妊娠期糖尿病PAI-1、D-2聚体、血脂相关因子检测的临床意义

Correlation among plasma plasminogen activator inhibitor,D-2 polymers,lipid disorder in gestational diabetes mellitus

目的探讨血浆PAI-1、D-2聚体、血脂与妊娠期糖尿病有无相关性。方法 (1)采集研究对象一般资料包括年龄、糖尿病家族史、身高、体重,计算BMI;(2)采用ELISA法分别检测55例GDM孕妇(研究组)和55例健康孕妇(对照组)血浆PAI-1的含量;采用甘油磷酸氧化酶法、酶偶联比色法、免疫比浊法分别检测两组中TG、TC、D-2聚体。同时将两组中BMI<28kg/m2为Ⅰ组(非肥胖组),BMI≥28kg/m2为Ⅱ组(肥胖组)。结果 (1)GDM组血浆PAI-1、D-2聚体、血脂高于正常孕妇组,两组差异有统计学意义(P<0.01);其中GDM肥胖组血浆PAI-1、D-2聚体明显高于正常孕妇组,两组差异有统计学意义(P<0.01);(2)GDM相关因素多元素相关线性多元回归分析结果显示:PAI-1与D-2聚体、TG、TC有显著相关性。结论 GDM存在凝血系统异常及血管并发症可能,PAI-1、D-2聚体、血脂可作为血管并发症敏感指标,指导临床早期干预。

Objective To explore the correlation among PAI-1 D-2 polymers,lipid disorder in GDM. Methods Common materials were collected of those hospitalized and ready for birth-giving including age,family history of diabetes,height,weight,and computed BMI. Plasma PAI-1 level of 55 pregnant women of GDM（study group）and 55 normal subjects（control group）was measured by ELISA. Using glycerol phosphate oxidase method,enzyme coupling colorimetric method,immune turbidimetric method,testing TG, TC,D-2polymers in both groups. The two groups were divided into non-obese（BMI 〈 28 kg/m2）and obese（BMI ≥ 28kg/m2）groups According to the BMI. Results First,the average of plasma PAI-1,plasma lipids, D-2polymers in GDM group were significantly higher than that in control group（P 〈 0.01）.The average of plasma PAI-1,D-2polymers in obese GDM group were clearly higher than that in non-obese GDM group （P 〈 0.01）. Second,GDM related factors multielement logistic regression analysis results showed that PAI-1 and D-2polymers,TG,TC had significant correlation. Conclusion GDM may exist clotting system anomaly and vascular complications,PAI-1,D-2polymers,plasma lipids can be used as a sensitive index in vascular complications,guiding clinical early intervention.