[1]陈　霏,王　碧.血清游离雌三醇和脂联素水平与妊娠糖尿病孕晚期发生胎儿窘迫的相关性研究[J].现代检验医学杂志,2019,34(06):101-104.[doi:10.3969 ／ j.issn.1671-7414.2019.06.025]
　CHEN Fei,WANG Bi.Correlation Research on Serum Levels of Free Estriol and Adiponectin in Fetal Distress in Late Pregnancy of Gestational Diabetes Mellitus[J].Journal of Modern Laboratory Medicine,2019,34(06):101-104.[doi:10.3969 ／ j.issn.1671-7414.2019.06.025]
点击复制

血清游离雌三醇和脂联素水平与妊娠糖尿病孕晚期发生胎儿窘迫的相关性研究()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第34卷
期数:
2019年06期
页码:
101-104
栏目:
论著
出版日期:
2019-12-30

文章信息/Info

Title:
Correlation Research on Serum Levels of Free Estriol and Adiponectin in Fetal Distress in Late Pregnancy of Gestational Diabetes Mellitus
文章编号:
1671-7414（2019）06-101-04
作者:
陈　霏;  王　碧
（陕西省核工业二一五医院检验科，陕西咸阳　712000）
Author(s):
CHEN Fei;  WANG Bi
（Department of Clinical Laboratory , 215 Hospital of Nuclear Industry of Shaanxi Province, Shaanxi Xianyang 712000, China ）
关键词:
妊娠糖尿病; 孕晚期; 胎儿窘迫; 游离雌三醇; 脂联素; 血糖; 脐动脉收缩末期/ 舒张末期最大血 流速度值
分类号:
R714.256；R446.112
DOI:
10.3969 ／ j.issn.1671-7414.2019.06.025
文献标志码:
A
摘要:
目的　探讨血清游离雌三醇（free estriol，FE3）和脂联素（adiponectin，ADP）水平与妊娠糖尿病孕晚期胎儿 窘迫发生的相关性。方法　收集2016 年3 月～ 2019 年3 月期间在陕西省核工业二一五医院妇产科就诊的118 例妊娠 糖尿病（gestational diabetes mellitus，GDM）患者的临床资料进行回顾性分析，依据孕妇是否发生胎儿宫内窘迫(fetal distres，FD) 分为胎儿窘迫组(FD 组，22 例) 和非胎儿窘迫组(NFD 组，96 例)。血清FE3 和ADP 水平分别采用电化 学发光分析法和酶联免疫吸附法检测；血清葡萄糖水平采用己糖激酶法检测，胎儿脐动脉收缩末期/ 舒张末期最大血 流速度(S/D) 采用彩色多普勒超声分析仪检测。选择同期体检正常孕妇56 例作为对照组。比较分析以上指标的变化与 GDM 孕晚期胎儿窘迫发生的相关性。结果　在对照组、NFD 组和FD 组中，血清FE3(ng/ml) 和ADP(mg/L) 水平分别 为 18.85±3.77,11.27±2.43,7.09±1.31 和13.23±2.91,5.78±1.53,3.92±1.21。在NFD 组和FD 组中，血清FE3 和ADP 水平显著低于对照组。在FD 组中，两指标的水平显著低于NFD 组(F =45.17 ～ 63.93, 均P =0.000)。在对照组、NFD 组和FD 组中，血清空腹血糖(mmol/L)、1 h 血糖(mmol/L)、2 h 血糖(mmol/L) 水平及S/D 值分别为4.92±0.81, 7. 37 ±1.22 和8.73±1.91；7.29±2.10，12.73±2.52 和13.91±3.32；5.75±1.33，9.62±1.53 和10.90±2.03, 及2.61±0.15， 2.83±0.17 和3.17±0.18。在NFD 组和FD 组中，空腹血糖、1 h 血糖、2 h 血糖水平及S/D 值均显著高于对照组。在 FD 组中，各指标均显著高于NFD 组(F =29.38 ～ 51.97，均P =0.000)。相关性分析显示，FD 组血清FE3 及ADP 水平有 正相关性(r =0.789，P <0.01)。两指标分别与空腹血糖(r =-0.729，-0.737，均P <0.01)，1 h 血糖(r =-0.752，-0.761，均 P <0.01)，2 h 血糖(r =-0.772，-0.789，均P <0.01) 水平及S/D 值(r =-0.697，-0.709，均P <0.01) 均有负相关性。在NFD 组中，血清FE3 及ADP 水平有正相关性(r =0.793，P <0.01)。两指标分别与空腹血糖(r =-0.712，-0.723，均P <0.01)， 1 h 血糖(r =-0.738，-0.752，均P <0.01)，2 h 血糖(r =-0.761，-0.775，均P <0.01) 水平及S/D 值(r =-0.685，-0.692， 均P <0.01) 均有负相关性。结论　检测血清FE3 和ADP 水平可以预测GDM 孕晚期胎儿窘迫的发生, 两指标水平的变化 可以评价胎儿窘迫的改善状况。
Abstract:
Objective　To investigate the correlation on serum levels of free estriol (FE3) and adiponectin (GDM) in gestational diabetes mellitus(GDM) complicated with fetal distress. Methods　The clinical data of 118 patients with GDM who visited the Department of Obstetrics and Gynecology in 215 Hospital of Nuclear Industry of Shaanxi from March 2016 to March 2019 were retrospectively analyzed.According to whether fetal distress occured,they were divided into fetal distress group (FD group, 22 cases) and non-fetal distress group (NFD group, 96 cases). Serum levels of FE3 and ADP were detected by Electrochemiluminescence immunoassay and enzyme-linked immunosorbent assay,respectively. Serum levels of glucose were detected by automatic biochemical analyzer. The S/D ratio of fetal umbilical artery blood flow was measured by color doppler ultrasound analyzer. 56 pregnant women with normal physical examination at the same period were selected as control group.The correlation between the above indicators and fetal distress in gestational diabetes mellitus was compared and analyzed. Results　In control group, NFD group and FD group, serum levels of FE3 (ng/ ml) and ADP (mg/L) were 18.85±3.77,11.27±2.43,7.09±1.31 and 13.23±2.91,5.78±1.53,3.9±1.21, respectively. Univariate analysis of variance showed that the levels of FE3 and ADP in NFD group and FD group were significantly lower than those in control group, while those in FD group were significantly lower than those in NFD group(F =45.17~63.93, P =0.000).In control group, NFD group and FD group, fasting blood glucose (mmol/L), 1 hour blood glucose (mmol/L), 2 hour blood glucose (mmol/L), HbA1C (%) and S/D values were 4.92±0.81，7. 37±1.22 and 8.73±1.91; 7.29±2.10 ，12.73±2.52 and 13.91±3.32; 5.75±1.33， 9.62±1.53 and 10.90±2.03; 2.61±0.15，2. 83±0.17 and 3.17±0.18, respectively. Univariate variance the analysis showed that the fasting blood glucose, 1 hour blood glucose, 2 hour blood glucose, and S/D values in NFD group and FD group were significantly higher than those in control group, and the each index in FD group were significantly higher than those in NFD group (F =29.38~51.97, P =0.000).The correlation analysis showed that serum levels of FE3 and ADP were positively correlated in FD group (r = 0.789, P < 0.01). The two indices were correlated with fasting blood glucose (r = － 0.729, － 0.737, P < 0.01), 1 hour blood glucose (r = － 0.752, － 0.761, P < 0.01), 2 hour blood glucose (r = － 0.772, － 0.789, P < 0.01),and S/D values(r= － 0.697, － 0.709, P < 0.01).In NFD group, serum levels of FE3 and ADP were positively correlated (r = 0.793, P < 0.01) . Both indicators were positively correlated with fasting blood glucose (r = － 0.712, － 0.723, P < 0.01), 1 hour blood glucose (r = － 0.738, － 0.752, P < 0.01), 2 hour blood glucose (r = － 0.761, － 0.775, P < 0.01), and S/D value (r = － 0.685, － 0.692, P <0.01) all had a negative correlation. Conclusion　Detection of serum FE3 and ADP levels can predict the occurrence of fetal distress in late pregnancy of GDM, and the changes of the two indicators can evaluate the improvement of fetal distress.

参考文献/References:

[1]　张小平， 余海珍， 赵家宁，等．孕妇妊娠中期糖脂 代谢紊乱对不良妊娠结局的影响[J]. 现代检验医学 杂志，2015，30（6）：35-38． ZHANG Xiaoping, YU Haizhen, ZHAO Jianing, et al. Impaction of glucose and lipid metabolic abnormalities of pregnant women in second trimester for adverse pregnancy outcomes [J].Journal of Modern Laboratory Medicine,2015，30（6）：35-38．
[2]　蔡燕，刘一勤. 孕妇血雌三醇、胎心电子监护及超 声脐动脉血流S/D 比值检查预测胎儿窘迫的临床价 值分析[J]. 临床和实验医学杂志，2018，17（2）： 196-200. CAI Yan, LIU Yiqin. The diagnosis value research for fetal distress of free estriol, cardiotocography and ultrasound umbilical artery blood flow S/D ratio in pregnant women[J].Journal of Clinical and Experimental Medicine, 2018, 17 (2): 196-200.
[3]　王娜，鲁海鸟，周游，等．妊娠期糖尿病孕妇体质 指数和糖化血红蛋白水平与围生结局的关系[J]. 中 国妇幼保健，2017，32（15）：3418-3420. WANG Na, LU Hai niao, ZHOU You, et al. Relation on body mass index and glycosylated hemoglobin level of pregnant women with gestational diabetes mellitus with perinatal outcomes [J].Maternal and Child Health Care of China, 2017, 32 (15): 3418-3420.
[4]　邱秀芳. 妊娠期糖尿病孕妇胎儿脐动脉频谱血流收 缩期最大血流速度与舒张期血流速度比值预测胎儿 窘迫的价值 [J]. 中国妇幼保健，2018，33（ 22）： 5085-5087. QIU Xiufang. Value of the ratio of the maximum systolic blood flow velocity to diastolic blood flow velocity in umbilical artery spectrum of pregnant women with gestational diabetes mellitus in predicting fetal distress[J].Maternal and Child Health Care of China, 2018, 33 (22): 5085-5087.
[5]　黄兆明, 卢锦娥. 血糖水平控制正常妊娠期糖尿病 孕妇的围产结局分析[J]. 中华妇产科杂志,2018 , 53 (9):625-329. HUANG Zhaoming, LU Jin’e. Perinatal outcome analysis of pregnant women with normal gestational diabetes controlled by blood sugar level [J]. Chinese Journal of Obstetrics and Gynecology, 2018, 53 (9): 625-329.
[6]　HUR J, CHO E H, BAEK K H, et al.Prediction of gestational diabetes mellitus by unconjugated estriol levels in maternal serum[J].Int J Med Sci. 2017: 14(2): 123-127.
[7]　张如星. 妊娠糖尿病孕妇脐血流 SD 值与胎儿宫内窘 迫相关性分析[J].中国妇幼健康研究,2016,27(7):813- 815. ZHANG Ruxing. Correlation between SD value of umbilical blood in pregnant women with gestational and fetal distress in uterus[J]. Chinese Journal of women and Child Health Research, 2016,27(7): 813- 815.
[8]　韩连菊，邵岚，张蕾，等.β-HCG,AFP 及 uE 3 与妊 娠期并发症的相关性及对分娩结局的影响[J]. 现代 中西医结合杂志，2015,24(11),1199-1201. HAN Lianju, SHAO Lan, ZHANG Lei, et al. Correlation on beta-HCG,AFP and uE3 with complications during pregnancy as well as effect of beta-HCG,AFP and uE3 on delivery outcome[J]. Modern Journal of Integrated Traditional Chinese and Western Medicine, 2015,24(11), 1199-1201.
[9]　丁小莉，陈兰，钟燕. 初产妇孕期BMI 及孕中期 血清AFP、β-HCG，uE3 水平对不良妊娠结局的 影响[J]. 贵州医科大学学报，2017，42（4）： 490-494. DING Xiaoli, CHEN Lan, ZHONG Yan. Effects of BMI during pregnancy, serum AFP, β-HCG and uE3 levels during second trimester of pregnancy on adverse pregnancy outcomes [J].Journal of Guizhou Medical University, 2017, 42 (4): 490-494.
[10] 李浩，刘彩红. 饮食和运动干预对妊娠期糖尿病患 者母婴结局及血浆脂联素、瘦素的影响[J]. 医学综 述，2016，22（9）：1848-1851. LI Hao, LIU Caihong.The effects of diet and exercise intervention on pregnancy outcomes and maternal plasma adiponectin and leptin of GDM patients [J]. Medical Recapitulate, 2016, 22 (9): 1848-1851.
[11] 李格琳, 闫芳, 王丽丽, 等. 妊娠糖尿病患者孕 晚期血清HbAl c, RBP4 及脂联素水平与妊娠结 局[J]. 中国计划生育学杂志，2019，27（3）： 359-362. LI Gelin, YAN Fang, WANG Lili, et al. Anlysis of serum levels of HbAl c, RBP4 and adiponectin of women with gestational diabetes mellitus during the third trimester and their correlation to pregnancy outcomes [J]. Chinese Journal of Family Planning, 2019, 27 (3): 359-362.
[12] 宋茜 , 杨伟东. 妊娠期糖尿病临床特点及相关影 响因素分析[J]. 中国妇幼保健,2018,33(12):2681- 2684. SONG Qian, YANG Weidong. Clinical characteristics of gestational diabetes mellitus and analysis of related influencing factors [J].Maternal and Child Health Care of China, 2018,33(12): 2681-2684.
[13] 徐婧, 任卫东. 多普勒获得的胎儿血流信息在妊娠 糖尿病诊断中的意义[J]. 中国医学装备,2017,14(9): 71-74. XU Jing, REN Weidong.The significance of the blood flow information of fetus obtained from Doppler ultrasound in the diagnosis of gestational of gestational diabetes mellitus[J].China Medical Equipment, 2017,14(9):71-74.

相似文献/References:

[1]梁培松,王结珍,陈 康,等.孕早期年龄,BMI 和PAPPA 水平综合评价对GDM 的预测价值[J].现代检验医学杂志,2020,35(01):133.[doi:10.3969/j.issn.1671-7414.2020.01.035]
　LIANG Pei-song,WANG Jie-zhen,CHEN Kang,et al.Predictive Value of Comprehensive Evaluation of Early Pregnant Age,BMI and PAPPA Levels to the GDM[J].Journal of Modern Laboratory Medicine,2020,35(06):133.[doi:10.3969/j.issn.1671-7414.2020.01.035]
[2]梁玉珊a,朱冬梅b,尤芳芳a.妊娠期糖尿病患者血、尿生化指标与尿路结石发生的相关指标分析[J].现代检验医学杂志,2020,35(02):142.[doi:10.3969 ／ j.issn.1671-7414.2020.02.039]
　LIANG Yu-shana,ZHU Dong-meib,YOU Fang-fanga.Analysis of Correlation between Blood and Urine Biochemical Indexes andUrinary Calculus in Gestational Diabetes Mellitus[J].Journal of Modern Laboratory Medicine,2020,35(06):142.[doi:10.3969 ／ j.issn.1671-7414.2020.02.039]
[3]李　艳,李新宇.妊娠糖尿病患者外周血miRNA-21 检测的临床应用价值[J].现代检验医学杂志,2020,35(02):35.[doi:10.3969/j.issn.1671-7414.2020.02.011]
　LI Yan,LI Xin-yu.Clinical Application Value of Detection of miRNA-21 in Peripheral Blood ofPatients with Gestational Diabetes[J].Journal of Modern Laboratory Medicine,2020,35(06):35.[doi:10.3969/j.issn.1671-7414.2020.02.011]
[4]陈丽华a,王思思b,朱婕曼a,等.高龄产妇孕中期血清 FPG，HbA1c 及 TC 联合检测预测 GDM 风险的临床研究[J].现代检验医学杂志,2020,35(06):33.[doi:doi:10.3969/j.issn.1671-7414.2020.06.009]
　CHEN Li-hua a,WANGg Si-si b,ZHU Jie-man a,et al.Clinical Study on Prediction of GDM Risk by Combined Detection of SerumFPG, HbA1c and TC in the Second Trimester of Pregnancy in Elderly Women[J].Journal of Modern Laboratory Medicine,2020,35(06):33.[doi:doi:10.3969/j.issn.1671-7414.2020.06.009]
[5]丁　洁,何晓一,刘彦君,等.妊娠糖尿病患者胎盘LPL基因Hind片段多态性与新生儿发生胰岛素抵抗风险的相关性研究[J].现代检验医学杂志,2021,36(06):70.[doi:10.3969/j.issn.1671-7414.2021.06.014]
　DING Jie,HE Xiao-yi,LIU Yan-jun,et al.Relevance between Hind Fragment Polymorphism of Placental LPL Gene and the Risk of Neonatal Insulin Resistance in Patients with Gestational Diabetes Mellitus[J].Journal of Modern Laboratory Medicine,2021,36(06):70.[doi:10.3969/j.issn.1671-7414.2021.06.014]
[6]王　伟,张　静,浦　春.妊娠糖尿病患者血清、脐血及胎盘组织中 Visfatin和 Chemerin的表达与胰岛素抵抗发生机制的研究[J].现代检验医学杂志,2022,37(01):21.[doi:10.3969/j.issn.1671-7414.2022.01.005]
　WANG Wei,ZHANG Jing,PU Chun.Expression of Visfatin and Chemerin in Serum, Umbilical Blood and Placenta of Patients with Gestational Diabetes Mellitus andthe Mechanism of Insulin Resistance[J].Journal of Modern Laboratory Medicine,2022,37(06):21.[doi:10.3969/j.issn.1671-7414.2022.01.005]
[7]李 婧,程涵芬.妊娠糖尿病患者尿液8-oxo-Gsn 表达水平及其对妊娠结局预测价值研究[J].现代检验医学杂志,2023,38(01):135.[doi:10.3969/j.issn.1671-7414.2023.01.025]
　LI Jing,CHENG Han-fen.Urinary 8-oxo-Gsn Expression Level in Patients with Gestational Diabetes Mellitus and Its Predictive Value for Pregnancy Outcome[J].Journal of Modern Laboratory Medicine,2023,38(06):135.[doi:10.3969/j.issn.1671-7414.2023.01.025]

备注/Memo

备注/Memo:
作者简介：陈霏（1985 －），女，大学本科，主管检验师, 研究方向：妊娠糖尿病的实验室诊断，E-mail：3435077084@qq.com。 通讯作者：王碧（1984 －），女，大学本科，主管检验师，研究方向：妊娠糖尿病的实验室诊断，E-mail：3432936789@qq.com 收稿日期：2019-02-05
更新日期/Last Update: 2019-12-25