【摘要】 目的 探讨妊娠期糖尿病孕妇血清的糖化血清白蛋白、内脂素、C肽水平变化及新生儿低血糖发生情况,为新生儿低血糖预防及治疗提供参考。方法 选取2018年3月1日-2020年2月28日某院单胎分娩的78例GDM孕妇作为研究对象，根据新生儿有无低血糖分为NH组47例、新生儿血糖正常组31例。对比两组临床资料、血清GA、Visfatin、C肽水平，及血清GA、Visfatin、C肽水平与血糖水平的关系、NH发生危险因素，评价GDM孕妇血清GA、Visfatin、C肽水平对NH的预测价值，并随访12个月，对比不同血清指标水平患者新生儿神经行为异常比例。结果 2组新生儿出生体重、早产儿及孕妇BMI、空腹血糖、餐后2小时血糖、血清GA、Visfatin、C肽水平相比，差异有统计学意义(P<0.05);Pearson相关性分析，NH组孕妇血清GA、Visfatin、C肽水平与空腹血糖、餐后2小时血糖均呈正相关关系(P<0.05);Logistic回归分析模型结果可知，新生儿出生体重、早产儿及孕妇BMI、空腹血糖、餐后2小时血糖、血清GA、Visfatin、C肽水平过高均为NH发生危险因素(P<0.05);ROC曲线显示，GDM孕妇血清GA、Visfatin、C肽水平联合对NH的预测AUC最大，且>0.9，具有良好预测效能；随访1年，未出现失访，联合预测阳性与阴性新生儿神经行为异常发生率相比，差异无统计学意义(P>0.05)。结论 GDM孕妇血清GA、Visfatin、C肽高表达均为NH发生危险因素，可有效预测NH发生风险，为NH预防及治疗提供理论参考。更多还原

【Abstract】 Objectives To explore the changes of serum glycosylated serum albumin(GA), visfatin(Visfatin)and C peptide levels in pregnant women with gestational diabetes(GDM) and the occurrence of neonatal hypoglycemia(NH). Methods A total of 78 pregnant women with GDM who gave birth in our hospital from March 1st, 2018 to March 28th, 2020 were selected as the research subjects, and their newborns were all singletons.According to whether the newborns had hypoglycemia, they were divided into 47 cases in the NH group and 31 cases in the neonatal blood glucose group. The clinical data, serum GA, Visfatin, and C peptide levels were compared between the two groups, and the relationship between serum GA, Visfatin, and C peptide levels with blood glucose levels and risk factors for NH were analyzed. The ROC curve was drawn to evaluate the predictive value of serum GA, visfatin and C peptide levels in GDM pregnant women for NH. After a 12-month follow-up, the proportion of neonatal neurobehavioral abnormalities in patients with different serum index levels was compared. Results There were statistically significant differences between the two groups of newborns in terms of birth weight, premature infants and pregnant women’s BMI, fasting blood glucose, 2 h postprandial blood glucose, serum GA, Visfatin, and C peptide levels(P<0.05). Pearson correlation analysis showed that the serum GA, Visfatin, and C peptide levels of pregnant women in the NH group were positively correlated with fasting blood glucose and 2 hours postprandial blood glucose(P<0.05). The logistic regression analysis model showed that neonatal birth weight, premature infants and pregnant women’s BMI, fasting blood glucose, 2 h postprandial blood glucose, high serum GA, Visfatin, and C peptide levels were all risk factors for NH(P<0.05). The ROC curve showed that the combination of serum GA,Visfatin, and C peptide levels in pregnant women with GDM had the largest predictive AUC of NH, and was greater than 0.9, which had good predictive power. There was no loss of follow-up after 1 year of follow-up. There was no statistically significant difference in the incidence of neurobehavioral abnormalities between the combined positive and negative neonates(P>0.05). Conclusions The high expression of serum GA, Visfatin and C peptide in GDM pregnant women were risk factors for the occurrence of NH, which could effectively predict the risk of NH and provide a theoretical reference for the prevention and treatment of NH.更多还原