妊娠期糖尿病孕妇PF4、β-TG和LP-PLA2的测定及意义

Detection of PF4,β-TG and LP-PLA2 in pregnant women with gestational diabetes mellitus and its clinical significance

目的研究妊娠期糖尿病(GDM)孕妇外周血血小板因子4(PF4)、β-血小板球蛋白(β-TG)和脂蛋白相关磷脂酶A2(LP-PLA2)的浓度水平变化及其临床意义。方法选取46例GDM孕妇为研究对象,46例同期正常妊娠孕妇为正常妊娠组。比较2组PF4、β-TG、LP-PLA2浓度水平差异,并研究GDM患者外周血PF4、β-TG、LP-PLA2浓度水平与糖化血红蛋白(HbA1c)、空腹胰岛素及凝血酶原时间(PT)的相关性。采用二分类Logistic回归分析孕妇发生GDM的危险因素。结果GDM患者外周血PF4、β-TG、LP-PLA2浓度、HbA1c、空腹胰岛素水平均高于正常妊娠组(P<0.05);Pearson相关分析发现GDM患者外周血PF4、β-TG、LP-PLA2浓度水平均与糖化血红蛋白HbA1c、空腹胰岛素呈正相关(r值分别为0.659、0.441、0.438、0.543、0.578、0.457,P<0.05),与PT成负相关(r值分别为-0.406、-0.416、-0.455,P<0.05);PF4、β-TG、LP-PLA2是孕妇发生GDM的危险因素。结论PF4、β-TG、LP-PLA2可能是GDM患者凝血功能监测的新标志物,亦可能是孕妇发生GDM的危险因素,检测PF4、β-TG、LP-PLA2可能对监测病情、指导临床医生积极防治和减少不良妊娠结局具有重要意义。

Objective To investigate the changes of serum levels of platelet factor-4(PF4),beta-thromboglobulin(β-TG)and lipoprotein-associated phospholipase A2(LP-PLA2)in pregnant women with gestational diabetes mellitus(GDM),and to explore its clinical significance.Methods Fourty-six pregnant women with GDM were enrolled as observation group,at the same time,the other 46 pregnant women with normal pregnancy were enrolled as control group.The serum levels PF4,β-TG,and LP-PLA2 were observed and compared between the two groups.Moreover the correlation between the levels of PF4,β-TG,LP-PLA2 in peripheral blood and glycosylated hemoglobin HbA1c,fasting insulin levels as well as prothrombin time(PT)in patients with GDM was analyzed by means of Pearson correlation analysis.Results The levels of PF4,β-TG and LP-PLA2 in peripheral blood in observation group were significantly higher than those in control group(P<0.05).Pearson correlation analysis showed that the levels of PF4,β-TG,LP-PLA2,HbA1c and fasting insulin in observation group were positively correlated with those of HbA1c and fasting insulin(P<0.05),however,which were negatively correlated with those of PT(P<0.05).Moreover PF4,β-TG,and LP-PLA2 were the risk factors of incidence of GDM in pregnant women.Conclusion The PF4,β-TG and LP-PLA2 may be new markers in monitoring the coagulation function in patients with GDM,moreover,to detect the levels of PF4,β-TG and LP-PLA2 may play an important role in monitoring the disease condition,guiding clinicians to actively prevent these factors,so as to decrease the incidence rate of adverse pregnancy outcome.