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  

Levels of serum homocysteine and urinary microalbumin in patients with gestational diabetes mellitus and their correlation with pregnancy outcome

作　　者：王浩哲 刘荣 郭维[2] WANG Hao-zhe;LIU Rong;GUO Wei(Department of Obstetrics and Gynecology, Shaanxi Friendship Hospital, Xi'an 710068, Shaanxi, CHINA;Department of Obstetrics, Shaanxi People's Hospital, Xi'an 710068, Shaanxi, CHINA)

机构地区：[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

出　　处：《海南医学》2019年第7期853-855,共3页Hainan Medical Journal

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。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 selected 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 until the end of pregnancy. The incidence of adverse pregnancy outcomes was analyzed and the differences of pregnancy outcomes at different levels of HCY and MAU were analyzed. Results Compared with the control group, the observation 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 of serum HCY and urinary MAU in GDM patients achieving blood glucose control standard were lower than those not achieving blood glucose control standard(P<0.05): 8.36(7.25, 11.52)μ mol/L vs 13.62(9.62, 17.05)μ mol/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 HCY group 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 MAU group(18.18% vs 63.16%, P<0.05). Conclusion The levels of serum HCY and urinary MAU in patients with gestational diabetes mellitus are significantly increased. The levels of HCY and MAU are related to blood sugar level and adverse pregnancy outcomes.

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 

分 类 号：R714.256[医药卫生—妇产科学]