心肌酶谱、凝血功能指标与妊娠期糖尿病的关系及对不良妊娠结局的预测价值分析  

Relationship between myocardial enzyme profile, coagulation function index and gestational diabetes mellitus and the predictive value of adverse pregnancy outcome

作　　者：成春岚 钟太清 李宁[1] 石艳艳[1] 朱巧英[1] CHENG Chun-lan;ZHONG Tai-qing;LI Ning(Department of Clinical Laboratory,Sichuan Provincial Maternity and Child Health Care Hospital,Chengdu Sichuan 610045,China)

机构地区：[1]四川省妇幼保健院检验科,四川成都610045

出　　处：《临床和实验医学杂志》2023年第13期1431-1434,共4页Journal of Clinical and Experimental Medicine

基　　金：四川省科技厅应用基础研究项目(编号:2019YJ0578)。

摘　　要：目的 分析心肌酶谱、凝血功能指标与妊娠期糖尿病的关系及对不良妊娠结局的预测价值。方法 回顾性选取2020年1月至2022年1月四川省妇幼保健院收治的200例妊娠期糖尿病患者作为观察组,另选同期的200例正常妊娠孕妇作为对照组。在妊娠24~28周,检测两组心肌酶谱[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、α-羟丁酸脱氢酶(HBDH)、乳酸脱氢酶(LDH)]、凝血功能[凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原(FIB)、D二聚体(DD)]、胰岛素抵抗指数、胰岛素分泌指数的差异,使用Pearson相关性分析心肌酶谱、凝血功能指标与妊娠期糖尿病患者胰岛素抵抗程度的关系,通过受试者工作特征(ROC)曲线下面积(AUC)评价心肌酶谱联合凝血功能指标预测妊娠期糖尿病患者发生流产的准确性。结果 在妊娠24~28周,观察组血清CK、CK-MB、HBDH、LDH水平分别为(289.56±22.43)、(33.34±7.76)、(156.34±18.97)、(293.62±45.48) U/L,均明显高于对照组[(108.74±8.56)、(10.72±3.30)、(72.45±7.81)、(125.06±16.74) U/L],差异均有统计学意义(P<0.05)。观察组PT、APTT分别为(10.47±1.72)、(28.02±2.13) s,均短于对照组[(12.95±2.36)、(31.45±4.58) s],FIB、DD水平分别为(4.86±0.89) g/L、(1.70±0.64) mg/L,均高于对照组[(3.36±0.57) g/L、(0.98±0.30) mg/L],差异均有统计学意义(P<0.05)。观察组胰岛素抵抗指数为3.28±0.56,大于对照组(1.97±0.24),胰岛素分泌指数为123.57±11.27,小于对照组(183.54±15.29),差异均有统计学意义(P<0.05)。经Pearson相关性分析,妊娠期糖尿病患者血清CK、CK-MB、FIB、DD水平均与胰岛素抵抗指数呈正相关(P<0.05),与胰岛素分泌指数呈负相关(P<0.05)。在200例妊娠期糖尿病患者中,发生流产36例,占18.00%;其中流产组血清CK、CK-MB、FIB、DD水平均高于非流产组,差异均有统计学意义(P<0.05)。经ROC曲线分析,血清CK、CK-MB、FIB联合DD预测妊娠期糖尿病患�Objective To analyze the relationship between myocardial enzyme profile,coagulation function index and gestational diabetes mellitus and the predictive value of adverse pregnancy outcome.Methods Two hundred patients with gestational diabetes mellitus admitted to our hospital from January 2020 to January 2022 were selected as the observation group,and 200 normal pregnant women during the same period were selected as the control group.At 24 to 28 weeks of gestation,myocardial enzyme profile[creatine kinase(CK),creatine kinase isoenzyme(CK-MB),α-hydroxybutyrate dehydrogenase(HBDH)and lactate dehydrogenase(LDH)]and coagulation function index[prothrombin time(PT)and activated partial prothrombin time(APTT),fibrinogen(FIB)and D dimer(DD)],insulin resistance index,insulin secretion index of the two groups were detected,and the relationship between myocardial enzyme profile and coagulation function index and insulin resistance degree of gestational diabetes patients was analyze by using Pearson correlation.The area under the curve(AUC)of receiver operating characteristic(ROC)was used to evaluate the accuracy of myocardial enzyme profile combined with coagulation function index in predicting abortion in patients with gestational diabetes.Results At 24 to 28 weeks of gestation,the serum levels of CK,CK-MB,HBDH and LDH in observation group were(289.56±22.43),(33.34±7.76),(156.34±18.97),(293.62±45.48)U/L,which were higher than those in control group[(108.74±8.56),(10.72±3.30),(72.45±7.81),(125.06±16.74)U/L],the differences were statistically significant(P<0.05).The PT and APTT levels in the observation group were(10.47±1.72)and(28.02±2.13)s,respectively,shorter than those in the control group[(12.95±2.36)and(31.45±4.58)s].The FIB and DD levels were(4.86±0.89)g/L and(1.70±0.64)mg/L,respectively,which were higher than those in the control group[(3.36±0.57)g/L and(0.98±0.30)mg/L],the differences were statistically significant(P<0.05).The insulin resistance index of the observation group was 3.28±0.56,which was

关 键 词：妊娠期糖尿病 心肌酶谱 凝血功能 不良妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]