摘要
目的探讨妊娠糖尿病(GDM)患者血清丝氨酸蛋白酶抑制剂B1(SerpinB1)、人类软骨糖蛋白-39(YKL-40)水平改变及其与不良母婴结局的关系分析。方法选取2020年5月至2021年5月郑州大学第三附属医院收治的95例GDM孕妇和同期进行孕检的83例健康孕妇,分别记为GDM组、健康组,所有孕妇均进行血清SerpinB1、YKL-40检测,随访所有孕妇及胎儿的母婴结局。对比GDM组与健康组的血清SerpinB1与YKL-40水平变化、母体不良结局和围产儿不良结局发生率,logistic分析GDM组血清SerpinB1、YKL-40水平变化与母体不良结局、围产儿不良结局的关系。结果GDM组血清SerpinB1、YKL-40水平均高于健康组(P<0.05);GDM组母体不良结局发生率、围产儿不良结局发生率高于健康组(P<0.05);GDM组母体不良结局者孕前体重指数、入组孕周、受教育程度与无母体不良结局者对比,差异无统计学意义(P>0.05),GDM患者母体不良结局者年龄、孕期体重指数、家族糖尿病病史占比、经产妇占比、血清SerpinB1与YKL-40水平高于无母体不良结局者(P<0.05),年龄、孕期体重指数、家族糖尿病病史、经产妇、血清SerpinB1与YKL-40偏高是GDM患者母体不良结局的独立危险因素(OR=2.190,P=0.023;OR=2.008,P=0.025;OR=2.044,P<0.001;OR=2.184,P<0.001;OR=2.132,P=0.010;OR=2.032,P=0.001)。GDM组围产儿不良结局者母体的孕前体重指数、入组孕周、受教育程度与无围产儿不良结局者对比,差异无统计学意义(P>0.05),GDM组围产儿不良结局者母体的年龄、孕期体重指数、家族糖尿病史占比、经产妇占比、血清SerpinB1与YKL-40水平高于无围产儿不良结局者(P<0.05),母体的年龄、孕期体重指数、家族糖尿病史、经产妇、血清SerpinB1与YKL-40水平偏高是GDM患者围产儿不良结局的独立危险因素(OR=2.223,P=0.014;OR=2.268,P=0.012;OR=2.106,P=0.015;OR=2.153,P=0.007;OR=2.250,P=0.019;OR=2.100,P=0.017)。结论GDM组SerpinB1、YKL-40水平均偏高,GDM组母体不良结局、围产儿不良结局发生风险高,且母体血清SerpinB1与YKL-40水平等与GDM患者母体不良结局、围产儿不良结局有密切关系。
Objective To investigate changes of serum serine protease inhibitor B1(SerpinB1)and human cartilage glycoprotein-39(YKL-40)levels in patients with gestational diabetes mellitus(GDM)and their relationship with adverse maternal and perinatal outcomes.Methods A total of 95 pregnant women with GDM admitted to the Third Affiliated Hospital of Zhengzhou University from May 2020 to May 2021 and 83 healthy pregnant women who underwent pregnancy examination during the same period were selected as GDM group and healthy group.Serum SerpinB1 and YKL-40 were detected in all pregnant women.All pregnant women and fetuses were followed up for diagnosis of maternal and neonatalt outcomes.The clinical datas,serum SerpinB1 and YKL-40 levels,and adverse maternal outcomes and perinatal outcomes were compared between GDM group and healthy group,and the relationship between serum SerpinB1 and YKL-40 levels and adverse maternal outcomes and perinatal outcomes were logistic analyzed in GDM group.Results The serum levels of SerpinB1 and YKL-40 in GDM group were higher than those in healthy group(P<0.05).The incidence of adverse maternal outcomes and perinatal outcomes in GDM group were higher than those in healthy group(P<0.05).There were no significant differences in maternal pre-pregnancy body mass index(BMI),gestational age,education levels between those with adverse maternal outcomes and those without adverse maternal outcomes in GDM group(P>0.05).GDM patients with maternal adverse outcomes were higher than those without maternal adverse outcomes in age,gestational BMI,proportion of family history of diabetes,proportion of multipara,serum SerpinB1 and YKL-40 levels(P<0.05).High of age,gestational BMI,family history of diabetes mellitus,multipara,serum SerpinB1 and YKL-40 were all independent risk factors for GDM patients with maternal adverse outcomes(OR=2.190,P=0.023,OR=2.008,P=0.025,OR=2.044,P<0.001,OR=2.184,P<0.001,OR=2.132,P=0.010,OR=2.032,P=0.001).There were no significant differences in maternal pre-pregnancy BMI,gestational age,education levels between those with adverse perinatal outcomes and those without adverse perinatal outcomes in GDM group(P>0.05).GDM patients with adverse perinatal outcomes were higher than those without adverse perinatal outcomes in age,gestational BMI,proportion of family history of diabetes,proportion of multipara,serum SerpinB1 and YKL-40 levels(P<0.05).High of maternal age,BMI during pregnancy,family history of diabetes,multipara,serum SerpinB1 and YKL-40 levels were independent risk factors for perinatal adverse outcomes in GDM patients(OR=2.223,P=0.014,OR=2.268,P=0.012,OR=2.106,P=0.015,OR=2.153,P=0.007,OR=2.250,P=0.019,OR=2.100,P=0.017).Conclusion The serum levels of SerpinB1 and YKL-40 are higher in GDM group,GDM patients have higher risk of adverse maternal outcomes and perinatal outcomes.Maternal serum SerpinB1 and YKL-40 levels are closely related to adverse maternal and perinatal outcomes in patients with GDM.
作者
张琳
史中娜
张丽
ZHANG Lin;SHI Zhongna;ZHANG Li(Department of Obstetrics and Gynecology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《河南医学研究》
CAS
2024年第15期2765-2770,共6页
Henan Medical Research
关键词
妊娠糖尿病
丝氨酸蛋白酶抑制剂B1
人软骨糖蛋白-39
母婴结局
gestational diabetes mellitus
serine protease inhibitor B1
human cartilage glycoprotein-39
maternal and perinatal outcomes
