妊娠期糖尿病患者β-hCG水平TNF-α/IL-10比值与不良妊娠结局关系研究  

Relationship betweenβ-hCG Levels TNF-α/IL-10 Ratio and Adverse Pregnancy Outcomes in Pregnant Women with Gestational Diabetes Mellitus

作　　者：朱玲 曾令芳 ZHU Ling;ZENG Lingfang(Huangshan People's Hospital,Anhui Huangshan 245000,China)

机构地区：[1]安徽省黄山市人民医院,安徽黄山245000

出　　处：《河北医学》2024年第12期2059-2063,共5页Hebei Medicine

基　　金：安徽省卫生健康科研项目,(编号:AHWJ2022b108)。

摘　　要：目的:观察妊娠期糖尿病(GDM)患者β-人绒毛膜促性腺激素(β-hCG)、肿瘤坏死因子α(TNF-α)/白介素-10(IL-10)比值变化情况,并分析其与不良妊娠结局的关系。方法:纳入2020年1月至2023年1月本院收治的GDM患者102例,检测患者血清β-hCG、TNF-α/IL-10比值,分析其水平变化与发生不良妊娠结局的关联性。结果:不良妊娠结局孕妇血清β-hCG、TNF-α/IL-10比值明显高于正常妊娠结局,差异有统计学意义(P<0.05);单因素分析显示:不良孕产史、细菌性阴道病、年龄、HbA1c与GDM患者不良妊娠结局有关,差异有统计学意义(P<0.05);Logistic回归分析显示:不良孕产史及年龄、HbA1c、β-hCG、TNF-α/IL-10比值是影响GDM患者不良妊娠结局的危险因素(P<0.05);ROC,结果显示:血清β-hCG、TNF-α/IL-10评估GDM患者不良妊娠结局的AUC分别为0.804(95%CI:0.695~0.912)、0.729(95%CI:0.614~0.844),二项指标联合评估GDM患者不良妊娠结局的AUC为0.867(95%CI:0.787~0.947),最大约登指数下的敏感度、特异度分别为0.786、0.811。结论:GDM孕妇血清β-hCG、TNF-α/IL-10异常升高与不良妊娠结局存在一定的关联性,二者联合评估对不良妊娠结局具有较高的评估价值。Objective:To observe the changes ofβ-human chorionic gonadotropin(β-hCG)and tumor necrosis factor-α(TNF-α)/interleukin-10(IL-10)ratio in patients with gestational diabetes mellitus(GDM),and to analyze the relationship with adverse pregnancy outcomes.Methods:A total of 102 GDM patients admitted to our hospital from January 2020 to January 2023 were included.The serum levels ofβ-hCG and the TNF-α/IL-10 ratio were detected,and their association with adverse pregnancy outcomes was analyzed.Results:Serumβ-hCG and TNF-α/IL-10 ratio of pregnant women with adverse pregnancy outcomes were significantly higher than those of pregnant women with normal pregnancy outcomes(P<0.05).Univariate analysis showed that history of adverse pregnancy,bacterial vaginosis,age and HbA1c were associated with adverse pregnancy outcomes in GDM patients(P<0.05).Logistic regression analysis indicated that adverse pregnancy history,age,HbA1c,β-hCG,and TNF-α/IL-10 ratio were risk factors for adverse pregnancy outcomes in GDM patients(P<0.05).ROC results suggested that the AUCs of serumβ-hCG and TNF-α/IL-10 in evaluating adverse pregnancy outcomes in GDM patients were 0.804(95%CI:0.695~0.912)and 0.729(95%CI:0.614~0.844)respectively.The AUC of the combination of the two indicators was 0.867(95%CI:0.787~0.947)in assessing the adverse pregnancy outcomes,and the sensitivity and specificity under the maximum Youden index were 0.786 and 0.811,respectively.Conclusion:Abnormal increases in serumβ-hCG and the TNF-α/IL-10 ratio in GDM pregnant women are associated with adverse pregnancy outcomes,and their combined assessment has a high evaluation value for adverse pregnancy outcomes.

关 键 词：妊娠期糖尿病 妊娠结局 Β-人绒毛膜促性腺激素 肿瘤坏死因子Α 白介素-10 

分 类 号：R714.256[医药卫生—妇产科学]