摘要
目的分析炎症指标、血脂及凝血功能在妊娠期糖尿病患者中的变化及其临床意义。方法回顾性选取首都医科大学附属北京世纪坛医院2019年1月至2020年12月例行产检孕周为27~30周的妊娠期糖尿病孕妇98例作为观察组,选取同期孕周为27~30周的健康孕妇80例作为对照组。分别检测两组孕妇的炎症指标、血脂及凝血功能并进行比较分析。通过logistic回归分析妊娠期糖尿病的危险因素,采用受试者工作特征曲线分析凝血指标对妊娠期糖尿病患者高凝状态的预测价值。结果观察组C反应蛋白、中性粒细胞绝对值、淋巴细胞绝对值、低密度脂蛋白胆固醇、总胆固醇、甘油三酯均显著高于对照组,高密度脂蛋白胆固醇显著低于对照组,差异有显著性(P<0.05)。凝血功能分析显示,观察组纤维蛋白原、D-二聚体水平均显著高于对照组,活化部分凝血活酶时间和凝血酶时间低于对照组,差异有显著性(P<0.05);两组间凝血酶原时间差异无显著性(P>0.05)。Logistic回归分析显示,炎症指标C反应蛋白、中性粒细胞绝对值、淋巴细胞绝对值以及血脂指标甘油三酯是妊娠期糖尿病的独立危险因素。受试者工作特征曲线分析结果显示,D-二聚体、纤维蛋白原预测妊娠期糖尿病高凝状态更有临床价值。结论妊娠期糖尿病患者的炎症指标及血脂水平显著高于正常孕妇,且通过监测凝血指标纤维蛋白原、D-二聚体,可对妊娠期糖尿病患者体内的高凝状态做出预测,对改善妊娠期糖尿病患者的不良妊娠结局具有重要意义。
Objective To analyze the clinical significance of inflammatory markers,lipid and coagulation function in gestational diabetes mellitus(GDM).Method 98 cases with GDM in Beijing Shijitan Hospital from January 2019 to December 2020 were selected as observation group.At the same time,80 healthy pregnant women(27-30 weeks)were selected as control group.The level of inflammatory markers,lipid and coagulation function were analyzed.The Logistic regression curve were used to analyze the risk factors of GDM,furthermore,the receiver operating characteristic curve(ROC)were used to evaluate the value of D-dimer and FIB in predicting the hypercoagulable state of GDM patients.Result The level of CRP,NLR,PLR,LDL-C,TC and TG in the observation group were significantly higher than those in control group respectively(P<0.05),on the other hand,the level of HDL in GDM group was lower compared with control group(P<0.05).The level of FIB and D-dimer in the observation group were higher than those in control group,moreover,APTT and TT were lower compared with the control group respectively(P<0.05),while the level of PT in the two groups had no statistical difference(P>0.05).The result of Logistic regression analysis showed that CRP,NLR and PLR were the independent risk factors of GDM.The result of ROC curve analysis showed that FIB and D-dimer were more valuable in predicting the hypercoagulable state of GDM patients than APTT and TT.Conclusion The levels of inflammatory markers and lipid in GDM patient are significantly higher than those in healthy pregnant woman.Furthermore,by detecting the level of FIB and D-dimer,the hpercoagulable state of GDM could be predicted,which is important for improving pregnancy outcome.
作者
孙然
侯军林
王霞
Sun Ran;Hou Junlin;Wang Xia(Department of Clinical Laboratory,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)
出处
《中国医刊》
CAS
2022年第11期1211-1214,共4页
Chinese Journal of Medicine
关键词
妊娠期糖尿病
C反应蛋白
血脂
凝血功能
D-二聚体
Gestational diabetes mellitus
C-reactive protein
Lipid
Coagulation function
D-dimer
