标题:妊娠糖尿病患者血清同型半胱氨酸和尿微量白蛋白的水平及其与妊娠结局的关系
作者:王浩哲 1,刘荣 1,郭维 2 1.陕西省友谊医院妇产科,陕西 西安 710068;2.陕西省人民医院产科,陕西 西安 710068
卷次:
2019年30卷7期
【摘要】 目的 了解妊娠糖尿病(GDM)患者血清同型半胱氨酸(HCY)、尿微量白蛋白(MAU)水平,分析其与妊娠结局的相关性。方法 选择 2015年 3月至 2017年 3月陕西省友谊医院产科门诊诊治的 30例GDM患者为观察组,选择同期我院妇产保健门诊规律产检的正常妊娠孕妇 30例为对照组,检测并比较两组受检者的血清HCY、尿MAU、空腹血糖(FPG)和空腹胰岛素(FINS)水平,观察组患者均随访至妊娠事件终止并统计不良妊娠结局发生情况,分析不同HCY、MAU水平孕妇妊娠结局的差异。结果 观察组和对照组受检者的血清HCY [8.51(6.01,10.58) μmol/L vs 11.62 (7.15,15.69) μmol/L]、FPG [5.68 (3.01,8.92) mmol/L vs 3.95 (3.02,4.58) mmol/L]、FINS[16.95 (10.25,22.35) mmol/L vs 12.01 (10.25,14.35) mmol/L],尿MAU [25.75 (20.35,36.58) mg/24 h vs 21.09 (15.02,26.38) mg/24 h]水平比较,观察组均明显高于对照组,差异均有统计学意义(P<0.05);血糖控制达标GDM孕妇血清HCY、尿MAU水平低于血糖控制不达标组[8.36 (7.25,11.52) μmol/L vs 13.62 (9.62,17.05) μmol/L、22.60 (17.32,28.65) mg/24 h vs 28.04 (21.02,39.02) mg/24 h],差异均有统计学意义(P<0.05);HCY正常组孕妇的不良妊娠结局发生率为 23.08%,明显低于HCY异常组的 64.71%,MAU正常组孕妇的不良妊娠结局发生率为 18.18%,明显低于MAU异常组的63.16%,差异均有统计学意义(P<0.05)。结论 妊娠糖尿病患者血清HCY、尿MAU水平明显增高,HCY、MAU水平与血糖水平、不良妊娠结局有关。
【关键词】 妊娠糖尿病;同型半胱氨酸;尿微量白蛋白;妊娠结局;妊娠
【中图分类号】 R714.256 【文献标识码】 A 【文章编号】 1003—6350(2019)07—0853—03
Levels of serum homocysteine and urinary microalbumin in patients with gestational diabetes mellitus and theircorrelation with pregnancy outcome.
WANG Hao-zhe 1, LIU Rong 1, GUO Wei 2. 1. Department of Obstetrics andGynecology, Shaanxi Friendship Hospital, Xi'an 710068, Shaanxi, CHINA; 2. Department of Obstetrics, Shaanxi People'sHospital, Xi'an 710068, Shaanxi, CHINA
【Abstract】 Objective To investigate the levels of serum homocysteine (HCY) and urinary microalbumin(MAU) in patients with gestational diabetes mellitus (GDM) and to analyze their correlation with pregnancy outcome.Methods Thirty GDM patients in Department of Obstetrics and Gynecology, Shaanxi Friendship Hospital from March2015 to March 2017 were selected as the observation group, and 30 normal pregnant women in the same period were se-lected as the control group. The levels of serum HCY, urinary MAU, fasting blood sugar (FPG), and fasting insulin(FINS) were detected and compared between the two groups. All patients in the observation group were followed up un-til the end of pregnancy. The incidence of adverse pregnancy outcomes was analyzed and the differences of pregnancyoutcomes at different levels of HCY and MAU were analyzed. Results Compared with the control group, the observa-tion group had significantly higher HCY, FPG, FINS, urinary MAU (P<0.05): HCY: 8.51 (6.01, 10.58) μmol/L vs 11.62(7.15, 15.69) μmol/L; FPG: 5.68 (3.01, 8.92) mmol/L vs 3.95 (3.02, 4.58) mmol/L; FINS: 16.95 (10.25, 22.35) mmol/L vs12.01 (10.25, 14.35) mmol/L; urinary MAU: 25.75 (20.35, 36.58) mg/24 h vs 21.09 (15.02, 26.38) mg/24 h. The levels ofserum HCY and urinary MAU in GDM patients achieving blood glucose control standard were lower than those notachieving blood glucose control standard (P<0.05): 8.36 (7.25, 11.52) μmol/L vs 13.62 (9.62, 17.05) μmol/L, 22.60(17.32, 28.65) mg/24 h vs 28.04 (21.02, 39.02) mg/24 h. The incidence of adverse pregnancy outcomes in normal HCYgroup was lower than that in abnormal HCY group (23.08% vs 64.71%), and the difference was statistically significant(P<0.05). The incidence of adverse pregnancy outcomes in normal MAU group was lower than that in abnormal MAUgroup (18.18% vs 63.16%, P<0.05). Conclusion The levels of serum HCY and urinary MAU in patients with gestation-al diabetes mellitus are significantly increased. The levels of HCY and MAU are related to blood sugar level and adversepregnancy outcomes.
【Key words】 Gestational diabetes mellitus; Homocysteine (HCY); Microalbumin (MAU); Pregnancy outcome;Pregnancy
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