摘要
目的:分析血清甲状腺过氧化物酶抗体(TPO-Ab)、甲状腺球蛋白抗体(TG-Ab)、妊娠相关蛋白A(PAPP-A)、人绒毛膜促性腺激素(β-hCG)与妊娠期糖尿病(GDM)及妊娠结局的相关性.方法:将2020年1月-2022年1月兴化市妇幼保健院就诊的87例GDM孕妇纳入观察组,另将同期于江苏兴化市妇幼保健院行体检的91例健康孕妇纳入对照组,采集两组静脉血,检测对比其血清TPO-Ab、TG-Ab、PAPP-A、β-hCG水平;另绘制受试者工作曲线(ROC),分析TPO-Ab、TG-Ab、PAPP-A、β-hCG联合诊断GDM的效果;随访至分娩,统计对比两组的不良妊娠结局(包括巨大儿、新生儿窒息等)发生率;同时统计不良妊娠孕妇与正常妊娠孕妇的TPO-Ab、TG-Ab、PAPP-A、β-hCG 差异.结果:观察组 TPO-Ab、TG-Ab、β-hCG 高于对照组,PAPP-A低于对照组,差异有统计学意义(P＜0.05);ROC结果显示:TPO-Ab、TG-Ab、PAPP-A、β-hCG联合诊断GDM 的曲线下面积(AUC)为 0.933(95％CI:0.891～0.976),高于几者单独检测的 AUC:0.881(95％CI:0.827～0.935)、0.859(95％CI:0.801～0.918)、0.890(95％CI:0.835～0.946)、0.862(95％CI:0.808～0.915);观察组不良妊娠结局发生率高于对照组,差异有统计学意义(P＜0.05);不良妊娠孕妇的TPO-Ab、TG-Ab、β-hCG高于正常妊娠孕妇,PAPP-A低于正常妊娠孕妇,差异有统计学意义(P＜0.05).结论:TPO-Ab、TG-Ab、PAPP-A、β-hCG在GDM孕妇机体内呈异常表达状态,几者联合能够有效诊断出GDM,且上述指标水平高低与孕妇的妊娠结局具有紧密联系,具有较高的运用价值,值得临床推广.
Abstract
Objective:To analyze the association between serum Thyroid peroxidase antibody(TPO-Ab),thyroglobulin antibody(TG-Ab),pregnancy associated protein A(PAPP-A),and β-human chorionic gonadotropin(β-HCG)levels and gestational diabetes mellitus(GDM)with pregnancy outcome.Methods:87 pregnant women with GDM who visited Xinghua Maternal and Child Health Hospital in Jiangsu from January 2020 to January 2022 were included in the observation group,and 91 healthy pregnant women who underwent physical examinations at Xinghua Maternal and Child Health Hospital in Jiangsu were included in the control group.Venous blood was collected from two groups,and their serum TPO-Ab,TG-Ab,PAPP-A,and β-HCG levels were measured and compared between groups.Diagnostic value of both single parameter test and test encompassing all four proteins was evaluated using receiver operating curve(ROC).Incidence of adverse pregnancy outcomes(including macrosomia,neonatal asphyxia,etc.)between the two groups were also recorded.In addition,the TPO-Ab,TG-Ab,PAPP-A,and β-HCG levels of pregnant women with adverse pregnancy and those with normal pregnancy were also counted.Results:Observation group TPO-Ab,TG-Ab β-HCG was higher than the control group,while PAPP-A was lower than the control group,with a statistically significant difference(P＜0.05);ROC results show the area under the curve(AUC)of the combined test for GDM with was 0.933(95％CI:0.891～0.976),which was higher than the individual detection 0.881(95％CI:0.827～0.935),0.859(95％CI:0.801～0.918),0.890(95％CI:0.835～0.946),and 0.862(95％CI:0.808～0.915)for TPO-Ab,TG-Ab,PAPP-A,and β-HCG respectively.The incidence of adverse pregnancy outcomes in the observation group was higher than that in the control group,and the difference was statistically significant(P＜0.05);TPO-Ab,TG-Ab β-HCG were higher than those of normal pregnant women,while PAPP-A was lower than that of normal pregnant women,with a statistically significant difference(P＜0.05).Conclusion:TPO-Ab,TG-Ab,PAPP-A,and β-HCG are abnormally expressed in the body of pregnant women with GDM,and the combination of these indicators can effectively diagnose GDM.The level of these indicators is closely related to the pregnancy outcome of pregnant women,and has high practical value,which is worthy of clinical promotion.
维普
万方数据