【摘要】 目的 分析唐氏筛查指标在妊娠期糖尿病（gestational diabetes,GDM）筛查中的应用及与妊娠结局的关系。方法 回顾性分析2019年5月—2020年12月于肇庆市第二人民医院行产前检查并分娩的98例产妇为研究对象，其中46例GDM产妇设为观察组，52名健康产妇为对照组。比较两组孕早期唐氏筛查指标、孕中期唐氏筛查指标的中位数倍值（MoM）水平、绘制受试者工作特征曲线（ROC）评估唐氏筛查指标在GDM筛查中的价值、分析唐氏筛查指标与妊娠结局相关性。结果 观察组孕早期唐氏筛查指标PAPP-A MoM值明显低于对照组，差异有统计学意义（P<0.05）；两组HCG MoM值比较差异无统计学意义（P>0.05）；观察组孕中期唐氏筛查指标AFP MoM值、HCG MoM值显著高于对照组，差异有统计学意义（P<0.05）；两组uE3 MoM值比较差异无统计学意义（P>0.05）。孕早期PAPP-A MoM值应用于GDM的ROC曲线下面积为0.702，孕中期AFP MoM值、HCG MoM值预测GDM的ROC曲线下面积依次为0.683、0.635。PAPP-A MoM值、AFP MoM值与新生儿体质量、分娩孕周、新生儿Apgar评分均呈正相关（P<0.05）;HCG MoM值与新生儿体质量、分娩孕周呈正相关，与新生儿Apgar评分呈负相关（P<0.05）。结论 孕早期PAPP-A及孕中期AFP、HCG可较好地筛查GDM，且与妊娠结局存在相关性。更多还原

【Abstract】 Objective To analyze the application of Down syndrome screening indicators in the screening of gestational diabetes mellitus(gestational diabetes,GDM) and its relationship with pregnancy outcomes.Methods A retrospective analysis was performed on 98 parturitions who underwent prenatal examination and delivered in the Second People’s Hospital of Zhaoqing city from May 2019 to December 2020. 46 parturitions with GDM were included in the observation group and 52 healthy parturitions were included in the control group. The median multiple value(MoM)level of Down’s screening indexes in early pregnancy and middle pregnancy were compared between the two groups,the value of Down’s screening indexes in GDM screening was evaluated by receiver operating characteristic curve(ROC), and the correlation between Down’s screening indexes and pregnancy outcome was analyzed.Results The PAPP-A MoM value in the observation group was significantly lower than that in the control group, and the difference was statistically significant(P<0.05). There was no significant difference in HCG MoM value between the two groups(P>0.05). The AFP MoM and the HCG MoM value of down’s screening index in the observation group was significantly higher than that in the control group, and the difference was statistically significant(P<0.05). There was no significant difference in uE3 MoM value between the two groups(P>0.05). The area under ROC curve of PAPP-A MoM value applied to GDM in early pregnancy was 0.702, and the area under ROC curve of AFP MoM value and HCG MoM value predicted GDM in middle pregnancy was 0.683 and 0.635, respectively. Papp-a MoM value and AFP MoM value were positively correlated with newborn body weight, gestational age and Apgar score(P<0.05).HCG MoM value was positively correlated with neonatal body weight and gestational age, but negatively correlated with neonatal Apgar score(P<0.05).Conclusion PAPP-A in the first trimester and AFP and HCG in the second trimester can better screen for GDM, and are associated with pregnancy outcomes.更多还原