天津医药
天津醫藥
천진의약
TIANJIN MEDICAL JOURNAL
2013年
10期
953-956
,共4页
妊娠%血红蛋白A,糖基化%烟酰胺磷酸核糖基转移酶%预后
妊娠%血紅蛋白A,糖基化%煙酰胺燐痠覈糖基轉移酶%預後
임신%혈홍단백A,당기화%연선알린산핵당기전이매%예후
pregn%hemoglobin A,glycosylated%nicotinamide phosphoribosyltransferase%prognosis
目的探讨糖耐量正常（NGT）孕妇血清糖化血红蛋白（HbA1c）、内脂素水平与糖脂代谢、围生结局的相关性。方法135例研究对象均为经75 g口服糖耐量试验（OGTT）诊断为NGT的孕足月妇女，根据HbA1c水平是否≥5.5%分为高HbA1c组（n=66）和正常HbA1c组（n=69）。收集临床资料，高效液相离子层析法测定HbA1c水平，双抗体夹心酶标免疫分析法检测血清内脂素水平。比较不同HbA1c组孕妇体质指数（BMI）、孕期体质量增加量、内脂素、血糖、血脂等水平的差异，分析HbA1c、内脂素水平与糖脂代谢、分娩方式、围生结局等的相关性。结果高HbA1c组NGT孕妇孕期体质量平均增长量、血清内脂素水平、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）均高于正常HbA1c组；前组新生儿具有较高的平均出生体质量和较低的血糖水平以及较高的剖宫产率；羊水过多、羊水粪染、巨大儿、新生儿低血糖的发生率均高于正常HbA1c组。在135例NGT孕妇中，HbA1c水平与孕期体质量增加量、内脂素和新生儿出生体质量水平呈正相关。结论孕期体质量增长过多、内脂素表达上调可引发孕妇血糖水平升高；应选择适宜分娩时机及方式预防不良妊娠结局的发生。
目的探討糖耐量正常（NGT）孕婦血清糖化血紅蛋白（HbA1c）、內脂素水平與糖脂代謝、圍生結跼的相關性。方法135例研究對象均為經75 g口服糖耐量試驗（OGTT）診斷為NGT的孕足月婦女，根據HbA1c水平是否≥5.5%分為高HbA1c組（n=66）和正常HbA1c組（n=69）。收集臨床資料，高效液相離子層析法測定HbA1c水平，雙抗體夾心酶標免疫分析法檢測血清內脂素水平。比較不同HbA1c組孕婦體質指數（BMI）、孕期體質量增加量、內脂素、血糖、血脂等水平的差異，分析HbA1c、內脂素水平與糖脂代謝、分娩方式、圍生結跼等的相關性。結果高HbA1c組NGT孕婦孕期體質量平均增長量、血清內脂素水平、總膽固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）均高于正常HbA1c組；前組新生兒具有較高的平均齣生體質量和較低的血糖水平以及較高的剖宮產率；羊水過多、羊水糞染、巨大兒、新生兒低血糖的髮生率均高于正常HbA1c組。在135例NGT孕婦中，HbA1c水平與孕期體質量增加量、內脂素和新生兒齣生體質量水平呈正相關。結論孕期體質量增長過多、內脂素錶達上調可引髮孕婦血糖水平升高；應選擇適宜分娩時機及方式預防不良妊娠結跼的髮生。
목적탐토당내량정상（NGT）잉부혈청당화혈홍단백（HbA1c）、내지소수평여당지대사、위생결국적상관성。방법135례연구대상균위경75 g구복당내량시험（OGTT）진단위NGT적잉족월부녀，근거HbA1c수평시부≥5.5%분위고HbA1c조（n=66）화정상HbA1c조（n=69）。수집림상자료，고효액상리자층석법측정HbA1c수평，쌍항체협심매표면역분석법검측혈청내지소수평。비교불동HbA1c조잉부체질지수（BMI）、잉기체질량증가량、내지소、혈당、혈지등수평적차이，분석HbA1c、내지소수평여당지대사、분면방식、위생결국등적상관성。결과고HbA1c조NGT잉부잉기체질량평균증장량、혈청내지소수평、총담고순（TC）、삼선감유（TG）、저밀도지단백（LDL）、고밀도지단백（HDL）균고우정상HbA1c조；전조신생인구유교고적평균출생체질량화교저적혈당수평이급교고적부궁산솔；양수과다、양수분염、거대인、신생인저혈당적발생솔균고우정상HbA1c조。재135례NGT잉부중，HbA1c수평여잉기체질량증가량、내지소화신생인출생체질량수평정정상관。결론잉기체질량증장과다、내지소표체상조가인발잉부혈당수평승고；응선택괄의분면시궤급방식예방불량임신결국적발생。
Objective To investigate the relationship between the levels of serum glycosylated hemoglobin (HbA1c), serum visfatin, glucose and lipid metabolism and the perinatal outcome in pregnant women with normal glucose tolerance (NGT). Methods A total of 135 NGT pregnant women diagnosed by oral glucose tolerance test (OGTT) entered this study. Patients were divided into two groups, high HbA1c group (HbA1c≥5.5%, n=66) and normal HbA1c group (HbA1c<5.5%, n=69). The clinical data were collected in two groups. HbA1c levels were measured by HPLC, and the serum visfatin levels were measured by ELISA method. The values of body mass index (BMI), pregnant weight gain, visfatin, glucose and lipid met-abolic levels were analyzed between two groups. The relationship between levels of HbA1c, visfatin, glucose and lipid metab-olism and perinatal outcome were compared between two groups.Results The values of mean pregnancy weight gain, visfa-tin, total cholesterol (TC), triacylglycerol (TG), low density lipoprotein (LDL) and high density lipoprotein (HDL) were higher in high HbA1c group than those of normal HbA1c group. In NGT women with high HbA1c level,there were higher average birth weight, lower blood glucose level in newborn babies and higher rates of cesarean section. The incidences of polyhydram-nios, meconium-stained fluid, macrosomia and neonatal hypoglycemia were also higher in NGT women with high HbA 1c than those of normal HbA1c group. There was a positive relationship between HbA1c level, pregnant weight gain and visfatin and birth weight of newborn babies in 135 NGT pregnant women. Conclusion The excessive weight gain during pregnancy can induce the up-regulation of the visfatin level, resulting in the increased blood glucose level. The optimal timing and mode of delivery could prevent the occurrence of adverse pregnancy outcomes.
