妊娠期糖尿病孕妇肠道菌群、炎症因子及T细胞亚群分析  

Analysis of the intestinal flora situation and the levels of inflammatory cytokines and T cell subsets of pregnant women with gestational diabetes mellitus

作　　者：张中敏[1] 王海艳[2] 任春丽[2] 刘艳芳 ZHANG Zhongmin;WANG Haiyan;REN Chunli;LIU Yanfang(Staff Hospital of Chengde Iron and Steel Group Co. Ltd., Chengde, Hebei Province, 067102;Affiliated Hospital of Chengde Medical College;Chengde Maternal and Child Health Care Hospital)

机构地区：[1]承德钢铁集团有限公司职工医院,067102 [2]承德医学院附属医院 [3]河北省承德市妇幼保健院

出　　处：《中国计划生育学杂志》2021年第9期1924-1929,共6页Chinese Journal of Family Planning

基　　金：河北省科技支撑计划项目(201801A057)。

摘　　要：目的:探讨妊娠期糖尿病(GDM)孕妇肠道菌群、炎症因子及T细胞亚群水平及其妊娠结局。方法:回顾性收集2016年1月—2018年1月本院产前检查并分娩的196例孕妇临床资料,其中132例健康妊娠孕妇为对照组,64例GDM孕妇为观察组,检测两组孕妇肠道菌群[肠杆菌、肠球菌、双歧杆菌、乳杆菌、拟杆菌、梭杆菌]数量、炎性因子[白细胞介素-2(IL-2)、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]水平、T细胞亚群[CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)]水平;logistic多因素分析妊娠期发生GDM危险因素;Spearman相关系数分析肠道菌群、炎性因子、T细胞亚群与GDM妊娠结局相关性。结果:观察组IL-2、CRP、TNF-α值及肠杆菌、肠球菌、拟杆菌、梭杆菌数量均大于对照组,而CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)值及双歧杆菌、乳杆菌数量均小于对照组,新生儿低血糖、巨大儿及剖宫产发生率高于对照组(均P<0.05)。乳酸杆菌和双歧杆菌数量、IL-2、CRP、TNF-α值、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)是妊娠期妇女发生GDM危险因素(P<0.05),GDM孕妇乳酸杆菌、双歧杆菌、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)与剖宫产、巨大儿、新生儿低血糖呈负相关(P<0.05),IL-2、CRP、TNF-α值与巨大儿、剖宫产呈正相关(P<0.05)。结论:GDM孕妇伴有肠道益生菌群数量和免疫功能降低、炎性反应增高,且肠道菌群、免疫功能及炎性反应异常可导致不良妊娠结局,进行干预对降低GDM发生与不良结局可能有临床价值。Objective:To investigate the intestinal flora situation,and the levels of inflammatory cytokines and T cell subsets,and the pregnancy outcomes of pregnant women with gestational diabetes mellitus(GDM).Methods:The clinical data of 196 pregnant women from January 2016 to January 2018 were analyzed retrospectively,which included 132 healthy pregnant women in control group and 64 pregnant women with GDM in research group.The number of intestinal flora,such as enterobacter,enterococcus,bifidobacterium,lactobacillus,bacteroides,and fusobacterium,the levels of inflammatory factors interleukin-2(IL-2),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),and the levels of T cell subsets CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)of the women in the two groups were detected.Logistic multivariate analysis was used to determine the risk factors of GDM during pregnancy.Spearman correlation coefficient was used to analyze the correlation between intestinal flora number,the levels of inflammatory factors and T cell subsets of the women with GDM and their pregnancy outcomes.Results:The levels of IL-2,CRP,and TNF-α,and the number of enterobacter,enterococcus,bacteroidetes and fusobacterium of the women in the research group were significant higher than those of the women in the control group,while the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),and the number of bifidobacteria and lactobacillus of the women in the research group were significant lower than those of the women in the control group.The incidence of neonatal hypoglycemia,macrosomia,and cesarean section of the women in the research group were significant higher than those of the women in the control group(all P<0.05).The number of lactobacillus and bifidobacterium,and the levels of IL-2,CRP,TNF-α,CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)were the risk factors of GDM of pregnant women(P<0.05).The number of lactobacillus and bifidobacterium,and the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)of pregnant women with GDM were negatively correlated with their rates of caesarean sectio

关 键 词：妊娠期糖尿病 肠道菌群 炎症因子 T细胞亚群 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]