摘要
目的探究血清载脂蛋白CⅢ(ApoCⅢ)和胰高血糖素样肽-2(GLP-2)在高龄妊娠期糖尿病病人中的水平,及其与妊娠结局的相关性。方法选取2022年1月至2023年6月在保定市妇幼保健院阴道试产的高龄妊娠期糖尿病孕妇80例作为研究组,根据妊娠结局和新生儿结局将病人分为结局不良组(31例)和结局良好组(49例),另选取同期在该院产检且正常健康的78例孕妇为健康组。比较研究组和健康组的血清ApoCⅢ、GLP-2水平、妊娠结局及新生儿结局;比较结局不良组和结局良好组一般临床资料和血清ApoCⅢ、GLP-2水平;采用logistic回归分析影响高龄孕妇妊娠期糖尿病病人母婴结局的因素;采用受试者操作特征曲线(ROC曲线)分析血清ApoCⅢ,GLP-2水平对高龄孕妇妊娠期糖尿病病人母婴结局的预测效能。结果研究组不良妊娠结局发生率以及新生儿不良结局发生率均显著高于健康组的发生率(P<0.05);研究组血清ApoCⅢ水平显著高于健康组(P<0.05),GLP-2水平显著低于健康组(P<0.05)。结局不良组的产次显著高于结局良好组(P<0.05);与结局良好组[(5.83±1.65)mg/L、(1.26±0.33)µg/L]相比,结局不良组产妇血清ApoCⅢ水平[(9.21±2.38)mg/L]显著升高(t=7.50,P<0.05),血清GLP-2水平[(0.82±0.21)µg/L]显著降低(t=6.62,P<0.05)。logistic回归结果显示ApoCⅢ、GLP-2水平均是高龄妊娠期糖尿病病人母婴结局的影响因素(P<0.01)。ROC曲线显示血清ApoCⅢ,GLP-2联合预测高龄妊娠期糖尿病病人结局的曲线下面积(AUC)为0.96,二者联合预测的效能优于血清ApoCⅢ,GLP-2单独预测(Z_(二者联合-ApoCⅢ)=2.53、Z_(二者联合-GLP-2)=2.08,P=0.011、P=0.038)。结论高龄妊娠期糖尿病病人血清ApoCⅢ水平明显升高,GLP-2水平明显降低,且二者联合预测病人母婴结局具有较高的临床应用效能。
Objective To investigate the level of serum apolipoprotein CⅢ(ApoCⅢ)and glucagon-like peptide-2(GLP-2)in elderly pregnant women with gestational diabetes mellitus(GDM),and their correlation with pregnancy outcomes.Methods Eighty cases of elderly pregnant women with GDM who underwent vaginal trial of labor in Baoding Maternal and Child Health Hospital from January 2022 to June 2023 were selected as the study group,and the patients were classified into the group with poor outcome(31 cases)and the group with good outcome(49 cases)according to the outcome of pregnancy and the outcome of the newborn,and 78 pregnant women who had a normal and healthy obstetrics checkup in the same hospital during the same period of time were also selected as the control group.The serum ApoCⅢ,GLP-2 levels,pregnancy outcomes,and neonatal outcomes were compared between the research group and the control group;the general clinical data and serum ApoCⅢ,GLP-2 levels were compared between the unfavorable outcome group and the favorable outcome group;and logistic regression analysis was used to investigate the factors affecting the maternal and fetal outcomes of women of advanced maternal age with GDM.The receiver operating characteristic curve(ROC curve)was used to analyze the predictive efficacy of serum ApoCⅢ,GLP-2 levels for the maternal and fetal outcomes of women of advanced maternal age with GDM.Results The incidence of adverse pregnancy outcomes and the incidence of adverse neonatal outcomes in the study group were significantly higher than those in the control group(P<0.05).The level of ApoCⅢin the study group was significantly higher than that in the control group(P<0.05),while the level of GLP-2 in the study group was significantly lower than that in the control group(P<0.05).The parity of the women in the unfavorable outcome group was significantly higher than that in the favorable outcome group(P<0.05).Compared with the good outcome group[(5.83±1.65)mg/L,(1.26±0.33)μg/L],the serum ApoCⅢlevel in the poor outcome group[(9.21±2.38)mg/L]was significantly increased(t=7.50,P<0.05),while serum GLP-2 level[(0.82±0.21)μg/L]was significantly decreased(t=6.62,P<0.05).The logistic regression results showed that ApoCⅢand GLP-2 levels were both influencing factors for the maternal and fetal outcomes of women of advanced maternal age with gestational diabetes(P<0.01).ROC curve showed that the area under the curve(AUC)of serum ApoCⅢand GLP-2 in predicting the outcome of gestational diabetes in women of advanced maternal age was 0.955,and the combined prediction efficiency of the two was better than that of serum ApoCⅢ,GLP-2 prediction alone(Z_(combined-ApoCⅢ)=2.53,Z_(combined-GLP-2)=2.08,P=0.011,P=0.038).Conclusion Serum ApoCⅢlevels are significantly higher and GLP-2 levels are significantly lower in patients of advanced maternal age with GDM,and the combination of the two has high clinical efficacy in predicting maternal and infant outcomes in patients.
作者
成秀兰
杨春红
张春艳
CHENG Xiulan;YANG Chunhong;ZHANG Chunyan(Department of Obstetrics and Gynecology,Baoding Maternal and Child Health Hospital,Baoding,Hebei 071000,China)
出处
《安徽医药》
2026年第1期136-140,共5页
Anhui Medical and Pharmaceutical Journal
基金
保定市科技计划自筹经费项目(2241ZF084)。
关键词
糖尿病
妊娠
妊娠
高危
载脂蛋白CⅢ
胰高血糖素样肽-2
妊娠结局
新生儿结局
年龄因素
高龄产妇
Diabetes,gestational
Pregnancy,high-risk
Apolipoprotein C-Ⅲ
Glucagon-like peptide-2
Pregnancy outcome
Neonatal outcomes
Age factors
Women of advanced maternal age
