早期妊娠糖脂代谢指标、高敏C反应蛋白在妊娠期糖尿病不良妊娠结局预测中的价值

Predictive value of the early glucolipid metabolism index and hs-CRP in the adverse pregnancy outcome of gestational diabetes mellitus patients

目的:探讨早期妊娠糖脂代谢指标、高敏C反应蛋白(hs-CRP)对妊娠期糖尿病(GDM)病人及新生儿结局的临床预测价值。方法:回顾性分析372例GMD病人的临床资料,根据有无不良妊娠结局分为不良妊娠结局组(n=53)和正常妊娠结局组(n=319),比较2组病人的早期糖脂生化指标及hs-CRP水平,应用ROC曲线分析糖脂生化指标及hs-CRP在不良妊娠结局中的预测价值。结果:不良妊娠结局组hs-CRP、低密度脂蛋白-胆固醇(LDL-C)、三酰甘油(TG)、总胆固醇(TC)、糖化血红蛋白(Hb A1c)均明显高于正常妊娠结局组(P<0.01)。经ROC曲线分析可知,hs-CRP、LDL-C、空腹血糖、TG、TC、Hb A1c对GDM病人不良妊娠结局的预测切点分别为5.03 mg/L、4.97 mmol/L、9.06 mmol/L、5.29 mmol/L、8.13 mmol/L、7.89%,ROC曲线下面积分别为0.843、0.635、0.647、0.826、0.609和0.819。结论:GDM不良妊娠结局病人的血清hs-CRP及早期妊娠糖脂代谢指标水平均明显升高,在GDM病人及新生儿结局预测中具有一定应用价值。

Objective： To investigate the predictive value of the early glucolipid metabolism index and hypersensitive C reactive protein（ hs-CRP） in the outcome of gestational diabetes mellitus（ GDM） patients and neonates. Methods： The clinical data of 372 patients with GDM were retrospectively analyzed,and the patients were divided into the adverse pregnancy outcome group（ 53 cases）and normal pregnancy outcome group（ 319 cases）. The early glucolipid metabolism indexes and level of hs-CRP between two groups were compared. The value of early glucolipid metabolism indexes and hs-CRP level in predicting the adverse pregnantcy outcome were analyzed using the ROC curve. Results： The levels of hs-CRP,LDL-C,TG,TC,and Hb A1 c in adverse pregnancy outcome group were significantly higher than those in normal pregnancy outcome group（ P〈0. 01）. ROC curve analysis showed that the tangent points of hsCRP,LDL-C,fasting blood glucose,TG,TC and Hb A1 c to predict the adverse GDM pregnancy outcome were 5. 03 mg/L,4. 97 mmol/L,9. 06 mmol/L,5. 29 mmol/L,8. 13 mmol/L and 7. 89%,respectively. The areas under ROC curve of hs-CRP,LDL-C,fasting blood glucose,TG,TC,Hb A1 c were 0. 843,0. 635,0. 647,0. 826,0. 609 and 0. 819,respectively. Conclusions： The levels of serum hs-CRP and early glucolipid metabolism indexes in adverse pregnancy outcome patients with GDM significantly increase,which has a certain application value in the prediction of the GDM patients and neonatal outcomes.