VCAM-1、PDGF-AA与妊娠期糖尿病关系及检测意义

The relationship between levels of VCAM-1 or PDGE-AA and women with gestational diabetes mellitus and its significances

目的:探讨血管细胞粘附分子-1(VCAM-1)、血小板衍生生长因子-AA(PDGE-AA)在妊娠糖尿病的临床意义。方法:收集2015年12月—2018年6月兰州大学第二医院治疗并分娩的妊娠期糖尿病患者100例为观察组,另选取同期于该院产检并分娩的血糖正常孕妇85例为对照组。检测孕妇血清中VCAM-1、PDGF-AA水平并采用Pearson分析二者相关性,观察妊娠糖尿病患者妊娠及新生儿结局,分析VCAM-1、PDGF-AA对母婴结局的影响,采用受试者工作特征曲线(ROC)分析VCAM-1、PDGF-AA的临床诊断价值,对影响妊娠糖尿病患者不良妊娠结局的相关因素进行logistic多元回归分析。结果:观察组血清中VCAM-1、PDGF-AA水平均高于对照组(P<0.05); VCAM-1与PDGF-AA水平呈正相关(P<0.05);观察组中不良母婴结局孕妇的VCAM-1、PDGF-AA水平均高于正常结局孕妇(P<0.05);诊断妊娠期糖尿病VCAM-1的敏感度为83.8%,特异度为90.0%;PDGF-AA的敏感度为79.7%,特异度为86. 7%; VCAM-1与PDGF-AA均是妊娠糖尿病患者发生不良结局的独立危险因素。结论:妊娠糖尿病患者血清VCAM-1、PDGF-AA水平高于正常孕妇,二者呈正相关且与母婴不良结局紧密相关,检测血清中VCAM-1、PDGF-AA水平可作为诊断妊娠糖尿病的参考指标。

Objective: To study the significances of the levels of vascular endothelial cell adhesion molecule-1(VCAM-1) and platelet derived growth factor-AA(PDGE-AA) for women with gestational diabetes mellitus(GDM). Methods: 100 pregnant women with GDM were selected in research group, and another 85 normal pregnant women were in control group during the same period. Levels of serum VCAM-1 and PDGF-AA of all included women were detected, and correlation between levels of VCAM-1 and PDGE-AA and women with GDM was analyzed by Pearson. The outcomes of women in research group were observed. Receiver operating characteristic curve(ROC) was used to analyze the clinical diagnostic levels of VCAM-1 and PDGF-AA, and logistic regression analysis was performed to study the related factors of adverse pregnancy outcomes of women with GDM. Results: The levels of serum VCAM-1 and PDGF-AA of women in research group were significant higher than those of women in control group(P<0.05). The level VCAM-1 was positive correlation to the level of PDGF-AA(P<0.05).In research group, the VCAM-1 and PDGF-AA levels of pregnant women with adverse maternal and neonatal outcomes were significant higher than other women(P<0.05). ROC curve analysis showed that the sensitivity of VCAM-1 was 83.8%, the specificity was 90.0%, the sensitivity of PDGF-AA was 79.7%, and the specificity was 86.67%. Logistic multiple regression analysis showed that VCAM-1 and PDGF-AA were independent risk factors of adverse outcomes of women with GDM. Conclusion: The levels of serum VCAM-1 and PDGF-AA of women with GDM are higher than those of normal pregnant women, which are closely related to maternal and neonatal adverse outcomes, so they can be used as reference indexes for diagnosing GDM of pregnant women.