±0.64		6.05±0.66
对照组		180		18.78±7.13		5.03±0.67		128.24±25.83		1.98±0.68		5.93±0.71
t值				24.888		7.878		24.167		4.741		1.661
P值				<0.01		<0.01		<0.01		<0.01		0.098
组别	例数		HDL-C(mmol/L)		LDL-C(mmol/L)		Apo A1(g/L)		Apo B(g/L)		Apo E(mg/L)		Lp(a) (mg/L)
观察组	180		1.93±0.57		3.41±0.75		2.11±0.57		1.04±0.43		47.23±5.36		223.62±27.28
对照组	180		1.88±0.68		3.35±0.70		2.04±0.53		0.97±0.51		46.28±4.89		219.93±23.56
t值			0.756		0.785		1.207		1.408		1.757		1.373
P值			0.450		0.433		0.228		0.160		0.080		0.170

组别		例数		TPOAb(U/ml)		HbA₁c(%)		PLGF(pg/ml)		TG(mmol/L)		TC(mmol/L)
观察组		180		43.66±11.36		5.57±0.63		69.68±19.74		2.31±0.64		6.05±0.66
对照组		180		18.78±7.13		5.03±0.67		128.24±25.83		1.98±0.68		5.93±0.71
t值				24.888		7.878		24.167		4.741		1.661
P值				<0.01		<0.01		<0.01		<0.01		0.098
组别	例数		HDL-C(mmol/L)		LDL-C(mmol/L)		Apo A1(g/L)		Apo B(g/L)		Apo E(mg/L)		Lp(a) (mg/L)
观察组	180		1.93±0.57		3.41±0.75		2.11±0.57		1.04±0.43		47.23±5.36		223.62±27.28
对照组	180		1.88±0.68		3.35±0.70		2.04±0.53		0.97±0.51		46.28±4.89		219.93±23.56
t值			0.756		0.785		1.207		1.408		1.757		1.373
P值			0.450		0.433		0.228		0.160		0.080		0.170

组别		例数		TPOAb(U/ml)		HbA₁c(%)		PLGF(pg/ml)		TG(mmol/L)		TC(mmol/L)
不良		56		64.22±12.14		6.23±0.58		58.14±19.66		2.69±0.69		6.07±0.69
正常		124		33.83±9.64		5.29±0.61		74.43±22.15		2.14±0.72		5.98±0.68
t值				17.885		9.613		4.672		4.755		0.179
P值				<0.01		<0.01		<0.01		<0.01		0.858
组别	例数		HDL-C(mmol/L)		LDL-C(mmol/L)		Apo A1(g/L)		Apo B(g/L)		Apo E(mg/L)		Lp(a) (mg/L)
不良	56		1.96±0.61		3.47±0.79		2.24±0.63		1.10±0.48		47.64±5.69		228.35±28.53
正常	124		1.89±0.64		3.36±0.81		2.09±0.64		0.98±0.52		47.03±5.84		220.47±29.04
t值			0.682		0.841		1.448		1.451		0.647		1.677
P值			0.496		0.401		0.149		0.186		0.518		0.095

TPOAb、HbA₁c、PLGF及血脂水平对妊娠期糖尿病孕妇妊娠结局的影响

Effect of TPOAb, HbA₁c, PLGF and lipid level on pregnancy outcome in pregnant women with gestational diabetes mellitus

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