妊娠期糖尿病母胎并发症分析及相关因子VEGF的表达

Maternal and Fetal Complications of Gestational Diabetes Mellitus and Study of VEGF Expression in Serum

目的探讨妊娠期糖尿病孕妇(GDM)常见母胎并发症与孕母血清、胎盘组织中血管内皮生长因子(VEGF)表达的变化,并阐述其意义。方法在孕龄24～28周之间被诊断患有GDM的孕妇中收集产前检查提示存在母胎并发症的孕妇,为病例组,总数为264例;随机选择GDM无母胎并发症的孕妇,作为对照组,30例;采用酶联免疫法检测孕母血清VEGF水平,分娩后收集胎盘,采用反转录-聚合酶链反应方法检测胎盘组织中VEGF的mRNA表达。结果①GDM合并胎儿生长受限(FGR)组孕母血清VEGF水平明显低于其他组(P<0.05);②GDM合并妊娠期高血压疾病组孕母血清VEGF水平明显高于其他组(P<0.05);③GDM合并胎儿FGR组胎盘组织中VEGF的mRNA表达明显低于其他组(P<0.05);④GDM合并妊娠期高血压疾病组胎盘组织中VEGF的mRNA表达明显高于其他组(P<0.05)。结论①GDM孕母血清低VEGF水平可作为GDM产前预测合并FGR的筛查指标之一。②GDM孕母血清高VEGF水平可作为GDM产前预测合并妊娠期高血压疾病的筛查指标之一。

Objective To explore the maternal and fetal complications of gestational diabetes mellitus（GDM） during pregnancy and the levels of vascular endothelial growth factor（VEGF） in maternal serum and placental tissues,and explain its significance.Methods Gestational diabetes pregnant woman with confirmed maternal and fetal complications were enrolled as case group,264 cases in total;30 GDM cases without maternal and fetal complications pregnant women were randomly selected as the control group;VEGF levels of maternal serum were detected by ELISA;VEGF mRNA of placental tissue was detected by using reverse transcription-polymerase chain reaction（RT-PCR）.Results In GDM with fetal growth restriction group,the VEGF levels in maternal serum were significantly lower than those in other groups（P0.05）.In GDM with hypertensive disorders in pregnancy group,the levels of VEGF in maternal serum were significantly higher than those in other groups（P0.05）.The placental VEGF mRNA expression of GDM with fatal growth restriction group was significantly lower than other groups（P0.05）.The placental VEGF mRNA expression of GDM with hypertensive disorders in pregnancy group was significantly higher than other groups（P0.05）.Conclusion ①Low VEGF levels in GDM maternal serum may be one screening indicator to predict GDM combined with FRG.②high VEGF levels in GDM maternal serum may be one screening indicator to predict GDM combined with hypertensive disorders in pregnancy.