| 刘晓娟,王苏敏,杨彩,等.母体血清内脂素、脂肪酸结合蛋白4 及妊娠相关血浆蛋白A水平对高龄妊娠期糖尿病病人围产儿不良结局的预测价值[J].安徽医药,2022,26(8):1652-1656. |
| 母体血清内脂素、脂肪酸结合蛋白4 及妊娠相关血浆蛋白A水平对高龄妊娠期糖尿病病人围产儿不良结局的预测价值 |
| Predictive value of maternal serum visfatin, fatty acid binding protein 4 and pregnancy associated plasma protein A levels on perinatal adverse outcomes in elderly patients with gestational diabetes mellitus |
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| DOI：10.3969/j.issn.1009-6469.2022.08.039 |
| 中文关键词: 糖尿病，妊娠 内脂素 脂肪酸结合蛋白4 妊娠相关血浆蛋白A 高龄孕妇 围产儿结局 |
| 英文关键词: Diabetes,gestational Visfatin Fatty acid binding protein 4 Pregnancy associated plasma protein A Pregnant woman in elder age Perinatal outcome |
| 基金项目:秦皇岛市科学技术研究与发展计划项目(201805A071) |
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| 中文摘要: |
| 目的探讨母体血清内脂素(Visfatin)、脂肪酸结合蛋白4(FABP4)、妊娠相关血浆蛋白A(PAPP-A)水平对高龄妊娠期糖尿病病人围产儿不良结局的预测价值。方法选取2018年6月至2020年6月秦皇岛市妇幼保健院收治的高龄妊娠期糖尿病病人164例作为观察组，另选取同期接诊的高龄正常妊娠者145例作为高龄对照组、正常年龄段妊娠者148例作为适龄对照组，均检测其血清Visfatin、FABP4、PAPP-A水平。结果观察组母体血清Visfatin［(149.25±33.64)μg/L比(105.46±12.16)μg/L、(95.44±14.16)μg/L］、FABP4［(25.47±4.40)μg/L比(19.02±2.39)μg/L、(14.88±3.51)μg/L］水平均高于高龄对照组和适龄对照组(P<0.05)，且高龄对照组均高于适龄对照组(P<0.05)；观察组血清PAPP-A水平低于高龄对照组和适龄对照组［(22.17±3.98)μg/L比(28.02±4.12)μg/L、(30.12±4.67)μg/L，P<0.05］，且高龄对照组低于适龄对照组(P<0.05)；观察组围产儿不良结局发生率为24.39%，高于高龄对照组的5.52%和适龄对照组的3.38%(P<0.017)；不良结局组母体血清Visfatin、FABP4水平均高于良好结局组(P<0.05)；不良结局组血清PAPP-A水平低于良好结局组(P<0.05)；母体血清Visfatin、FABP4、PAPP-A水平三者联合预测高龄妊娠期糖尿病病人围产儿不良结局的灵敏度和曲线下面积(AUC)为97.50%和0.946，均显著高于单一指标(P<0.05)，其特异度与单一指标对比均差异无统计学意义(P>0.05)。结论母体血清Visfatin、FABP4、PAPP-A水平均能够有效预测高龄妊娠期糖尿病病人围产儿不良结局发生情况，联合检测预测价值更高。 |
| 英文摘要: |
| Objective To analyze the predictive value of maternal serum visfatin, fatty acid binding protein 4 (FABP4) and pregnan?cy associated plasma protein A (PAPP-A) levels on perinatal adverse outcomes in elderly patients with gestational diabetes mellitus.Methods A total of 164 cases of elderly patients with gestational diabetes mellitus in Qinhuangdao Maternal and Child Health Hospi?tal from June 2018 to June 2020 were selected as the observation group, and 145 cases of elderly normal pregnancy in the same period were randomly selected as the elderly control group, 148 cases of pregnant women of normal age as the right age control group. The lev?els of visfatin, FABP4 and PAPP-A were compared.Results The maternal serum Visfatin [(149.25±33.64)μg/L vs. (105.46±12.16)μg/L,(95.44±14.16)μg/L] and FABP4 levels[(25.47±4.40)μg/L vs.(19.02±2.39)μg/L,(14.88±3.51)μg/L] in the observation group were high?er than those in the elderly control group and right age control group (P<0.05), which in the elderly control group were higher than those in the right age control group. The PAPP-A level in the observation group was lower than those in the elderly control group and right age control group [(22.17±3.98)μg/L vs.(28.02±4.12)μg/L,(30.12±4.67)μg/L,P<0.05], which in the control group was lower than that in the right age control group (P<0.05). The incidence of adverse perinatal outcomes in the observation group was 24.39 %, which was higher than that of 5.52 % in the elderly control group and 3.38 % in the right age control group (P<0.017). The maternal serum visfatin and FABP4 levels in adverse outcome group were higher than those in good outcome group (P<0.05). The PAPP-A level in adverse outcome group was lower than that in good outcome group (P<0.05). The sensitivity and area under the curve (AUC) of the combination of the three in predicting adverse perinatal outcomes in elderly patients with gestational diabetes mellitus were 97.50 % and 0.946, which were significantly higher than those predicted by single index (P<0.05). There was no significant difference between the specificity and single index evaluation (P>0.05).Conclusion Maternal serum visfatin, FABP4, PAPP-A levels can effectively predict the incidence of ad?verse perinatal outcomes in elderly patients with gestational diabetes mellitus, and the combined detection has higher predictive value. |
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