妊娠期糖尿病肝肾功能与外周炎性因子水平变化及临床意义

Changes and clinical significance of liver and kidney function and peripheral inflammatory factors in gestational diabetes mellitus

目的探讨妊娠期糖尿病(GDM)孕妇肝肾功能与外周炎性因子水平的相关性。方法选取50例行产检及分娩的GDM孕妇,根据肝肾功能指标水平分为肝肾功能正常组(28例)与肝肾功能异常组(22例);并纳入同期50例正常妊娠者为对照组。比较三组外周炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及超敏C反应蛋白(hs-CRP)]、肝功能[丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)]及肾功能[血肌酐(Scr)、血尿素氮(BUN),尿酸(UA)]水平,并分析各指标与GDM孕妇的相关性。结果肝肾功能异常组孕妇ALT、AST、Scr、BUN及UA水平均高于对照组和肝肾功能正常组,TBIL水平低于对照组和肝肾功能正常组,差异具有统计学意义(P<0.05)。肝肾功能异常组和肝肾功能正常组孕妇IL-6、TNF-α及hs-CRP水平均高于对照组,差异具有统计学意义(P<0.05)。GDM孕妇血清AST、ALT、TBIL、Scr、BUN、UA与IL-6、TNF-α、hs-CRP水平均呈正相关(P<0.05)。结论GDM孕妇肝肾功能损伤与外周炎性因子水平紧密相关,临床应加强指标的监测,对临床早期干预GDM及肝肾损伤具有重要意义。

Objective To investigate the correlation between liver and kidney function and peripheral inflammatory factors in pregnant women with gestational diabetes mellitus(GDM).Methods 50 GDM pregnant women who underwent prenatal examination and delivery were divided into normal liver and kidney function group(28 cases)and abnormal liver and kidney function group(22 cases)according to the level of liver and kidney function indexes;50 cases of normal pregnancy in the same period were included as the control group.The peripheral inflammatory factors[interleukin-6(IL-6)and tumor necrosis factor were compared among the three groups-α(TNF-α)And the levels of high-sensitivity C-reactive protein(hs-CRP)],liver function[alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL)]and renal fimction[serum creatinine(Scr),blood urea nitrogen(BUN),uric acid(UA)]were analyzed,and the correlation between each index and pregnant women with GDM was analyzed.Results The levels of ALT,AST,Scr,BUN and UA in abnormal liver and kidney function group were higher than those in control group and nonnal liver and kidney function group,while the levels of TBIL were lower than those in control group and nonnal liver and kidney fimction group,with statistical significance(P<0.05).The levels of IL-6,TNF-α and hs-CRP in abnormal liver and kidney function group and normal liver and kidney function group were higher than those in control group,the differences were statistically significant(PV0.05).Serum AST,ALT,TBIL,Scr,BUN,UA were significantly positively correlated with IL-6,TNF-α and hs-CRP levels in GDM pregnant women(P<0.05).Conclusion The liver and kidney function mjury of pregnant women with GDM is closely related to the level of peripheral inflammatory factors.Clinical monitoring of indicators should be strengthened,which is of great significance for early clinical intervention of GDM and liver and kidney injury.