维生素及叶酸水平对妊娠期糖尿病并发子痫前期的预测价值  

Predictive value of vitamin and folic acid levels in gestational diabetes mellitus complicated by preeclampsia

作　　者：曹君阳 马春星 刘志娜 CAO Junyang;MA Chunxing;LIU Zhina(Department of Obstetrics,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China;Department of Gynecology,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China;Department of Obstetrics,Chongli Hospital,Peking University Third Hospital)

机构地区：[1]河北北方学院附属第一医院产科,075000 [2]河北北方学院附属第一医院妇科,075000 [3]北京大学第三医院崇礼院区产科

出　　处：《天津医药》2024年第12期1278-1282,共5页Tianjin Medical Journal

基　　金：河北省医学科学研究课题计划(20241283)。

摘　　要：目的探究维生素A、E、D及叶酸水平与妊娠期糖尿病(GDM)患者并发子痫前期(PE)的相关性。方法纳入108例GDM并发PE患者作为PE组,另纳入同期诊治并完成随访的108例GDM未合并PE患者作为GDM组,108例孕检正常孕妇作为正常对照组。比较3组一般资料,维生素A、E、D及叶酸水平。依病情严重程度将PE组再分为轻中度PE组62例和重度PE组46例并比较这2组患者维生素A、E、D及叶酸水平。结果正常对照组、GDM组和PE组收缩压、舒张压、空腹血糖(FBG)、空腹胰岛素(FINS)依次升高(P<0.05),维生素A、E、D及叶酸水平依次降低(P<0.05)。PE组甘油三酯、总胆固醇、糖化血红蛋白高于GDM组和正常对照组,高密度脂蛋白胆固醇低于后2组(P<0.05)。重度PE组维生素A、E、D及叶酸水平低于轻中度PE组(P<0.05)。较高水平的维生素A、E、D及叶酸为影响GDM患者并发重度PE的保护因素。单指标分析时,叶酸预测效能较高,敏感度较高,维生素A预测特异度较高,四者联合预测GDM患者并发重度PE的效能优于各单独指标。结论维生素A、E、D及叶酸水平在GDM并发PE患者血清中显著降低,四者联合可提高对GDM患者并发重度PE的预测价值。Objective To investigate the correlation between vitamin A,E,D and folic acid levels and concomitant preeclampsia(PE)in patients with gestational diabetes mellitus(GDM).Methods A total of 108 patients with GDM complicated with PE were used as the PE group,and another 108 GDM patients without PE were used as the GDM group.A total of 108 normal pregnant women with normal pregnancy test were used as the normal control group.The general information and vitamin A,E,D and folic acid levels were compared between the three groups.According to the severity of the disease,the PE group was subdivided into the mild-moderate PE group(62 cases)and the severe PE group(46 cases),and vitamin A,E,D and folic acid levels were compared between these two groups.Results Systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG),fasting insulin(FINS)were increased in turn in the normal control group,the GDM group and the PE groups(P<0.05),and vitamins A,E,D and folic acid levels were decreased in turn(P<0.05).Triglyceride,total cholesterol and glycated haemoglobin were higher in the PE group than those in the GDM group and the normal control,and high density lipoprotein(HDL)cholesterol was lower than that in the GDM group and the normal control group(P<0.05).Vitamin A,vitamin E,vitamin D and folic acid levels were lower in the severe PE group than those in the mild to moderate PE group(P<0.05).Higher levels of vitamin A,vitamin E,vitamin D and folate were protective factors for GDM patients with severe PE.Folic acid showed higher predictive efficacy and specificity in single indicator analysis.Vitamin A showed high predictive specificity.The combined prediction of four indicators for severe PE in GDM patients was more effective than each individual indicator.Conclusion Serum vitamin A,E,D and folate levels are significantly lower in patients with GDM complicated with PE,and the combination of all four may improve the predictive value of severe PE complicated with GDM.

关 键 词：维生素A 维生素E 维生素D 叶酸 糖尿病 妊娠 高血压 妊娠性 子痫前期 

分 类 号：R714.256[医药卫生—妇产科学] R714.245[医药卫生—临床医学]