摘要
目的:探讨超敏C反应蛋白(hs-CRP)和单核细胞/淋巴细胞比值(MLR)与孕晚期妊娠糖尿病(GDM)发生不良妊娠结局相关性。方法:选取2019-06-2022-02确诊的147例非高龄GDM患者为研究对象,根据有无不良妊娠结局分为合并不良妊娠结局组即A组(69例)和无不良妊娠结局组即B组(78例)。选择同期无GDM的92名孕妇作为正常对照组。检测所有对象外周血白细胞计数(WBC)、中性粒细胞计数(NEU)、单核细胞计数(MONO)、淋巴细胞计数(LYM)和血清hs-CRP,同时计算MLR,分析以上指标各组间的差异。Logistic分析评价指标与GDM不良妊娠结局的危险因素;ROC曲线分析hs-CRP和MLR对孕晚期GDM患者发生不良妊娠结局的预测价值。结果:与对照组相比,A组和B组孕妇外周血MLR和血清hs-CRP水平升高,B组LYM减少;与A组比较,B组MLR和hs-CRP水平升高,LYM减少,差异均具有统计学意义(P<0.05)。而三组间WBC、NEU、MONO无明显差异(P>0.05)。Logistic回归分析显示,hs-CRP和MLR是GDM孕妇发生不良妊娠结局的危险因素。ROC分析的结果显示hs-CRP、MLR二者联合检测对GDM孕妇发生不良妊娠结局。结论:血清hs-CRP水平和MLR与妊娠晚期GDM孕妇发生不良妊娠结局有关,hs-CRP和MLR升高可以预测GDM不良妊娠结局风险。
Objective:To investigate the relationship between high sensitive C-reactive protein(hs-CRP)and monocyte/lymphocyte ratio(MLR)and adverse pregnancy outcome in third trimester gestational diabetes mellitus(GDM).Method:147 non-elderly GDM patients diagnosed from June 2019 to February 2022 were selected as the study objects.According to whether there were adverse pregnancy outcomes,they were divided into group A(69 cases)with adverse pregnancy outcomes and group B(78 cases)without adverse pregnancy outcomes.92 pregnant women without GDM in the same period were selected as the normal control group.The peripheral white blood cell count(WBC),neutrophil count(NEU),monocyte count(MONO),lymphocyte count(LYM)and serum hs-CRP were measured for all subjects,and the MLR was calculated at the same time to analyze the differences among the above indicators.The correlation between the evaluation indexes and the adverse pregnancy outcome of GDM was analyzed by logistic regression.ROC curve was used to analyze the diagnostic efficacy of hs-CRP and MLR in patients with GDM in the third trimester.Results:Compared with the control group,the levels of MLR and hs-CRP in peripheral blood and serum of pregnant women in Group A and Group B were increased, while LYM was decreased in Group B( P <0.05). WBC, NEU and MONO had no significant difference among the three groups ( P >0.05). Logistic regression analysis showed that hs-CRP and MLR were risk factors for adverse pregnancy outcomes in GDM pregnant women. The results of ROC analysis showed that the area under the ROC curve and its 95% confidence interval of h( P <0.05)nt women were 0.771 (0.697-0.846), 0.643 (0.553-0.733) and 0.774 (0.698-0.851), respectively( P <0.01). Conclusion: The levels of hs-CRP and MLR are correlated with the adverse pregnancy outcome of GDM pregnant women in the third trimester of pregnancy. The increase of hs-CRP and MLR may indicate the adverse pregnancy outcome.
作者
李革
余怡如
陈放
熊文俊
陈俊昆
LI Ge;YU Yi-ru;CHEN Fang;XIONG Wen-jun;CHEN Jun-kun(Tongji Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)
出处
《微循环学杂志》
2022年第4期70-74,共5页
Chinese Journal of Microcirculation
