中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2015年
35期
2817-2820
,共4页
顾珣可%王丁然%陶立元%靳红艳%赵扬玉%王永清
顧珣可%王丁然%陶立元%靳紅豔%趙颺玉%王永清
고순가%왕정연%도립원%근홍염%조양옥%왕영청
宫颈机能不全%松弛素%早产/流产%多囊卵巢综合征%体质量指数
宮頸機能不全%鬆弛素%早產/流產%多囊卵巢綜閤徵%體質量指數
궁경궤능불전%송이소%조산/유산%다낭란소종합정%체질량지수
Uterine cervical incompetence%Relaxin%Abortion/premature birth%Polycystic ovary syndrome%Body mass index
目的 探讨宫颈机能不全孕妇血清松弛素水平的变化.方法 对象为2008年2月至2012年9月,在北京大学第三医院建档规律产检的首次妊娠并于妊娠26周前临床诊断为宫颈机能不全者及相应孕周未发生宫颈机能不全者(对照组),各33例.排除双胎(多胎)妊娠、合并妊娠期高血压疾病、肾病、自身免疫病等全身疾病患者、既往因宫颈病变行宫颈锥切术及既往有宫颈机能不全病史的患者.比较两组病例妊娠第一期末的宫颈长度(cm)、孕前体质量指数(BMI)、是否合并糖尿病(DM)和(或)妊娠期糖尿病(GDM)、是否合并多囊卵巢综合征(PCOS)及妊娠结局等,并测定两组血清松弛素(RLN,mg/L)水平.结果 符合入选标准的宫颈机能不全孕妇共33例,其中流产15例(45.45％),早产12例(36.36％),足月产6例(18.18％),终止妊娠孕周(30±6)周,孕前BMI(27±4) kg/m2,血清松弛素水平(2 748 ±82) mg/L.对照组共33例,其中流产1例(3.03％),早产4例(12.12％),足月产28例(84.85％),终止妊娠孕周(38±4)周,孕前BMI(23±3)kg,/m2,血清松弛素水平(2 602±126) mg/L.病例组合并PCOS比例及合并DM和(或)GDM比例明显高于对照组(P＜0.01,＜0.05),其妊娠结局较差(P＜0.01),其孕前BMI水平及血清松弛素水平均比对照组明显升高,差异均有统计学意义(均P＜0.01),非条件logistic回归显示,BMI和血清松弛素水平是宫颈机能不全的独立危险因素.结论 血清松弛素水平升高是宫颈机能不全的独立危险因素;PCOS孕妇可能更容易发生宫颈机能不全;血清松弛素对宫颈机能不全可能具有预测价值.
目的 探討宮頸機能不全孕婦血清鬆弛素水平的變化.方法 對象為2008年2月至2012年9月,在北京大學第三醫院建檔規律產檢的首次妊娠併于妊娠26週前臨床診斷為宮頸機能不全者及相應孕週未髮生宮頸機能不全者(對照組),各33例.排除雙胎(多胎)妊娠、閤併妊娠期高血壓疾病、腎病、自身免疫病等全身疾病患者、既往因宮頸病變行宮頸錐切術及既往有宮頸機能不全病史的患者.比較兩組病例妊娠第一期末的宮頸長度(cm)、孕前體質量指數(BMI)、是否閤併糖尿病(DM)和(或)妊娠期糖尿病(GDM)、是否閤併多囊卵巢綜閤徵(PCOS)及妊娠結跼等,併測定兩組血清鬆弛素(RLN,mg/L)水平.結果 符閤入選標準的宮頸機能不全孕婦共33例,其中流產15例(45.45％),早產12例(36.36％),足月產6例(18.18％),終止妊娠孕週(30±6)週,孕前BMI(27±4) kg/m2,血清鬆弛素水平(2 748 ±82) mg/L.對照組共33例,其中流產1例(3.03％),早產4例(12.12％),足月產28例(84.85％),終止妊娠孕週(38±4)週,孕前BMI(23±3)kg,/m2,血清鬆弛素水平(2 602±126) mg/L.病例組閤併PCOS比例及閤併DM和(或)GDM比例明顯高于對照組(P＜0.01,＜0.05),其妊娠結跼較差(P＜0.01),其孕前BMI水平及血清鬆弛素水平均比對照組明顯升高,差異均有統計學意義(均P＜0.01),非條件logistic迴歸顯示,BMI和血清鬆弛素水平是宮頸機能不全的獨立危險因素.結論 血清鬆弛素水平升高是宮頸機能不全的獨立危險因素;PCOS孕婦可能更容易髮生宮頸機能不全;血清鬆弛素對宮頸機能不全可能具有預測價值.
목적 탐토궁경궤능불전잉부혈청송이소수평적변화.방법 대상위2008년2월지2012년9월,재북경대학제삼의원건당규률산검적수차임신병우임신26주전림상진단위궁경궤능불전자급상응잉주미발생궁경궤능불전자(대조조),각33례.배제쌍태(다태)임신、합병임신기고혈압질병、신병、자신면역병등전신질병환자、기왕인궁경병변행궁경추절술급기왕유궁경궤능불전병사적환자.비교량조병례임신제일기말적궁경장도(cm)、잉전체질량지수(BMI)、시부합병당뇨병(DM)화(혹)임신기당뇨병(GDM)、시부합병다낭란소종합정(PCOS)급임신결국등,병측정량조혈청송이소(RLN,mg/L)수평.결과 부합입선표준적궁경궤능불전잉부공33례,기중유산15례(45.45％),조산12례(36.36％),족월산6례(18.18％),종지임신잉주(30±6)주,잉전BMI(27±4) kg/m2,혈청송이소수평(2 748 ±82) mg/L.대조조공33례,기중유산1례(3.03％),조산4례(12.12％),족월산28례(84.85％),종지임신잉주(38±4)주,잉전BMI(23±3)kg,/m2,혈청송이소수평(2 602±126) mg/L.병례조합병PCOS비례급합병DM화(혹)GDM비례명현고우대조조(P＜0.01,＜0.05),기임신결국교차(P＜0.01),기잉전BMI수평급혈청송이소수평균비대조조명현승고,차이균유통계학의의(균P＜0.01),비조건logistic회귀현시,BMI화혈청송이소수평시궁경궤능불전적독립위험인소.결론 혈청송이소수평승고시궁경궤능불전적독립위험인소;PCOS잉부가능경용역발생궁경궤능불전;혈청송이소대궁경궤능불전가능구유예측개치.
Objective To analyze the serum relaxin and clinical character of cervical incompetence patients and normal pregnant women.Methods A total of 33 cervical incompetence patients (research group) and 33 normal pregnancy women with the same gestational age (control group) were recruited into the study.The serum relaxin level was detected with enzyme labeled immunosorbent assay (ELSIA) in the two groups,and the cervical length of early pregnancy period (cm),body mass index (BMI,kg/m2),frequency of polycystic ovary syndrome (％),gestational diabetes mellitus/diabetes mellitus (％) and outcomes in the two groups were analyzed with independent samples t test and chi-square test.Results All the cervical incompetence patients were recruited between Feb.2008 and Sept.2012,with the average termination gestational age of 30 ±6 weeks.Among them,15 (45.45％) was abortion,12 (36.36％) was preterm birth,6 (16.18％) was term birth.The average BMI before pregnancy was 27 ±4 kg/m2,and the average serum relaxin was 2 748 ± 82 mg/L;for the 33 patients in the control group,the average termination gestational age was 38 ±3 weeks,and 1 (3.03％) of them was abortion,4 (12.12％) was preterm birth,28 (84.85％) was term birth.The average BMI before pregnancy was 23 ± 3 kg/m2,the average serum relaxin was 2 602 ± 126 mg/L.Compared with the control group,the research group had more patients who complicated with polycystic ovary syndrome and gestational diabetes mellitus/diabetes mellitus (P ＜ 0.01,＜0.05) and worse pregnancy outcomes (P ＜ 0.01);the average BMI before pregnancy and the average serum relaxin level of the research group were significantly higher than control group (P ＜ 0.01,P ＜ 0.01).Analysis through the unconditional logistic regression showed that BMI and serum relaxin were both independent risk factors of cervical incompetence.Conclusions The high level of serum relaxin is an independent risk factor of cervical incompetence;women with polycystic ovary syndrome may more likely to have cervical incompetence and serum relaxin may have the predictive value for cervical incompetence.
