妊娠中晚期外周血淋巴细胞亚群对妊娠期糖尿病不良妊娠结局的预测价值  

Predictive value of peripheral blood lymphocyte subsets for adverse pregnancy outcomes in patients with gestational diabetes mellitus

作　　者：张明红[1] 殷娟[2] Zhang Minghong;Yin Juan(Department of Clinical Laboratory,Renhe District People′s Hospital of Panzhihua City,Panzhihua 617061,China;Department of Clinical Laboratory,Panzhihua Central Hospital,Panzhihua 617000,China)

机构地区：[1]攀枝花市仁和区人民医院检验科,攀枝花617061 [2]攀枝花市中心医院检验科,攀枝花617000

出　　处：《中国医师进修杂志》2024年第12期1116-1120,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的分析妊娠期糖尿病(GDM)孕妇外周血T淋巴细胞亚群与妊娠结局的关系及其对不良妊娠结局的预测价值。方法回顾性分析2020年1月至2022年10月攀枝花市仁和区人民医院收治的518例孕妇的临床资料,根据是否患有GDM分为GDM组(113例)和非GDM组(405)例。两组均在妊娠24~28周时检测外周血T淋巴细胞亚群百分比,并随访孕妇妊娠结局。以发生剖宫产、早产、大于胎龄儿(LGA)、子痫前期等其中任一事件认定为不良妊娠复合终点事件。采用Logistic回归分析不良妊娠复合终点事件的影响因素,采用受试者工作特征曲线分析T淋巴细胞亚群对不良妊娠结局的预测价值。结果单因素Logisitc回归分析结果显示,CD_(4)^(+)T淋巴细胞升高、CD_(8)^(+)T淋巴细胞降低和CD_(4)^(+)/CD_(8)^(+)升高是GDM孕妇发生不良妊娠复合终点事件的危险因素(P<0.05)。多因素Logisitc回归分析结果显示,CD_(4)^(+)/CD_(8)^(+)升高是GDM孕妇发生不良妊娠复合终点事件的独立危险因素(P<0.05)。ROC曲线分析结果表明,CD_(4)^(+)/CD_(8)^(+)预测GDM孕妇不良妊娠复合终点事件的曲线下面积(AUC)为0.798(95%CI 0.713~0.868),特异度为61.7%,灵敏度为93.8%;CD_(4)^(+)/CD_(8)^(+)预测GDM孕妇剖宫产、早产、LGA、子痫前期的AUC分别为0.737、0.772、0.712、0.718。结论CD_(4)^(+)/CD_(8)^(+)升高是GDM孕妇不良妊娠的危险因素,可作为GDM孕妇不良妊娠结局的预测指标。ObjectiveTo analysis the relationship between peripheral blood lymphocyte subsets and adverse pregnancy outcomes in patients with gestational diabetes mellitus(GDM),and to explore its predictive values.MethodsA total of 518 GDM patients′clinical data who treated in the Renhe District People′s Hospital of Panzhihua City from January 2020 to October 2022 were retrospectively analzed.According to whether they had GDM,they were divided into the GDM group(113 cases)and the non-GDM group(405 cases).All participants detected peripheral blood lymphocyte subset during the 24-28 gestational weeks,and the pregnancy outcomes were followed up.Any of these events,including cesarean section,premature delivery,larger-than-gestational age(LGA),and preeclampsia were considered as adverse pregnancy complex end points.Logistic regression was used to analyze the influencing factors of adverse pregnancy complex endpoint events,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of T lymphocyte subsets for adverse pregnancy outcomes.ResultsSingle-factor Logisitc regression analysis showed that increased CD_(4)^(+)T lymphocytes,decreased CD_(8)^(+)T lymphocytes and increased CD_(4)^(+)/CD_(8)^(+)were risk factors for adverse pregnancy complex endpoint events in GDM pregnant women(P<0.05).Multivariate Logisitc regression analysis showed that increased CD_(4)^(+)/CD_(8)^(+)was an independent risk factor for adverse pregnancy complex endpoint events in GDM pregnant women(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of CD_(4)^(+)/CD_(8)^(+)in predicting adverse pregnancy complex endpoint events in GDM women was 0.798(95%CI 0.713-0.868),the specificity was 61.7%,and the sensitivity was 93.8%.The CD_(4)^(+)/CD_(8)^(+)predicted the AUC of cesarean section,preterm delivery,LGA and preeclampsia in GDM pregnant women were 0.737,0.772,0.712 and 0.718,respectively.ConclusionsThe increased CD_(4)^(+)/CD_(8)^(+)is a risk factor for adverse pregnancy in GDM pregnant women,and the CD_(4)^(

关 键 词：糖尿病 妊娠 T淋巴细胞亚群 妊娠结局 预测 

分 类 号：R714.256[医药卫生—妇产科学]