【摘要】 目的探讨妊娠期糖尿病(GDM)患者脂蛋白相关磷脂酶A2(Lp-PLA2)的活性变化及其与妊娠不良结局的关系。方法以该院产科门诊2012年9月-2014年1月收集的62例GDM孕妇作为研究对象,其中血糖控制良好的孕妇35例(A组)、血糖未良好控制孕妇27例(B组)。另选取同期正常妊娠妇女30例作为对照组。检测并比较3组研究对象Lp-PLA2活性及妊娠结局差异。结果 3组研究对象Lp-PLA2、空腹血糖值(FBG)、2 h餐后血糖值(2h BG)、胰岛素抵抗指数(HOMAIR)、甘油三酯(TG)值比较,差异均有统计学意义(P<0.05)。B组患者的Lp-PLA2、FBG、2h BG、HOMA-IR、TG值均显著高于A组及对照组(P<0.05);A组Lp-PLA2、FBG、2h BG、HOMA-IR值均显著高于对照组(P<0.05)。B组巨大儿发生率(33.33%)、胎膜早破率(22.22%)、早产率(37.04%)均显著高于A组和对照组(P<0.05)。GDM孕妇的FBG值与LpPLA2呈正相关(P<0.05)。结论 GDM患者的Lp-PLA2活性显著增强,并且与血糖控制水平具有相关性,同时妊娠期血糖控制不良可能导致妊娠不良结局发生率增加。更多还原

【Abstract】 Objective To explore the change of lipoprotein-pregnancy associated phospholipase A2( Lp-PLA2) activity in patients with gestational diabetes mellitus( GDM) and its relationship with adverse pregnancy outcome. Methods Sixty-two GDM pregnant women were collected from Obstetric Outpatient in the hospital from September 2012 to January 2014,then they were divided into group A( 35 pregnant women with well-controlled blood glucose) and group B( 27 pregnant women without good blood glucose control). Thirty normal pregnant women during the same period were selected as control group. Lp-PLA2 activity and pregnancy outcomes in the three groups were detected and compared. Results There were statistically significant differences in Lp-PLA2 activity,fasting blood glucose( FBG),2-hour postprandial blood glucose( 2 h BG),insulin resistance index( HOMA-IR),and triglyceride( TG) levels among the three groups( P<0. 05). Lp-PLA2,FBG,2 h BG,HOMA-IR,and TG levels in group B were statistically significantly higher than those in group A and control group( P<0. 05); Lp-PLA2,FBG,2 h BG,and HOMA-IR in group A were statistically significantly higher than those in control group( P<0. 05). The incidence rates of macrosomia,premature rupture of fetal membrane( PROM),and premature birth in group B were 33. 33%,22. 22%,and 37. 04%,respectively,which were statistically significantly higher than those in group A and control group( P<0. 05). Among the GDM pregnant women,FBG level was positively correlated with Lp-PLA2( P<0. 05). Conclusion Lp-PLA2 activity increases significantly among GDM patients,which is correlated with the level of blood glucose control; bad blood glucose control during pregnancy may lead to increase of incidence rate of adverse pregnancy outcomes.更多还原