OGTT试验、血清铁蛋白和相关炎性因子在妊娠期糖尿病诊断中的应用  

Application Value of OGTT Test,Serum Ferritin and Related Inflammatory Factors in Gestational Diabetes Mellitus Diagnosis

作　　者：席向红 马婷婷 席雪晗 柳娜 张建荣 郭小龙 XI Xianghong;MA Tingting;XI Xuehan;LIU Na;ZHANG Jianrong;GUO Xiaolong(Medical Experimental Center,Geneal Hospital of Ningxia Medical University,Yinchuan 750004,China;Department of Clinical Medicine,Chuanbei Medical College,Nanchong 637100,China)

机构地区：[1]宁夏医科大学总医院医学实验中心,银川750004 [2]川北医学院临床医学系,四川南充637100

出　　处：《宁夏医科大学学报》2021年第8期816-819,835,共5页Journal of Ningxia Medical University

基　　金：宁夏医科大学重点项目(XZ2018010)。

摘　　要：目的探讨妊娠期糖尿病(GDM)孕妇糖代谢指标、血清铁蛋白(SF)等炎性因子及生长激素(GH)含量的变化及意义。方法选取69例孕中期GDM孕妇和63例葡萄糖耐量正常孕妇(NGT),进行75 g口服葡萄糖耐量试验(OGTT)试验和血细胞计数,测定SF、GH、空腹胰岛素(FINS)及白介素-6(IL-6)的水平,计算胰岛素抵抗指数(HOMA-IR)并统计分析,采用Logistic回归分析GDM发生的影响因素。结果69例GDM孕妇OGTT结果显示,空腹血糖(FBS)异常26例(37.7%),餐后1 h 32例(46.4%)和2 h 45例(65.2%)。其中1项异常41例(59.4%),2项异常17例(24.6%),3项异常11例(15.9%)。尿糖的检出率5.8%,漏诊率达94.2%。GDM孕妇血清FBS、餐后1 h血糖、餐后2 h血糖、SF、FINS、IL-6水平和HOMA-IR均高于对照组,GH水平低于对照组(P均<0.01);白细胞(WBC)计数、中性粒细胞绝对值(Neu)、单核细胞绝对值(Mono)与对照组比较差异均无统计学意义(P均>0.05)。Logistic回归分析结果显示,SF和GH是GDM发生的影响因素(P均<0.05)。结论OGTT不同时间点的血糖值诊断GDM有一定差异,3点血糖监测方式可有效降低GDM的漏诊。SF和GH与GDM的发病有关。Objective To investigate the value of glucose metabolism and inflammatory cytokines such as the oral glucose tolerance test(OGTT),serum ferritin(SF)and growth hormone(GH)in pregnant women with gestational diabetes mellitus(GDM).Methods A total of 69 cases of pregnant women with GDM was selected as the experimental group and 63 cases of pregnant women with normal glucose tolerance(NGT)as the control group.The 75 g OGTT test and blood cell count were performed and also the levels of SF,GH,fasting insulin(FINS)and interleukin-6(IL-6)were measured in the above two groups.Insulin resistance index(HOMA-IR)was calculated and statistically analyzed.Logistic regression was used to analyze the influencing factors of GDM.Results There were only 26(37.7%)of 69 GDM pregnant women with abnormal fasting blood glucose(FBS),much lower than the number of 1 hour(32 cases,46.4%)and 2 hours(45 cases,65.2%)after meals.In these GDM pregnant women,41 cases(59.4%)were found to be abnormal with one indicator of OGTT,17 cases(24.6%)with two indicators and 11 cases(15.9%)with three indicators.The urine sugar detection rate was only 5.8%,and the missed diagnosis rate was 94.2%.The levels of serum FBS,1 h glucose,2 h glucose,SF,FINS and HOMA-IR in the experimental group were significantly higher than those in the control group.Serum SF and IL-6 in the experimental group was significantly higher than the control group,while GH levels were lower than the control group(P all<0.01).There was no statistically significant difference in white blood cell count(WBC count),Neu and Mono count between these two groups(P all>0.05).Logistic regression analysis showed that the serum level of SF and GH were the independent risk factors of GDM(P all<0.05).Conclusion The OGTT blood glucose value at different time points has certain differences in the diagnosis of GDM.The 3-point blood glucose monitoring method can effectively reduce the missed diagnosis of GDM.The serum levels of SF and GH are independent factors of GDM,respectively.

关 键 词：妊娠期糖尿病 葡萄糖耐量试验 炎性因子 生长激素 

分 类 号：R714.256[医药卫生—妇产科学]