GDM孕妇治疗前后血栓弹力图特征与其糖代谢的相关性

Correlation between thromboelastogram characteristics and glucose metabolism status in GDM pregnant women before and after treatment

目的:分析GDM孕妇治疗前后血栓弹力图特征与其糖代谢的相关性。方法选取2017年1月至2018年1月于上海交通大学附属第一人民医院行常规产检并分娩的40例GDM孕妇和40例健康孕妇。对GDM组孕妇进行干预,比较GDM孕妇治疗前、治疗后和对照组孕妇的空腹血糖、糖化血红蛋白、胰岛素水平及血栓弹力图特征,并分析血栓弹力图特征与其糖代谢相关指标的相关性。结果GDM治疗前及治疗后的FPG、HbA1c均明显高于对照组,差异均有统计学意义(均P<0.05);GDM治疗前的FINs明显高于对照组(均P<0.05)。GDM治疗前的R、K值明显低于GDM治疗后及对照组,MA、α角及CI明显高于GDM治疗后及对照组。GDM治疗前的FPG与R值呈负相关(r=-0.757,P=0.000),与CI呈正相关(r=0.869,P=0.000);GDM治疗前的HbA1c与K呈负相关(r=-0.667,P=0.000),与CI呈正相关(r=0.835,P=0.000);治疗前的FINs与CI呈正相关(r=0.744,P=0.000)。GDM治疗后TEG各参数与FPG、HbA1c及FINs无相关性。结论GDM治疗前孕妇的血栓弹力图多项参数与糖代谢指标存在相关性,血栓弹力图是检测GDM患者凝血功能变化的有效监测指标。

Objective:To analyze the correlation between the characteristics of thromboelastography and glucose metabolism before and after treatment of GDM pregnant women.Methods:From Jan.2017 to Jan.2018,40 patients who underwent routine check-up and delivery in our hospital were diagnosed as GDM pregnant women in the GG group by OGTT test at 24~28 weeks of pregnancy,and 40 healthy pregnant women were selected as the control group.To compare the fasting blood glucose,glycosylated hemoglobin,C-peptide,insulin level and thromboelastogram characteristics of GDM before treatment,GDM treatment and control group.The correlation between of characteristics of thromboelastography and glucose metabolism was analyzed.Results:The FPG and HbA1c levels after GDM treatment and before treatment were significantly higher than those in the control group.The FINs before GDM treatment were significantly higher than those in the control group(P<0.05).The R and K values before GDM treatment were significantly lower than those after GDM treatment and control.Group,MA,αangle and CI were significantly higher than GDM treatment and control group.FPG was negatively correlated with R value before treatment(r=-0.757,P=0.000),and positively correlated with CI(r=0.869,P=0.000);HbA1c was negatively correlated with K before treatment(r=-0.667,P=0.000),and positively correlated with CI(r=0.835,P=0.000).FINs before treatment were positively correlated with CI(r=0.744,P=0.000).There was no correlation between TEG parameters and FPG,HbA1c and FINs after GDM treatment.Conclusion:There are correlations between multiple parameters of thromboelastography and glucose metabolism in pregnant women before GDM treatment.Thromboelastography is an effective monitoring index for detecting changes in coagulation function in GDM patients.