妊娠早期糖尿病患者血清中和肽素及生化指标的诊断价值  

Diagnostic value of serum neutralizing peptides and biochemical indexes in early gestational diabetes mellitus

作　　者：宋莉莉[1] 侯秀真 冯妙肖 张艳红 马合红[1] SONG Lili;HOU Xiuzhen;FENG Miaoxiao;ZHANG Yanhong;MA Hehong(The First Department of Obstetrics,Cangzhou Central Hospital,Hebei Cangzhou,061000,China)

机构地区：[1]沧州市中心医院产一科,河北沧州061000

出　　处：《新疆医科大学学报》2021年第4期474-478,共5页Journal of Xinjiang Medical University

基　　金：河北省科技计划项目(17277725D);沧州市重点研发计划指导项目(172302084)。

摘　　要：目的分析妊娠早期糖尿病(GDM)患者血清中和肽素及生化指标的诊断价值。方法选取2017年6月—2019年6月期间我院收治的1 086例妊娠早期GDM患者为观察组,并选取同期我院收治的1086例非GDM孕产妇为对照组。比较两组的血糖、胰岛素、和肽素、IR相关指数、各项生化指标情况,分析和肽素、各生化指标与空腹血糖的相关性,并分析和肽素与各生化指标单独检测与联合检测对妊娠早期GDM的诊断价值。结果与对照组比较,观察组患者的空腹血糖、餐后不同时刻血糖、空腹胰岛素水平均升高,餐后不同时刻胰岛素均降低,差异统计学有意义(P<0.05)。与对照组比较,观察组患者的和肽素、HOMA-β、INS_(AUC)/PG_(AUC)水平均降低,HOMA-IR水平均升高,差异统计学有意义(P<0.05)。与对照组相比,观察组患者的HDL-C、Ca^(2+)、P^(3+)、iPTH、Alb、BUN、Scr、NTproBNP水平比较差异统计学无意义(P>0.05);与对照组相比,观察组患者的TG、LDL-C、TC、TSH、FIB、hs-CRP水平均升高(P<0.05)。TG、LDL-C、TC、TSH、FIB、hs-CRP水平与空腹血糖呈现正相关,和肽素与空腹血糖呈现负相关(P<0.05)。以和肽素和FIB开展探究,显示和肽素的灵敏度、特异性和Youden指数分别为96.32%、89.53%和0.86,FIB的灵敏度、特异性和Youden指数分别为90.70%、83.93%和0.75,和肽素+FIB的灵敏度、特异性和Youden指数分别为98.16%、94.58%和0.93。和肽素+FIB的灵敏度、特异性和Youden指数均优于单独使用和肽素、FIB。同样方式计算得出和肽素与任一有意义的生化指标联合检测的诊断效果均优于单独诊断。结论妊娠早期GDM患者的血清和肽素、TG、LDL-C、TC、TSH、FIB、hs-CRP水平升高,与胰岛素功能相关,对妊娠早期GDM患者有一定的诊断价值,且联合诊断效果更佳。Objective To analyze the diagnostic value of serum neutralizing peptides and biochemical indexes in patients with early gestational diabetes mellitus(GDM).Methods A total of 1,086 early pregnancy GDM patients admitted to our hospital from June 2017 to June 2019 were selected as the observation group,and 1,086 non-GDM pregnant women admitted to our hospital during the same period were selected as the control group.Blood glucose,insulin,pep-tidin,IR correlation index and various biochemical indexes of the two groups were compared,and the correlation be-tween peptidin and various biochemical indexes and fasting blood glucose was analyzed,and the diagnostic value ofpeptidin alone and combined with various biochemical indexes in the diagnosis of GDM in early pregnancy was ana-lyzed.Results Compared with the control group,fasting blood glucose,blood glucose at different moments after mealand fasting insulin levels in observation group were all increased,while insulin levels at different moments after mealwere all decreased,and the difference was statistical significance(P<0.05).Compared with the control group,the lev-els of peptidin,HOMA-β,INS_(AUC)/PG_(AUC)in the observation group were decreased,and the levels of HOMA-IR were in-creased,the differences were statistically significant(P<0.05).Compared with the control group,the levels of HDL-C,Ca2+,P3+,i PTH,Alb,BUN,Scr and NT-pro BNP in the observation group were statistically insignificant(P>0.05).Compared with the control group,the levels of TG,LDL-C,TC,TSH,FIB and hs-CRP in observation group were allincreased(P<0.05).TG,LDL-C,TC,TSH,FIB,hs-CRP levels were positively correlated with fasting blood glucose,and copeptin was negatively correlated with fasting blood glucose(P<0.05).The sensitivity,specificity and Youden in-dex of peptidin and FIB were 96.32%,89.53%and 0.86,respectively.The sensitivity,specificity and Youden index ofFIB and peptidin+FIB were 90.70%,83.93%and 0.75,respectively.The sensitivity,specificity and Youden index ofpeptidin+FIB were 98.16%,94.58%an

关 键 词：妊娠糖尿病 早期 肽素 生化指标 

分 类 号：R587.1[医药卫生—内分泌]