连南瑶族县孕妇血清胎球蛋白-A水平与妊娠结局的关系

Relationship between Serum AHSG Level and Pregnancy Outcome in Liannan Yao Autonomous County Pregnant Women

【目的】探讨妊娠早中期妇女血清胎球蛋白-A(AHSG)是否可预测晚期血糖水平而影响妊娠结局,以期构建新的妊娠糖尿病及其妊娠结局预测体系,并试图分析其民族差异性。【方法】对776例孕周为38～41孕妇做回顾性分析,并按照民族分汉族组、瑶族组,初步分析孕晚期血糖水平与妊娠结局的关系。对每位参与本研究的孕妇进行空腹血糖(FBG)、糖化血红蛋白(HbAlc)、BMI等检测,录入基本信息及妊娠结局情况,建立数据库。其中有90例妊娠早中期(孕周7～22 W)孕妇检测了血清AHSG水平,因16例未追踪到妊娠结局,只有74例入组,分析妊娠早中期血清AHSG、孕晚期血糖水平及妊娠结局三者之间的关系,并探讨其民族差异性。【结果】分娩前空腹血糖升高可导致妊娠结局异常(P<0.05),汉族组和瑶族组不存在民族差异性(P>0.05);标化后AHSG水平与妊娠结局显著相关(r=-0.283,P=0.014),而与分娩前FBG无关。【结论】高血糖可致不良妊娠结局,与民族无关,而AHSG水平与妊娠结局呈负相关,与分娩前FBG不相关,因此尚不能得出AHSG通过改变晚期血糖水平而影响妊娠结局的结论。而孕期AHSG可能有望作为妊娠结局的一项早期预测指标,为早期预防不良妊娠结局做指导。

[ Objective] To explore if the serum AHSG level of women during early and mid gestation can anticipate the level of blood glucose in the late trimester pregnancy and make the pregnancy outcome abnormal, then a forecast system of gestational diabetes mellitus and complications can be established, at the same time, the national differences will be discussed. [Methods] Retrospective study was used for the 776 women （gestational weeks： 38-41） who were divided into two groups according to the nationality. The relationship between the blood glucose in the late trimester pregnancy and the pregnancy outcome was investigated firstly. Database were established which included the following fundamental states： age, nationality, FBG, HbAlc, pregnancy outcome, and BMI. Ninty samples （7-22 weeks） were detected the serum AHSG level. Enzyme-linked immunosorbent assay was used in the detection. The pregnant outcomes of 16 samples were not available, 74 were absorbed in the terminal study, the ass＆：iation amony the serum AHSG level, blood glucose and the pregnancy outcome were analyzed, the ethnic differences would also be discussed. [ Results ] The high level FBG before the pregnant can result in adverse pregnancy outcomes （P 〈 0.05）, the AHSG level correlated significantly with pregnancy outcome （r = -0.238, P = 0.014）. However, there was no ethnic differences between them.[Conclusion] Adverse pregnancy outcomes can be induced by high level glucose, there was no ethnic differences, the AHSG level correlated significantly with pregnancy outcome but not with FBG, so we cannot draw a conclusion that the AHSG can result in Adverse pregnancy outcomes by changing the glucose level. However, AHSG can be used as a forecast factor of pregnant outcome.