孕早期产前筛查与妊娠期糖尿病相关性研究.docVIP

孕早期产前筛查与妊娠期糖尿病相关性研究 　　【摘要】 目的 探讨孕早期产前筛查各项指标与妊娠期糖尿病（GDM）的关系。方法 120例行口服葡萄糖耐量试验（OGTT）诊断为妊娠期糖尿病的单胎妊娠孕妇作为GDM组， 同时随机选取同时间段产检的100例OGTT正常的单胎妊娠孕妇作为对照组， 回顾性分析两组孕妇的临床资料， 比较两组孕妇一般情况以及孕早期产前筛查各项指标[妊娠相关血浆蛋白A（PAPP-A）、游离β-人绒毛膜促性腺激素（fβ-HCG）及胎儿颈项透明层厚度（NT）]。结果 两组孕妇年龄、体重及体质量指数（BMI）比较差异无统计学意义（P0.05）。GDM组孕妇血清PAPP-A的中位数倍数（MOM值）为（0.77±0.42）， 低于对照组的（0.91±0.47）， 差异具有统计学意义（P0.05）；两组孕妇孕早期唐氏综合征风险预测值比较差异无统计学意义（P0.05）。结论 妊娠期糖尿病孕妇孕早期血清PAPP-A明显偏低， PAPP-A可能是预测妊娠期糖尿病发生的重要指标。 　　【关键词】 妊娠期糖尿病；早期产筛；妊娠相关血浆蛋白A；胰岛素抵抗 　　DOI：10.14163/j.cnki.11-5547/r.2017.06.096 　　【Abstract】 Objective To investigate relationship between early pregnancy prenatal screening and gestational diabetes mellitus （GDM）. Methods There were 120 single pregnancy women with diagnosed gestational diabetes mellitus by oral glucose tolerance test （OGTT） as GDM group and another 100 healthy single pregnancy women in OGTT at the same period in antenatal examination as control group. Clinical data of the two groups were retrospectively analyzed. Comparison was made on indexes in general condition and early pregnancy prenatal screening [pregnancy-associated plasma protein A （PAPP-A）， free β-human chorionic gonadotropin （fβ-HCG）， fetal nuchal translucency （NT）] between the two groups. Results There was no statistically significant difference of age， weight， body mass index （BMI） between the two groups （P0.05）. The GDM group had multiples of median （MOM） of serum PAPP-A as （0.77±0.42）， which was lower than （0.91±0.47） in the control group， and their difference had statistical significance （P0.05）. The difference of risk predicted value of early Downs syndrome had no statistical significant between the two groups （P0.05）. Conclusion Due to remarkably low level of serum PAPP-A in early pregnancy of pregnant women with gestational diabetes mellitus， PAPP-A can be taken as an important index in predicting occurrence of gestational diabetes mellitus. 　　【Key words】 Gestational diabetes mellitus； Early pregnancy prenatal screening； Pregnancy-associa