| 马营营,李志红,王宝仪,等.血清 HbAlc、VASH-1、sFlt-1联合对妊娠期糖尿病孕妇母婴结局的预测价值[J].安徽医药,2026,30(4):749-753. |
| 血清 HbAlc、VASH-1、sFlt-1联合对妊娠期糖尿病孕妇母婴结局的预测价值 |
| The predictive value of the combination of serum HbAlc, VASH-1 and sFlt-1 on maternal and infant outcomes of pregnant women with gestational diabetes mellitus |
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| DOI：10.3969/j.issn.1009-6469.2026.04.022 |
| 中文关键词: 妊娠期糖尿病 糖化血红蛋白 血管生成抑制蛋白1 可溶性血管内皮生长因子受体 1 母婴结局 |
| 英文关键词: Gestational diabetes mellitus Glycosylated hemoglobin Vasohibin-1 Soluble Fms-like tyrosine kinase-1 Mater-nal and infant outcomes |
| 基金项目:廊坊市科技计划项目( 2022013130) |
| 作者 | 单位 | | 马营营 | 廊坊市人民医院,产科,河北廊坊 065000 | | 李志红 | 廊坊市人民医院,产科,河北廊坊 065000 | | 王宝仪 | 廊坊市人民医院,检验科,河北廊坊 065000 | | 马惠涵 | 廊坊市人民医院,产科,河北廊坊 065000 | | 李燕 | 廊坊市人民医院,产科,河北廊坊 065000 |
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| 中文摘要: |
| 目的探究血清糖化血红蛋白( HbAlc)、血管生成抑制蛋白1( VASH-1)、可溶性血管内皮生长因子受体 1(sFlt-1)联合对妊娠期糖尿病孕妇母婴结局的预测价值。方法选取 2021年 5月至 2023年 5月在廊坊市人民医院治疗的 312例妊娠期糖尿病孕妇为患病组，根据妊娠结局分为正常母婴结局( 234例)和不良母婴结局(78例)另选取 180例在该院产前检查正常的孕妇作为对照组。对所选病例进行回顾性分析。采用酶联免疫吸附分析( ELISA)检测血，清 HbAlc、VASH-1、sFlt-1的水平；采用多因素 logistic回归分析妊娠期糖尿病孕妇母婴结局的影响因素；受试者操作特征曲线( ROC曲线)分析血清 HbAlc、VASH-1、 sFlt-1水平对妊娠期糖尿病孕妇母婴结局的诊断价值。结果患病组孕妇血清 HbAlc、VASH-1、sFlt-1水平与对照组孕妇相比显著升高( P<0.05)；不良母婴结局组孕妇孕次 ≥2次、身体质量指数( BMI)≥25 kg/m2妊娠期营养过度、有糖尿病家族史人数占比显著高于正常母婴结局组( P<0.05)；不良母婴结局组孕妇血清 HbAlc(9.64±2.8、3)%、VASH-1(412.69±78.52)ng/L、sFlt-1(2532.36±374.74)ng/L水平与正常母婴结局组孕妇血清 HbAlc(7.58±1.52)%、VASH-1(327.44±62.28)ng/L、sFlt-1(2205.25± 332.61)ng/L水平相比显著升高( P<0.05)； logistic回归分析显示 HbAlc、VASH-1、sFlt-1均为病人出现不良妊娠结局的独立危险因素( P<0.05)；血清 HbAlc、VASH-1、sFlt-1预测妊娠期糖尿病母婴结局的 AUC分别为 0.77［95%CI:(0.72，0.82)］、 0.80［95%CI:(0.75，0.85)］、 0.76［95%CI:(0.71，0.81)］，三者联合预测的 AUC为 0.88［95%CI:(0.83，0.91)］。结论妊娠期糖尿病孕妇血清 HbAlc、VASH-1、sFlt-1水平均上调，且均为病人产生不良母婴结局的独立危险因素，三者联合对病人发生不良母婴结局具有潜在的预测价值。 |
| 英文摘要: |
| Objective To explore the predictive value of the combination of serum glycosylated hemoglobin (HbAlc), vasohibin-1 (VASH-1) and soluble Fms-like tyrosine kinase 1 (sFlt-1) on maternal and infant outcomes of pregnant women with gestational diabetes mellitus.Methods From May 2021 to May 2023, 312 pregnant women with gestational diabetes mellitus diagnosed in Langfang Peo-ple's Hospital were collected as the diseased group. According to pregnancy outcomes, they were separated into normal outcome group(n=234) and poor outcome group (n=78). Another 180 pregnant women who underwent normal prenatal check ups were chosen as con-trol group. Conduct a retrospective analysis of the selected cases. Enzyme linked immunosorbent assay (ELISA) was applied to detectthe levels of serum HbAlc, VASH-1, and sFlt-1. Multivariate logistic regression was used to analyze the risk factors for maternal and in-fant outcomes of pregnant women with gestational diabetes mellitus. Receiver operating characteristic curve (ROC curve) was applied toanalyze the diagnostic value of serum HbAlc, VASH-1, and sFlt-1 expression levels for maternal and infant outcomes.Results The levels of serum HbAlc, VASH-1 and sFlt-1 of pregnant women in the diseased group were significantly higher than those in the control group (P<0.05). The proportions of pregnant women with gravidity ≥ 2, BMI ≥ 25 kg/m2, excessive nutrition during pregnancy, and dia-betic family history in the poor outcome group were significantly higher than those in the normal outcome group (P<0.05). The serum levels of HbAlc [(9.64 ± 2.83)% vs. (7.58±1.52)% ], VASH-1 [(412.69±78.52) ng/L vs. (327.44±62.28) ng/L] and sFlt-1 [(2532.36± 374.74) ng/L vs, (2205.25±332.61) ng/L] in the poor outcome group were significantly higher than those in the normal outcome group (P <0.05). Logistic regression analysis results showed that HbAlc, VASH-1, and sFlt-1 were independent risk factors for adverse pregnancy outcomes (P<0.05). The AUC of serum HbAlc, VASH-1, and sFlt-1 in predicting the maternal and infant outcomes of gestational diabe-tes mellitus were 0.77 [95%CI:(0.72, 0.82)], 0.80 [95%CI: (0.75, 0.85)], and 0.76 [95%CI: (0.71, 0.81)], respectively. The AUC predict-ed by the combination of the three was 0.88 [95%CI:(0.83, 0.91)].Conclusions The levels of serum HbAlc, VASH-1, and sFlt-1 in pregnant women with gestational diabetes mellitus are all up-regulated, which are independent risk factors for adverse maternal and in-fant outcomes. The combination of the three has potential predictive value for poor maternal and infant outcomes. |
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