妊娠期糖尿病合并子痫前期患者糖脂代谢指标水平、血液流变学变化与围生结局的相关性

Correlations between levels of glucose and lipid metabolism indexes,hemorheology changes and perinatal outcomes in patients with gestational diabetes mellitus complicated with preeclampsia

目的分析妊娠期糖尿病(GDM)合并子痫前期(PE)患者糖脂代谢指标水平、血液流变学变化与围生结局的相关性。方法选取临颍县妇幼保健院2019年10月至2021年5月收治的279例GDM患者为研究对象,统计其PE发生情况、围生结局,采集血液标本检测糖脂代谢指标[抵抗素、内脂素、空腹血糖(FPG)、胰岛素(FINS)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)]水平,检测脐动脉血液流变学指标[血流阻力指数(RI)、脐动脉搏动指数(PI)、脐动脉收缩期血流峰值/舒张末期血流速度(S/D)]水平,比较合并PE及未合并PE GDM患者,以及不同围生结局孕妇、胎儿糖脂代谢指标、脐动脉血液流变学指标水平。结果279例GDM患者中,有50例患者合并PE,纳入合并组;有229例患者未合并PE,纳入未合并组。合并组抵抗素、内脂素、FPG、FINS、TC、HbA1c、TG、RI、PI、S/D水平均明显高于未合并组,差异有统计学意义(P<0.05)。合并组围生结局不良孕妇、胎儿的血清抵抗素、内脂素、FPG、FINS、TC、HbA1c、TG、RI、PI、S/D水平均高于围生结局良好孕妇、胎儿,差异有统计学意义(P<0.05)。结论GDM并发PE时可引起糖脂代谢紊乱、血液流变学改变,同时会增加不良妊娠结局发生风险。

Objective To analyze the relationships between perinatal outcome and the levels of glucose and lipid metabolism indexes,hemorheology changes in gestational diabetes mellitus(GDM)patients complicated with preeclampsia(PE).Methods A total of 279 GDM patients admitted to Linying County Maternal and Child Health Hospital from October 2019 to May 2021 were selected as the research objects,and the occurrence of PE and perinatal outcome were statistically analyzed.Blood samples were collected to detect the levels of glucose and lipid metabolism indexes including resistin,endolipin,fasting plasma glucose(FPG),insulin(FINS),glycosylated hemoglobin(HbA1c),total cholesterol(TC)and triglyceride(TG).The umbilical artery hemorheology indexes including blood flow resistance index(RI),umbilical artery pulsatility index(PI),umbilical artery peak systolic flow velocity/end diastolic flow velocity(S/D)were detected.The levels of glucose and lipid metabolism indexes and umbilical artery hemorheology indexes in GDM patients complicated with PE or without PE,pregnant women and fetus with different perinatal outcomes were compared.Results Among 279 GDM patients,50 patients with PE were included in the combined group,229 patients without PE were included in the uncombined group.The levels of resistin,endolipin,FPG,FINS,TC,HbA1c,TG,RI,PI and S/D in the combined group were significantly higher than those in the non-combined group,the differences were statistically significant(P<0.05).The levels of serum resistin,endolipin,FPG,FINS,TC,HbA1c,TG,RI,PI and S/D of pregnant women and fetus with poor perinatal outcome in the combined group were higher than those of pregnant women and fetus with good perinatal outcome,the differences were statistically significant(P<0.05).Conclusion GDM complicated with PE could cause disorders of glucose and lipid metabolism,changes in hemorheology,and increase the risk of adverse pregnancy outcome.