摘要
目的通过妊娠期糖尿病(GDM)患者孕期及产后血糖与血浆降钙素基因相关肽(CGRP)及内皮素(ET)水平对比观察,对其发病机制进行探讨。方法按照GDM筛查方法,将临床确诊的297例GDM患者分为两组,第一组GDM169例,第二组GDM伴高血压者128例,正常对照组291例,均进行孕期及产后血糖及血浆CGRP和ET水平观察,经统计学分析,比较两组间结果差异。结果①孕期:第一组GDM患者,单纯血糖升高,血浆CGRP和ET水平与对照组比较均无明显变化;第二组GDM伴高血压组,与正常对照组比较血浆CGRP水平明显下降,而ET水平则明显升高,P<0.05,其差异均有显著性意义。②产后:第一、二组,血糖、血压均恢复正常者血浆CGRP和ET水平与正常对照组比较无明显差异;而血糖和/或血压未恢复正常者,与对照组比较,血浆CGRP仍在较低水平,而ET仍在较高水平,P<0.05,其差异均有显著性意义。结论本研究只是从CGRP和ET对GDM血管病变发病过程的影响进行了探讨,其结果提示,积极控制妊娠期高血糖和高血压,对调控CGRP和ET水平、防止血管内皮细胞损伤是有效的。
Objective To investigate the correlation between plasma calcitonin gene-related peptide(CGRP),endothelin(ET) and level of blood glucose in gestational diabetes mellitus(GDM) during preganacy and postpartum.Methods 297 clinical diagnosed GDM were divided into two groups,169 GDM in the first group and 128 GDM with hypertension suffereres in the second groupe.291 healthy subjects were in control group.Blood glucose and CGRP and ET level were measured.Statistical analysis was used to compare the differences between the two groups.Results 1.During pregnancy:in the first group,the blood sugar was higher,both plasma CGRP and ET level had no obvious change.In the second group,the plasma CGRP was lower and ET level was much higher,(P<0.05).2.Postpartum:in those blood sugar and blood pressure were back tonomalin both groups,CGRP and ET levels had no differences.Where as in those blood sugar or blood pressure were not return to nomal,CGRP was lower,ET level was higher when compared with those in controld group(P<0.05).Conclusion We studied the change levels in CGPR and ET in different conditions of GDM.Effective control of gestational hupertension and hyperglycemia can be very effective for adjust to CGRP and ET level.
引文
[1]周莉,吴连方.妊娠合并糖尿病并发症的诊断及处理.中国实用妇科与产科杂志,2007,23(6):417-420.
[2]杨慧霞.产科诊治指南解读·病案分析.北京:人民卫生出版社,2015:27-28.
[3]杨慧霞.妊娠糖尿病诊断新标准及其启示.中国糖尿病杂志,2011,19(9):711-712.
[4]Pedula K L.Hillier T A,Schmidt M M,et al.Ethnic differences in gestational oral glucose screening in a large US population.Ethn Dis,2009,19(4):414-419.
[5]刘红,王乃尊,黄瑞衡,等.糖尿病大血管病变与血浆内皮素及降钙素基因相关肽的关系研究.广西医科大学学报,1999,16(3):168.
[6]杨兰英,赵东勇,宋玲,等.妊娠高血压综合征患者分娩前后血浆降钙素基因相关肽水平的检测.中华妇产科杂志,2003,38(11):695-696.