妊娠期糖尿病并发妊娠期高血压患者血清学指标差异性分析及临床意义

Alterations of serological indicators and their clinical significance in patients with gestational diabetes mellitus and hypertension during pregnancy

目的:分析妊娠期糖尿病并发妊娠期高血压患者血清学指标差异性并探讨临床意义。方法:选取我院2017年10月~2019年10月收治的妊娠期糖尿病(GDM)患者93例,以其中未合并妊娠期高血压的45例患者为对照组,以合并妊娠期高血压的48例患者为观察组。检测并比较两组患者血清C-反应蛋白(CRP)、白细胞介素-6(IL-6)、空腹血糖(FBG)、胰岛素(FINS)、糖化血红蛋白(HbA1C)、同型半胱氨酸(Hcy)、尿酸(UA)水平。采用Logistic分析妊娠期糖尿病并发妊娠期高血压的影响因素。采用ROC曲线分析血清学指标对妊娠期糖尿病并发妊娠期高血压的预测价值。结果:观察组CRP、IL-6、FBG、FINS、Hcy、UA、HbA1C水平均显著高于对照组(P<0.05);CRP、IL-6、FBG、FINS、Hcy、UA、HbA1C水平异常升高是影响妊娠期糖尿病并发妊娠期高血压的独立危险因素;通过ROC分析,CRP、IL-6、UA对妊娠期糖尿病并发妊娠期高血压的预测切点分别为7.92 mg/L,216.03 pg/mL,298.05 mmol/L,ROC曲线下面积分别为0.635,0.673,0.787。结论:GDM患者并发妊娠期高血压可能与CRP、IL-6、FBG、FINS、Hcy、UA水平有一定相关性,CRP、IL-6、UA对GDM患者并发妊娠期高血压有一定预测价值。

Objective:To determine the alterations of serological indicators and their clinical significance in gestational diabetes mellitus(GDM)with hypertension during pregnancy.Methods:A total of 93 GDM patients admitted to our hospital between October 2017 and October 2019 were included.Among them,45 patients without gestational hypertension were assigned to the control group,and 48 with gestational hypertension were assigned to the study group.The levels of serum C-reactive protein(CRP),interleukin-6(IL-6),fasting blood glucose(FBG),fasting plasma insulin(FINS),glycosylated hemoglobin(HbA1C),homocysteine??(Hcy),and uric acid(UA)were measured and compared between the two groups of patients.Logistic regression was used to determine the influencing factors of GDM with hypertension during pregnancy.ROC curve analysis was used to evaluate the predictive value of the serological indicators for GDM with hypertension during pregnancy.Results:The levels of CRP,IL-6,FBG,FINS,Hcy,UA,and HbA1C were significantly higher in the study group than those in the control group(P<0.05).Abnormal elevation in levels of CRP,IL-6,FBG,FINS,Hcy,UA,and HbA1C were shown to be independent risk factors for GDM with hypertension during pregnancy.By ROC analysis,cut-offs of CRP,IL-6,and UA for predicting GDM with hypertension during pregnancy were 7.92 mg/L,216.03 pg/mL,and 298.05 mmol/L,with the areas under the curve being 0.635,0.673,and 0.787,respectively.Conclusion:Hypertension during pregnancy in GDM patients may be correlated with the levels of CRP,IL-6,FBG,FINS,Hcy,and UA.The levels of CRP,IL-6 and UA can be predictive of hypertension during pregnancy in GDM patients.