| 杜伟平,张 瑞,米思蓉,张宁梅,钟 瑛.妊娠期糖尿病患者糖化血红蛋白水平与甲状腺激素水平及不良妊娠结局的关系分析[J].,2019,19(20):3955-3958 |
| 妊娠期糖尿病患者糖化血红蛋白水平与甲状腺激素水平及不良妊娠结局的关系分析 |
| Analysis of the Relationship between Glycosylated Hemoglobin Level and Thyroid Hormone Level and Adverse Pregnancy Outcome in Patients with Gestational Diabetes Mellitus |
| 投稿时间：2019-05-03 修订日期：2019-05-26 |
| DOI：10.13241/j.cnki.pmb.2019.20.035 |
| 中文关键词: 妊娠期糖尿病 糖化血红蛋白 甲状腺激素 妊娠结局 相关性 |
| 英文关键词: Gestational diabetes mellitus Glycosylated hemoglobin Thyroid hormone Pregnancy outcomes Correlation |
| 基金项目:陕西省科学技术研究发展计划项目（2016HM1214） |
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| 中文摘要: |
| 摘要 目的：分析妊娠期糖尿病（GDM）患者糖化血红蛋白（HbAlc）水平与甲状腺激素水平及不良妊娠结局的关系。方法：选取2017年2月~2018年5月期间延安大学附属医院接收的GDM患者118例作为观察组，其中血清HbAlc水平≤6.5% 55例，>6.5% 63例。另外选取同期来我院接受孕检的110例非GDM孕妇作为对照组，比较对照组、观察组血清HbAlc、甲状腺激素水平以及不良妊娠结局，比较观察组中不同HbAlc水平患者不良妊娠结局情况，采用Pearson相关性分析HbAlc水平与甲状腺激素水平的关系。结果：观察组初次测量、二次测量时的血清HbAlc水平均高于对照组（P<0.05）。观察组血清三碘甲状腺原氨酸（T3）、游离甲状腺原氨酸（FT3）、总甲状腺素（T4）、游离甲状腺素（FT4）水平均低于对照组（P<0.05）。观察组羊水过多、胎儿窘迫、新生儿低血糖、早产、巨大儿的发生率均高于对照组（P<0.05）。HbAlc水平>6.5%的患者羊水过多、胎儿窘迫、新生儿低血糖、早产、巨大儿的发生率均高于HbAlc水平≤6.5%的患者（P<0.05）。Pearson相关性分析结果可知，HbAlc与T3、T4、FT4、促甲状腺素（TSH）无相关性（P>0.05），而与FT3呈负相关（P<0.05）。结论：血清HbAlc水平可较好地预测GDM患者不良妊娠结局，GDM患者多处于甲状腺激素水平较低状态，且HbAlc与甲状腺功能指标FT3密切相关。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the relationship between glycosylated hemoglobin (HbAlc) level and thyroid hormone level and adverse pregnancy outcome in patients with gestational diabetes mellitus (GDM). Methods: 118 patients with GDM who were received in Yan'an University Affiliated Hospital from February 2017 to May 2018 were selected as observation group. Serum HbAlc level ≤ 6.5% had 55 cases, and >6.5% had 63 cases. In addition, 110 non-GDM pregnant women who received pregnancy examination in our hospital during the same period were selected as the control group. Serum HbAlc, thyroid hormone levels and adverse pregnancy outcomes were compared between the control group and the observation group. The adverse pregnancy outcomes of patients with different HbAlc levels in the observation group were compared. Pearson correlation analysis was used to analyze the relationship between HbAlc level and thyroid hormone level. Results: The level of serum HbAlc in the observation group was higher than that in the control group at the first and second measurements (P<0.05). The serum levels of triiodothyronine (T3), free thyronine (FT3), total thyroxine (T4) and free thyroxine (FT4) in the observation group were lower than those in the control group (P<0.05). The incidence of excessive amniotic fluid, fetal distress, neonatal hypoglycemia, premature delivery and macrosomia in the observation group were higher than those in the control group (P<0.05). The incidence of excessive amniotic fluid, fetal distress, neonatal hypoglycemia, premature delivery and macrosomia in HbAlc level>6.5% were higher than those in HbAlc level≤6.5% group (P<0.05). Pearson correlation analysis showed that HbAlc were not correlated with T3, T4, FT4, thyrotropin (TSH) (P>0.05), but negatively correlated with FT3 (P<0.05). Conclusion: Serum HbAlc level can better predict the adverse pregnancy outcomes of GDM patients, and most of GDM patients are in a low thyroid hormone level, HbAlc is closely related to thyroid function index FT3. |
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