血清FABP4、OPG、CysC、AngⅡ用于诊断妊娠期糖尿病合并妊娠期高血压的临床价值分析

Analysis of the Clinical Value of Serum FABP4,OPG,CysC,AngⅡin the Diagnosis of Gestational Diabetes Merged the Function of Patients with Gestational Hypertension Disease

目的:探讨血清脂肪酸结合蛋白4(FABP4)、护骨素(OPG)、胱抑素C(CysC)、血管紧张素(AngⅡ)用于诊断妊娠期糖尿病合并妊娠期高血压疾病患者的临床价值。方法:选择2016年4月~2018年4月于华北理工大学附属医院产科门诊建档并定期规律产检的妊娠期糖尿病300例,其中104例并发妊娠期高血压疾病患者设为观察组,196例设为对照组。分析妊娠期糖尿病合并妊娠期高血压疾病患者血清FABP4、OPG、CysC、AngⅡ的表达及其与空腹血糖的相关性,并分析以上指标对妊娠期糖尿病合并妊娠期高血压的诊断价值。结果:观察组患者血清FABP4、OPG、CysC、AngⅡ、空腹血糖水平均显著高于对照组(P<0.05)。妊娠期糖尿病合并妊娠期高血压患者血清FABP4、OPG、CysC、AngⅡ、空腹血糖水平显著低于轻度子痫前期、重度子痫前期患者;轻度子痫前期患者以上指标水平显著低于重度子痫前期患者(P<0.05)。血清FABP4、OPG、CysC、AngⅡ和空腹血糖之间均呈显著正相关(P<0.05)。FABP4、OPG、CysC、AngⅡ诊断妊娠期糖尿病合并妊娠期高血压疾病的AUC分别为0.648、0.654、0.898、0.913,95%CI分别为0.576~0.719、0.586~0.722、0.854~0.943、0.886~0.941,以上指标联合检测诊断妊娠期糖尿病合并妊娠期高血压疾病的AUC为0.996,95%CI为0.992~1.000,单独检测分别和联合检测曲线下面积比较均具有显著差异(Z=9.569、9.669、4.115、6.310,P<0.05);联合检测诊断妊娠期糖尿病合并妊娠期高血压疾病的特异度、准确度分别为94.17%、94.28%。结论:妊娠期糖尿病合并妊娠期高血压疾病患者血清FABP4、OPG、CysC、AngⅡ的表达均与空腹血糖存在显著正相关,以上四者联合检测诊断妊娠期糖尿病合并妊娠期高血压疾病时具有较高的临床价值。

Objective:To study Analysis of the Serum Fatty acid binding protein 4(FABP4)and bone,urinary inhibition(OPG),C(CysC),angiotensin(AngⅡ)in gestational diabetes merged the function of patients with gestational hypertension disease.Methods:300 patients with gestational diabetes who were registered in the obstetrical outpatient department of the affiliated hospital of north China university of science and technology from April 2016 to April 2018 and underwent regular labor and examination were selected.Among them,104 patients with gestational hypertension were set as the observation group and 196 patients were set as the control group.Analysis of gestational diabetes combined gestational hypertension disease patient serum FABP4,OPG,CysC,AngⅡexpression and its correlation with fasting glucose,and analyze the above indicators for gestational diabetes combined gestational hypertension diagnosis value.Results:Observation group of patients serum FABP4,OPG,CysC,AngⅡ,fasting blood glucose levels were significantly higher than that of control group(P<0.05).Gestational diabetes with gestational hypertension patients serum FABP4,OPG,CysC,AngⅡ,fasting blood sugar level was significantly lower than in patients with mild preeclampsia,severe preeclampsia;The above level of indicators in patients with mild preeclampsia was significantly lower than that in patients with severe preeclampsia(P<0.05).FABP4,OPG,serum CysC,AngⅡand are significantly positive correlation between fasting glucose(P<0.05).FABP4,OPG,CysC,AngⅡdiagnosis gestational diabetes with gestational hypertension disease AUC were 0.648,0.654,0.898,0.913,95%CI 0.576~0.719,0.586~0.722,0.854~0.943,0.886~0.941,the above indexes combined detection in the diagnosis of gestational diabetes with gestational hypertension diseases of AUC is 0.996,95%CI 0.992~1.000,There were significant differences between the area under the curve of separate detection and that under the curve of combined detection(Z=9.569,9.669,4.115,6.310,P<0.05).The specificity and accuracy of combined detection and diagnosis of gestational diabetes mellitus with gestational hypertension were 94.17%and 94.28%,respectively.Conclusion:Gestational diabetes with gestational hypertension disease patients serum FABP4,OPG,CysC,AngⅡexpression with significant positive correlation between fasting glucose,the above four joint detection in the diagnosis of gestational diabetes merger gestational hypertension disease has high clinical value.