妊娠晚期糖尿病代谢和内皮损伤 指标检测的临床意义

Clinical significance of detection of metabolic and endothelial injury indexes in late pregnancy diabetic patients

摘要:

目的 通过检测妊娠晚期糖尿病患者的血脂、血管内皮损伤标志物及骨代谢指标，探究其临床 意义。方法 选取2015 年1 月-2016 年12 月在该院就诊的110 例妊娠晚期糖尿病患者，作为观察组；同 期选取110 例健康孕晚期孕妇作为对照组。于孕36 周，采集所有孕妇的血液标本，检测子宫动脉搏动指数 （UAPI）。比较两组血脂、血管内皮损伤标志物及骨代谢指标，分析妊娠晚期糖尿病患者UAPI、新生儿出生 体重与血脂、血管内皮损伤标志物及骨代谢指标的相关性，以及血脂、血管内皮损伤标志物及骨代谢指标三 者的相关性。结果 观察组血糖、新生儿出生体重、三酰甘油（TG）、血管细胞黏附分子-1、骨钙素、总 I 型胶原氨基端延长肽及β- 胶原降解产物水平高于对照组（P <0.05）。妊娠晚期糖尿病患者中，UAPI 与 TG 呈正相关（P <0.05），与高密度胆固醇呈负相关（P <0.05）；新生儿出生体重与TG 呈正相关（P <0.05）。 结论 妊娠晚期糖尿病患者体内血脂和骨代谢水平升高，提示妊娠晚期糖尿病患者可能合并脂代谢异常、血 管内皮损伤，且机体可代偿性地增强骨代谢。

Abstract:

Objective To detect the expressions of blood lipid indexes, vascular endothelial injury markers and bone metabolism indexes in patients with late-pregnancy diabetes mellitus, and to explore their clinical significance. Methods Totally 110 patients with late-pregnancy diabetes mellitus from January 2015 to December 2016 were selected as the observation group and 110 healthy pregnant women in the late stage of pregnancy during the same period were selected as the control group. The blood samples of all the pregnant women were collected at the 36th week of pregnancy, and uterine artery pulsation index (UAPI) was detected. The levels of blood lipid indexes, vascular endothelial injury markers and bone metabolism indexes were compared between the two groups. The correlations of UAPI and birth weight of the newborns with blood lipid indexes, vascular endothelial injury markers and bone metabolism indexes in the patients with late-pregnancy diabetes mellitus were analyzed, and the correlations among blood lipid indexes, vascular endothelial injury markers and bone metabolism indexes were also analyzed. Results The birth weight of the newborns, the levels of blood glucose, triglyceride (TG), vascular cell adhesion molecule-1 (VCAM-1), bone gla protein (BGP), total type I collagen amino terminal extension peptide and β-collagen degradation products in the observation group were significantly higher than those in the control group (P < 0.05). UAPI was positively correlated with TG but negatively correlated with high-density cholesterol in the patients with late-pregnancy diabetes mellitus (P < 0.05). And there was a positive correlation between the birth weight of the newborns and TG (P < 0.05). Conclusions The levels of blood lipid and bone metabolism in the patients with late-pregnancy diabetes mellitus are elevated, it suggests that the patients with late-pregnancy diabetes mellitus may be associated with abnormal lipid metabolism and vascular endothelial injury, and the body can be compensable to enhance bone metabolism.