妊娠期糖尿病合并高血压临床特点及血清炎症因子水平研究

Clinical characteristics and serum inflammatory factors in hypertensive patients with gestational diabetes mellitus

目的研究妊娠期糖尿病合并高血压的临床特点及血清炎症因子变化。方法选取150例孕妇,经糖代谢检查将其分为健康组(64例)、妊娠期糖尿病组(54例)、妊娠期糖尿病合并高血压组(32例)。检验三组肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、体质量指数(BMI)及胰岛素水平。结果妊娠期糖尿病合并高血压组FPG、HbA1c、孕前BMI及胰岛素水平均高于高于健康组、妊娠期糖尿病组,差异有统计学意义(F=128.47、137.28、27.08、42.33,P<0.05)。妊娠期糖尿病合并高血压组CRP、TNF-α及IL-6水平均明显高于高于健康组、妊娠期糖尿病组,差异有统计学意义(F=43.36、137.83、145.60,P<0.05)。经Logistic回归分析显示,妊娠期糖尿病合并高血压的发生与CRP、TNF-α、IL-6炎症因子具有密切关联(P<0.05)。结论对于单纯妊娠期糖尿病患者而言,FPG、HbA1c、体质量及胰岛素水平提高可能会增加合并高血压的风险,且对CRP、TNF-α及IL-6水平变化进行检验,有利于鉴别与诊断合并高血压,值得临床研究与借鉴。

Objective To study the clinical characteristics and changes of serum inflammatory factors in hypertensive patients with gestational diabetes mellitus.Methods 150 pregnant women were selected and divided into healthy group(64 cases),gestational diabetes group(54 cases)and gestational diabetes combined with hypertension group(32 cases)by glucose metabolism examination.The levels of tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6),fasting blood glucose(FPG),glycosylated hemoglobin A1c(HbA1c),body mass index(BMI)and insulin were measured.Results The levels of FPG,HbA1c,pre-pregnancy BMI and insulin in GDM complicated with hypertension group were higher than those in healthy group and GDM group,and the differences were statistically significant(F=128.47、137.28、27.08、42.33,P<0.05).The levels of CRP,TNF-αand IL-6 in GDM complicated with hypertension group were significantly higher than those in healthy group and GDM group,and the diff erences were statistically significant(F=43.36、137.83、145.60,P<0.05).Logistic regression analysis showed that the occurrence of gestational diabetes mellitus complicated with hypertension was closely associated with inflammatory factors such as CRP,TNF-αand IL-6(P<0.05).Conclusion For patients with gestational diabetes mellitus alone,the increase of FPG,HbA1c,body weight and insulin level may increase the risk of complicated hypertension.And the detection of CRP,TNF-αand IL-6 levels is conducive to the diff erential and diagnosis of complicated hypertension,which is worthy of clinical research and reference.