妊娠期糖尿病合并妊娠期高血压疾病患者的血清学指标特征分析

摘要

目的 探讨妊娠期高血压疾病合并妊娠期糖尿病患者的血清学指标及其相关性分析.方法 选择2013年12月至2015年12月来中山市人民医院就诊并定期产前检查的324例孕妇为研究对象,根据糖代谢检查分为A组(对照组,112例)、B组(单纯糖尿病组,180例)、C组(糖尿病合并高血压组,32例).检测空腹血清中糖化血红蛋白(HbA1c)、血糖、C-反应蛋白(CRP)、白介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平.结果 三组CRP、IL-6、TNF-α、FPG、HbA1c比较均有显著性差异(F值分别为2.954、3.971、3.013、3.145、3.771,均P<0.05),C组上述指标均最高.Logistic回归分析结果 显示:CRP、IL-6、TNF-α与妊娠期糖尿病合并妊娠期高血压疾病的发生有较强的相关性.ROC分析结果 显示:CRP、IL-6、TNF-α对妊娠期糖尿病合并妊娠期高血压疾病的预测切点分别为6.85mg/L、294.55pg/mL、122.95pg/mL,ROC曲线下面积分别为0.634、0.845、0.645.结论 妊娠期糖尿病患者血糖、HbA1c水平的升高将增加合并妊娠期高血压疾病的风险;CRP、IL-6指标的检测可能对妊娠期糖尿病合并妊娠期高血压疾病有一定预测价值.%Objective To explore the serological indicator characteristics of pregnant women with gestational diabetes mellitus ( GDM ) combining hypertensive disorder complicating pregnancy ( HDCP ) as well as their relationship. Methods Pregnant women receiving prenatal examination regularly in Zhongshan City People' s Hospital from December 2013 to December 2015 were selected in the study and were divided into group A (normal group, 112 cases), group B (GDM group, 180 cases), and group C (GDM combined with HDCP group, 32 cases). The serum levels of glycosylated hemoglobin (HbA1c), blood glucose, CRP, IL-6 and TNF-αwere detected. Results There were significant differences in the serum levels of CRP, IL-6, TNF-α, FPG and HbA1c among three groups ( F value was 2. 954, 3. 971, 3. 013, 3. 145 and 3. 771, respectively, all P<0. 05). Those levels in group C were highest. Logistic regression analysis showed that CRP, IL-6 and TNF-α were positively correlated with the incidence of GDM combined with HDCP. ROC analysis revealed that the tangent points of CRP, IL-6 and TNF-α to predict GDM combined with HDCP were 6. 85mg/L, 294. 55pg/mL and 122. 95pg/mL, respectively. The areas under ROC curve were 0. 634, 0. 745 and 0. 645, respectively. Conclusion High levels of HbA1c and blood glucose may increase the risk of GDM combined with HDCP. Detecting the levels of CRP and IL-6 has certain values for prediction of GDM combined with HDCP.