妊娠糖尿病晚期患者糖化血红蛋白和糖化白蛋白水平与产褥期感染相关性的初步探讨

Correlation between the Levels of Glycated Hemoglobin and Glycated Albumin in Patients with Advanced Gestational Diabetes and Puerperal Infection

目的:初步探讨妊娠期糖尿病晚期患者的糖化血红蛋白(HbA1c)和糖化白蛋白(GA)水平与产褥期感染的相关性。方法:回顾性分析2018-01—2019-12本院完成分娩并在分娩后获得随访的97例妊娠期糖尿病晚期患者临床资料,根据是否并发产褥期感染,将其分为感染组(21例)和未感染组(76例);另收集同期本院产科常规产检为健康正常分娩的50例产妇相关资料,将其设为对照组。检测受检者妊娠晚期血清HbA1c、GA水平;分析妊娠期糖尿病晚期患者HbA1c、GA水平与产褥期感染的关系。结果:感染组、未感染组患者HbA1c、GA水平均高于对照组;且感染组患者HbA1c、GA水平高于未感染组,差异有统计学意义(P<0.05);相关性分析结果显示,妊娠期糖尿病晚期患者HbA1c水平与GA水平呈正相关(r=0.683,P<0.05);Logistics回归分析结果显示,血清HbA1c、GA水平异常升高可能是妊娠期糖尿病晚期患者产褥期感染的影响因素(P<0.01);ROC曲线结果显示,HbA1c、GA水平预测妊娠期糖尿病晚期患者产褥期感染的曲线下面积分别为0.880、0.843(均>0.8,有一定预测价值)。结论:妊娠期糖尿病晚期患者HbA1c、GA可能是产褥期感染的影响因素,动态监测其水平变化可为产褥期感染提供重要指导。

Objective:To investigate the correlation between the levels of glycated hemoglobin(HbA1c)and glycated albumin(GA)in patients with advanced gestational diabetes and puerperal infection.Method:The clinical data of 97 patients with advanced gestational diabetes who completed the delivery from January 2018 to December 2019 and follow-up after delivery were retrospectively analyzed,according to whether they were complicated by puerperium infection,they were divided into an infected group(21 cases)and an uninfected group(76 cases);another relevant data of 50 parturients who were confirmed by routine obstetric examination in our hospital during the same period as healthy and normal delivery were collected and set as the control.The serum HbA1c and GA levels in the third trimester of pregnancy were detected and the relationship between HbA1c,GA levels and puerperal infection in patients with advanced gestational diabetes were analyzed.Results:The levels of HbA1c and GA in the infected and uninfected groups were higher than those in the control group;and the levels of HbA1c and GA in the infected group were higher than those in the uninfected group,the difference was statistically significant(P<0.05);the correlation analysis results showed that pregnancy HbA1c level and GA level were positively correadvancedd in patients with advanced diabetes mellitus(r=0.683,P<0.05).Logistic regression analysis showed that abnormally elevated serum HbA1c and GA levels may be the influencing factors of puerperal infection in patients with advanced gestational diabetes(P<0.01).The results of ROC curve showed that the area under the curve of HbA1c and GA levels predicted puerperium infection in patients with advanced gestational diabetes were 0.880 and 0.843,both>0.8,which had certain predictive value.Conclusion:HbA1c and GA in patients with advanced gestational diabetes may be the influencing factors of puerperal infection,and dynamic monitoring of their level changes can provide important guidance for puerperal infection.