GDM患者妊娠早期血清SerpinB1水平预测不良妊娠结局的研究  

Serum SerpinB1 level of patients with gestational diabetes mellitus in the first trimester of pregnancy in the prediction of adverse pregnancy outcome

作　　者：吴小妹[1] 王丽 邢增丽 李跃萍[2] Wu Xiaomei;Wang Li;Xing Zengli;Li Yueping(Department of Obstetrics,First Affiliated Hospital of Hainan Medical College;Department of Histology and Embryology,Hainan Medical CollegeyHaikou Hainan 570000,P.R.China)

机构地区：[1]海南医学院第一附属医院产科,海南海口570000 [2]海南医学院组织胚胎学教研室

出　　处：《中国计划生育和妇产科》2022年第3期54-57,共4页Chinese Journal of Family Planning & Gynecotokology

基　　金：海南省卫生健康行业科研项目(项目编号:19A20043)。

摘　　要：目的 观察妊娠早期血清丝氨酸蛋白酶抑制剂B1(Serine proteinase inhibitorB1,SerpinB1)在妊娠期糖尿病(gestational diabetes mellitus, GDM)患者中的表达,分析其预测GDM不良妊娠结局的价值。方法 选取2020年1~12月于海南医学院第一附属医院产检并分娩的孕妇1 200例,其中215例孕妇于孕24~28周经口服葡萄糖耐量试验确诊为GDM患者,记录患者不良妊娠结局情况并分为不良妊娠结局组和妊娠结局正常组。入院时由调查员询问并记录患者基线资料,于妊娠早期(孕12周之前)检测患者实验室相关指标,重点检测血清SerpinB1水平,分析妊娠早期血清SerpinB1水平预测GDM患者不良妊娠结局的价值。结果 215例GDM患者中74例发生不良妊娠结局,发生率为34.42%;不良妊娠结局组患者妊娠早期总胆固醇(total cholesterol, TC)、甘油三酯(triglyceride, TG)、糖化血红蛋白(hemoglobin A1C,HbA1C)、空腹血糖(fasting blood glucose, FBG)及SerpinB1水平均高于妊娠结局正常组(P<0.05);回归分析结果显示,妊娠早期TC、TG、HbA1C、FBG水平异常升高及SerpinB1过表达均与GDM患者不良妊娠结局有关,可作为GDM患者不良妊娠结局的风险因子(OR>1,P<0.05);绘制ROC曲线,妊娠早期血清SerpinB1水平预测GDM患者不良妊娠结局风险的AUC为0.872(95%CI:0.826-0.919,P<0.05),有一定预测价值,且当血清SerpinB1水平的cut-off值取2.96 ng/mL时,可获得最佳预测价值。结论 GDM患者妊娠早期血清SerpinB1水平异常升高与不良妊娠结局有关,对预测不良妊娠结局发生风险有一定价值。Objective To observe the expression of serum serine protease inhibitor B1(SerpinB1) in patients with gestational diabetes mellitus(GDM) in the first trimester of pregnancy, and to analyze the value of SerpinB1 in the prediction of adverse pregnancy outcome of GDM.Methods 1 200 cases of pregnant women who underwent prenatal examination and labor in First Affiliated Hospital of Hainan Medical College from January 2020 to December 2020 were prospectively selected, of which 215 cases were diagnosed as GDM by oral glucose tolerance test at 24~28 weeks of gestation;adverse pregnancy outcomes of patients were recorded and grouped into adverse pregnancy outcome group and normal pregnancy outcome group;the baseline data of the patients were inquired and recorded by the investigators at admission, in the first trimester of pregnancy(before 12 weeks of gestation),laboratory related indicators were detected, serum SerpinB1 level was mainly detected;the value of serum SerpinB1 level in the first trimester of pregnancy in predicting adverse pregnancy outcomes in patients with GDM was analyzed.Results Among 215 patients with GDM,74 had adverse pregnancy outcomes, the incidence was 34.42%;the levels of TC,TG,HbA1 C,FBG and SerpinB1 in the adverse pregnancy outcome group were significantly higher than those in the normal pregnancy outcome group(P<0.05);the results of Logistic regression analysis showed that abnormal increase of TC,TG,HbA1 C,FBG levels and overexpression of SerpinB1 in the first trimester of pregnancy were associated with adverse pregnancy outcomes in patients with GDM,which might be risk factors of adverse pregnancy outcome in GDM patients(OR>1,P<0.05);the ROC curve was drawn, the AUC of serum SerpinB1 level in the first trimester of pregnancy in predicting the risk of adverse pregnancy outcome in GDM patients was 0.872(95% CI:0.826-0.919,P<0.05),which had certain predictive value, when the cut-off value of serum SerpinB1 level was 2.96 ng/mL,the best predictive value could be obtained.Conclusion Abnormal increas

关 键 词：妊娠期糖尿病 妊娠结局 丝氨酸蛋白酶抑制剂B1 妊娠早期 预测 

分 类 号：R714.2[医药卫生—妇产科学]