孕妇血清PAPP-A、PP13、β-HCG水平与妊娠糖尿病发生风险的相关性研究  

Study on the relationship between serum PAPP-A, PP13, β-hCG and gestational diabetes mellitus in pregnant women

作　　者：张新 危丽华 ZHANG Xin;WEI Lihua(Department of Obstetrics,the Second People′s Hospital of Hengshui,Hengshui 053000,Hebei,China)

机构地区：[1]衡水市第二人民医院产一科,河北衡水053000

出　　处：《中国性科学》2021年第5期108-111,共4页Chinese Journal of Human Sexuality

基　　金：衡水市科技计划项目(2019014004Z)。

摘　　要：目的探讨孕妇血清妊娠相关血浆蛋白A(PAPP-A)、胎盘蛋白13(PP13)、β-人绒毛膜促性腺激素(β-HCG)水平与妊娠糖尿病发生风险的相关性。方法选取2017年1月至2019年12月衡水市第二人民医院诊治的120例妊娠期糖尿病患者作为研究对象,纳入观察组;选取同期临床资料完整的120例非妊娠期糖尿病孕妇作为对照组。收集患者的临床资料,检测血清PAPP-A、PP13、β-HCG水平,建立回归模型并绘制受试者操作特征(ROC)曲线。结果两组年龄、糖尿病家族史、受孕方式、孕前体重指数(BMI)、PAPP-A、PP13、β-HCG差异具有统计学意义(P<0.05)。Logistic回归分析结果显示糖尿病家族史(OR=1.782,95%CI:1.236~2.572)、受孕方式(OR=1.891,95%CI:1.156~3.092)、孕前BMI(OR=2.098,95%CI:1.214~3.625)、PAPP-A(OR=1.891,95%CI:1.156~3.092)、PP13(OR=2.511,95%CI:2.008~3.140)、β-HCG(OR=1.340,95%CI:1.182~1.519)是妊娠糖尿病的危险因素。以发生妊娠糖尿病为结果变量,PAPP-A、PP13、β-HCG为检验变量进行ROC曲线分析,结果显示PAPP-A、PP13、β-HCG预测妊娠糖尿病的临界值为0.79mU/L、68.54pg/mL、2 461.68mIU/mL,曲线下面积(AUC)为0.706、0.603、0.633,灵敏度为0.663、0.683、0.852,特异度为0.876、0.871、0.705,三者联合诊断的AUC为0.744,灵敏度为0.887,特异度为0.913。结论β-HCG、PP13、PAPP-A三者联合预测妊娠期糖尿病的价值较高。Objective To investigate the corelation between the levels of PAPP-A, PP13, β-HCG and gestational diabetes mellitus in pregnant women. Methods 120 patients with gestational diabetes treated in the Second People′s Hospital of Hengshui from January 2017 to December 2019 were selected as the observation group, and 120 non-gestational diabetes pregnant women with complete clinical data during the same period were selected as the control group. Collect the clinical data of patients, detect the expression level of serum PAPP-A, PP13, β-HCG, establish regression model and draw ROC curve. Results There were significant differences in age, family history of diabetes, conception method, pre-pregnancy BMI, PAPP-A, PP13 and β-HCG between the two groups(P<0.05). Logistic regression analysis showed that family history of diabetes mellitus(OR=1.782, 95%CI: 1.236~ 2.572), method of conception(OR=1.891, 95%CI: 1.156~ 3.092), pre-pregnancy BMI(OR=2.098, 95%CI: 1.214~3.625), PAPP-A(OR=1.891, 95%CI: 1.156~3.092), PP13(OR=2.511, 95%CI: 2.008~3.140), β-HCG(OR=1.340, 95%CI: 1.182~1.519) were risk factors for gestational diabetes mellitus. Taking the occurrence of gestational diabetes mellitus as the outcome variable and PAPP-A, PP13 and β-HCG as the test variables, ROC curve analysis showed that the critical values of PAPP-A, PP13 and β-HCG for predicting gestational diabetes mellitus were 0.79 mU/L, 68.54 pg/mL, 2,461.68 mIU/mL, respectively. The area under the curve(AUC) was 0.706, 0.603, 0.633, the sensitivity was 0.663, 0.683, 0.852, and the specificity was 0.876, 0.871, 0.705. The AUC of the combination of β-HCG, PP13 and PAPP-A is 0.744, the sensitivity 0.887, and the specificity 0.913. Conclusions The combination of β-HCG, PP13 and PAPP-A is of great value in predicting gestational diabetes mellitus and has certain clinical value.

关 键 词：妊娠相关血浆蛋白A 胎盘蛋白13 Β-人绒毛膜促性腺激素 妊娠糖尿病 

分 类 号：R714[医药卫生—妇产科学]