孕早期白细胞计数、肝功指标检测与妊娠期糖尿病发生的相关性分析  

Detection of white blood cell count and liver function detection in early pregnancy and their correlation with gestational diabetes mellitus

作　　者：王凤玲[1] 周义文[1] 王亮[1] 

机构地区：[1]绵阳市中心医院妇产科,四川绵阳621000

出　　处：《中国计划生育和妇产科》2017年第12期41-44,52,共5页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的对孕早期外周血白细胞计数(white blood cell,WBC)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)和天冬氨酸氨基转移酶(aspartate aminotransferase,AST)水平进行监测,并分析其与妊娠期糖尿病(gestational diabetes mellitus,GDM)发生的相关性。方法回顾性分析2014年1月至2017年1月在绵阳市中心医院确诊为GDM的孕妇156例的病历资料(GDM组),随机选取同期正常糖耐量(normal glucose tolerance,NGT)孕妇156例为对照(NGT组),比较两组孕妇的一般资料、血常规和肝功能指标,采用二分类Logistic回归分析,探究WBC、ALT和AST水平与GDM发生的相关性,受试者工作特征曲线评价WBC、ALT和AST单独及联合预测GDM的效果。结果两组平均年龄和孕前体质量指数(body mass index,BMI)比较差异无统计学意义(P>0.05),GDM组WBC(9.73±1.60)×10~9/L、中性粒细胞计数(7.45±1.92)×10~9/L、ALT(25.93±6.57)U/L、AST(25.30±7.55)U/L均明显高于NGT组[(7.57±1.62)×10~9/L、(6.71±1.69)×10~9/L、(18.32±5.66)U/L、(16.29±5.51)U/L](P<0.05)。经多因素Logistic回归分析显示,年龄、BMI、WBC、AST和ALT是GDM发生的独立危险因素(P<0.05)。WBC、AST和ALT联合预测GDM发生风险的效能较高(AUC=0.903,P<0.05),利用约登指数得出最佳截点为WBC≥9.31×10~9/L,ALT≥23 IU/L和AST≥21.34 IU/L。结论 GDM患者孕早期WBC、ALT和AST水平明显升高,孕早期应用WBC、ALT和AST联合监测可为预测GDM发生风险提供新手段。Objective To detect the level of white blood cell （WBC）, alanine aminotransferase （ALT） and aspartate aminotransferase（AST） , and their correlation with gestational diabetes mellitus （GDM） in early pregnancy. Methods From January 2014 to January 2017, 156 patients with GDM were retrospectively analyzed in Mianyang Central Hospital, and 156 normal glueose tolerance（NGT） pregnant women were randomly chosen as control. The general information, routine analysis of blood and liver function test in GDM group and NGT group were comparatively analyzed. The two - classification logistics regression analysis was used to observe the risk factors of GDM. A receiver operating characteristic （ ROC ） curve was plotted to evaluate predictive value and identify optimal cut - off points for variables that were significantly associated with GDM in the logistic regression analysis. Results The age and body mass index（BMI） in the GDM group were much higher than the NGT group. The WBC, neutrophil count, ALT and AST in GDM group were （ 9.73 ± 1. 60 ） ×109/L, （ 7.45 ±1.92 ） ×10^9/L, （ 25.93 ±6.57 ） IU/L and （ 25.30± 7.55 ） IU/L respectively, which were significantly higher than the NGT group （P 〈 0. 05 ）. The age, BMI, WBC, ALT and AST were the independent risk factors for GDM. The combination of WBC, ALT and AST has a efficiency high in the prediction for GDM （ AUC = 0. 903, P 〈 0. 05 ）, and the best cut - off predictive values tot GDM were 9.31 × 109/L for WBC, 23.02 U/L for ALT and 21.34 IU/L for ALT using Youden index in the ROC analysis. Conclusion The levels of WBC, ALT and AST in GDM patients were significantly higher than those in GDM patients. The combination of WBC, ALT and AST in early pregnancy could provide a new way to predict the risk of GDM.

关 键 词：妊娠期糖尿病 白细胞计数 谷氨酸氨基转移酶 天冬氨酸氨基转移酶 

分 类 号：R714.256[医药卫生—妇产科学]