摘要
目的探究孕中期妊娠期糖尿病(GDM)患者血清甲胎蛋白(AFP)、人绒毛膜促性腺激素(hCG)及游离雌三醇(uE3)对妊娠不良事件和胎儿生长发育的预测价值。方法选取2023年1月至2023年5月期间咸宁市中心医院产科收治的GDM患者117例,根据妊娠结局差异分为结局良好组(n=75)与结局不良组(n=42);根据胎儿生长发育情况分为正常发育组(n=89)与异常发育组(n=28)。收集并比较各组相关临床资料及实验室指标,采用多因素Logistic分析影响GDM患者妊娠不良事件和胎儿生长发育的危险因素,并以受试者工作特性曲线(ROC)分析孕中期血清AFP、hCG、uE3对GDM患者妊娠不良事件和胎儿生长发育的预测效能。结果多因素Logistic回归分析显示,孕前BMI≥24 kg/m^(2)、AFP、hCG水平升高以及uE3水平降低均为GDM患者妊娠不良事件的独立危险因素(P<0.05);孕前BMI≥24kg/m^(2)、孕次≥1次、AFP、hCG水平升高以及uE3水平降低均为影响GDM患者胎儿生长发育的独立危险因素(P<0.05)。AFP、hCG以及uE3单独和联合检测GDM患者妊娠不良事件的ROC面积分别为0.719、0.759、0.717以及0.824,三者单独和联合检测GDM患者胎儿生长发育的ROC面积分别为0.756、0.747、0.713以及0.811(P<0.05)。结论孕中期血清AFP、hCG、uE3水平均与GDM患者妊娠不良事件和胎儿生长发育密切关联,且三者联合检测对GDM妊娠不良事件和胎儿生长发育的预测价值更高。
Objective To investigate the predictive value of serum alpha-fetoprotein(AFP),human chorionic gonadotropin(hCG)and free estriol(uE3)in pregnancy adverse events and fetal growth in patients with second trimester gestational diabetes mellitus(GDM).Methods A total of 117 GDM patients admitted to the obstetrics Department of Xianning Central Hospital from January 2023 to May 2023 were selected and divided into a good outcome group(n=75)and a bad outcome group(n=42)based on the difference in pregnancy outcomes.According to the fetal growth and development,they were divided into a normal development group(n=89)and an abnormal development group(n=28).The relevant clinical data and laboratory indicators of each group were collected and compared.The risk factors affecting pregnancy adverse events and fetal growth and development in GDM patients were analyzed by multivariate logistic analysis,and the predictive efficacy of serum AFP,hCG and uE3 in pregnancy adverse events and fetal growth and development in GDM patients was analyzed by receiver operating characteristic curve(ROC).Results Multivariate logistic regression analysis showed that preregnancy BMI≥24 kg/m^(2),increased AFP and hCG levels and decreased uE3 levels were independent risk factors for adverse pregnancy events in GDM patients(P<0.05).Pre-pregnancy BMI≥24 kg/m^(2),pregnancy number≥1,increased AFP,hCG levels and decreased uE3 level were independent risk factors for fetal growth and development in GDM patients(P<0.05).The ROC area of AFP,hCG and uE3 alone and in combination were 0.719,0.759,0.717 and 0.824 in GDM patients,respectively.The ROC area of fetal growth and development in GDM patients were 0.756,0.747,0.713 and 0.811 respectively(P<0.05).Conclusion Serum AFP,hCG and uE3 levels in the second trimester are closely associated with pregnancy adverse events and fetal growth and development in GDM patients,and the combined detection of the three has a higher predictive value for GDM pregnancy adverse events and fetal growth and development.
作者
徐晖
冼妮
XU Hui;XIAN Ni(Obstetrics Department,Hubei Xianning Central Hospital,Xianning,Hubei,China,437100;Department of Gynecology,the First Affiliated Hospital of the Guangxi University of Chinese Medicine,Nanning,Guangxi,China,530000)
出处
《分子诊断与治疗杂志》
2024年第10期1987-1991,共5页
Journal of Molecular Diagnostics and Therapy
基金
广西壮族自治区中医药管理局项目(GXZYA20220085)。
作者简介
通信作者:冼妮,E-mail:xianni555@163.com。
