机构地区:[1]汕头大学附属粤北人民医院妇产科,广东省韶关市512026
出 处:《中国综合临床》2016年第10期883-888,共6页Clinical Medicine of China
基 金:广东省韶关市科技计划项目(2014CX/K237)
摘 要:探讨血清CRP在妊娠期代谢综合征( GMS)发病中的作用,并对妊娠期代谢综合征相关的危险因素进行分析。方法选取2012年5月至2015年5月在粤北人民医院定期产检并住院分娩的妊娠期代谢综合征患者共70例为研究组。100名健康孕妇为对照组。记录两组孕妇年龄、孕周、入组血压、身高、孕前体质量,检测CRP、FPG、TC、TG、LDL-C、HDL-C水平,计算CRP 与GMS发生的相关性,分析发生GMS的危险因素,按CRP水平,依据四分位法再将研究对象分4组,比较不同CRP 水平与GMS发生率的关系。结果(1) GMS组孕妇的年龄、孕前BMI、基础血压均高于对照组,孕周则比对照组偏小(P均<0.05)。(2)研究组孕妇的 CRP[(12.6±32.9) mg/L 与(3.90±3.70) mg/L]、FPG[(6.04±1.73) mmol/L与(4.64±0.29) mmol/L]、TC[(6.77±2.68) mmol/L 与(4.49±0.57) mmol/L]、TG [(4.54±2.84) mmol/L与(2.56±0.90) mmol/L]、LDL-C[(3.69±1.25) mmol/L与(2.65±0.51) mmol/L]水平均高于对照组( t值分别为2.21、6.72、6.97、5.63、6.61,P均<0.05),而HDL-C水平组间差异无统计学意义( P>0.05)。(3)多元回归分析结果显示,年龄、孕前BMI、CRP、TG、TC均是孕妇发生GMS的危险因素[ OR (95%CI )值分别为1.530(1.095~2.136)、18.427(4.402~77.142)、4.917(1.928~12.537)、2.665(1.379~5.149)、4.114(2.304~7.348);P均<0.01),其中BMI和TC是发生GMS的显著危险因素(P值均为0.000),而孕周、LDL-C与GMS的发生无显著相关(P均>0.05)。(4)不同CRP 水平组GMS检出率分别为20.69%、42.67%、56.06%和72.00%(χ2=15.28,P=0.002),当CRP≥20.0 mg/L时,GMS发生率显著高于前3组,组间差异均有统计学意义( P均<0.01)。结论 GMS孕妇中存在孕前体质�Objective To discuss the effect of C-reactive protein(CRP) levels in pregnant women with gestational metabolic syndrome ( GMS ) , and to analyze the risk factors of GMS. Methods Seventy pregnant women with GMS received regular check and hospital delivery in Yuebei People’ s Hospital Affiliated to Shantou University from May 2012 to May 2015 were selected as study group,and 100 normal pregnant women as control group. Information regarding age,gestational weeks,admission blood pressure,height and body mass index( BMI) before pregnancy was recorded. Biochemical indicators including C-reactive protein ( CRP ) , fasting plasma glu-cose(FPG),total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL-C),high density lipoprotein ( HDL-C) were tested. The correlation between CRP and GMS was calculated and the risk factors of GMS were analyzed. According to CRP levels,all pregnant women were divided into four groups to based on quartile method subjects, and the relationship of CRP levels and the incidence of GMS were evaluated between four groups. Results ( 1) The age,pre-pregnancy BMI,baseline blood pressure of GMS group were higher,gestation-al weeks was smaller than the control group(P〈0. 05). (2)The CRP,FPG,TC,TG,LDL-C of women with GMS were higher than those of normal women((12. 6±32. 9) mg/L vs. (0. 39±0. 37) mg/L,(6. 04±1. 73) mmol/L vs. (4. 64±0. 29) mmol/L,(6. 77±2. 68) mmol/L vs. (4. 49±0. 57) mmol/L,(4. 54±2. 84) mmol/L vs. (2. 56±0. 90) mmol/L,(3. 69±1. 25) mmol/L vs. (2. 65±0. 51) mmol/L),and the differences were statistical-ly significant( t=2. 21,6. 72,6. 97,5. 63,6. 61;P〈0. 05) ,while there was no significant difference about HDL-C level between the two groups(P〉0. 05). (3)Multiple regression analysis showed that the risk factors of GMS were age,pre-pregnancy BMI,CRP,TG and TC(OR 1. 530(1. 095-2. 136),18. 427(4. 402-77. 142),4. 917 (1. 928-12. 537),2. 665(1. 379-5
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