妊娠期糖尿病患者血清同型半胱氨酸和胱抑素C水平对妊娠结局的影响  

Effects of serum homocysteine and cystatin C levels on pregnancy outcome in patients with gestational diabetes mellitus

作　　者：黄立伟[1] 杨建彬[1] 何丹枫[1] HUANG Li-Wei;YANG Jian-Bin;HE Dan-Feng(Department of Clinical Laboratory,Nanxishan Hospital of Guangxi Zhuang Autonomous Region,Guilin,Guangxi Zhuang Autonomous Region 541002,China)

机构地区：[1]广西壮族自治区南溪山医院检验科,广西桂林541002

出　　处：《中国妇幼保健》2022年第18期3322-3326,共5页Maternal and Child Health Care of China

基　　金：广西壮族自治区卫生厅自筹经费科研课题(Z2011027)。

摘　　要：目的分析妊娠期糖尿病(GDM)患者血清同型半胱氨酸(Hcy)和胱抑素C(Cys-C)水平对妊娠结局的影响。方法选取2018年1月—2020年12月广西壮族自治区南溪山医院的GDM孕妇80例为GDM组,55例正常孕妇为对照组。采用循环酶法检测血清Hcy水平,采用免疫透射比浊法检测血清Cys-C水平,将GDM组根据血糖控制程度分为血糖控制良好组和血糖控制不良组,根据Hcy是否异常分为Hcy异常组和Hcy正常组。应用受试者工作特征(ROC)曲线分析血清Hcy、Cys-C预测妊娠结局的价值。结果对照组血清Hcy、Cys-C水平分别为(7.59±2.23)μmol/L和(0.72±0.14)mg/L;GDM组血清Hcy、Cys-C水平分别为(11.98±3.66)μmol/L和(1.15±0.35)mg/L。与对照组相比,GDM血清Hcy、Cys-C水平均显著升高,差异均有统计学意义(t=-7.923,P<0.05;t=-8.567,P<0.05)。妊娠结局良好组血清Hcy、Cys-C水平分别为(9.01±4.11)μmol/L和(0.90±0.61)mg/L;妊娠结局不良组血清Hcy、Cys-C水平分别为(15.70±4.82)μmol/L和(1.49±0.86)mg/L。妊娠结局不良组血清Hcy、Cys-C水平均显著高于妊娠结局良好组,差异均有统计学意义(t=-4.112,P<0.05;t=-2.891,P<0.05)。血糖控制不良组血清Hcy、Cys-C水平均显著高于血糖控制良好组,差异均有统计学意义(均P<0.05)。Hcy异常组不良妊娠结局总发生率显著高于Hcy正常组(P<0.05)。ROC曲线分析显示:血清Hcy预测妊娠结局的曲线下面积(AUC)为0.715(P<0.05),截断值为12.40μmol/L,灵敏度为57.70%,特异度为74.10%;血清Cys-C预测妊娠结局的AUC为0.693(P<0.05),截断值为1.13 mg/L,灵敏度为69.20%,特异度为64.80%。结论检测血清Hcy、Cys-C水平对GDM患者具有重要的临床价值,与GDM患者不良妊娠结局相关,可作为GDM患者不良妊娠结局的预测指标。Objective To analyze the effects of serum homocysteine(Hcy)and cystatin C(Cys-C)levels on pregnancy outcome in patients with gestational diabetes mellitus(GDM).Methods From January 2018 to December 2020,eighty pregnant women with GDM treated in Nanxishan Hospital of Guangxi Zhuang Autonomous Region were selected as GDM group,fifty-five normal pregnant women were selected as control group.Enzymatic cycling assay was used to detect serum Hcy level,immunity transmission turbidity was used to detect serum Cys-C level,the patients in GDM group were divided into good blood glucose control group and poor blood glucose control group according to blood glucose control level,and the patients in GDM group were divided into abnormal Hcy group and normal Hcy group according to serum Hcy level.Receiver operating characteristic(ROC)curve was used to analyze the value of serum Hcy and Cys-C in prediction of pregnancy outcomes.Results In control group,the levels of serum Hcy and Cys-C were(7.59±2.23)μmol/L and(0.72±0.14)mg/L,respectively;the levels of serum Hcy and Cys-C in GDM group were(11.98±3.66)μmol/L and(1.15±0.35)mg/L,respectively.Compared with control group,the levels of serum Hcy and Cys-C in GDM group increased,there were statistically significant differences(t=-7.923,P<0.05;t=-8.567,P<0.05).The levels of serum Hcy and Cys-C in good pregnancy outcome group were(9.01±4.11)μmol/L and(0.90±0.61)mg/L,respectively;the levels of serum Hcy and Cys-C in adverse pregnancy outcome group were(15.70±4.82)μmol/L and(1.49±0.86)mg/L,respectively.The levels of serum Hcy and Cys-C in adverse pregnancy outcome group were statistically significantly higher than those in good pregnancy outcome group(t=-4.112,P<0.05;t=-2.891,P<0.05).The levels of serum Hcy and Cys-C in poor blood glucose control group were statistically significantly higher than those in good blood glucose control group(P<0.05).The total incidence rate of adverse pregnancy outcome in abnormal Hcy group was statistically significantly higher than that in normal H

关 键 词：妊娠期糖尿病 同型半胱氨酸 胱抑素C 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]