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目的:分析妊娠期糖尿病(GDM)产妇脐血脂联素(APN)、胰岛素与新生儿结局的相关性。方法:前瞻性收集江西省妇幼保健院2012年6月~2013年1月收治的GDM产妇分娩的新生儿100例作为观察组;另选取该院同期糖耐量正常产妇分娩的新生儿100例作为对照组。新生儿娩出后立即取脐静脉血检测血清APN及胰岛素水平,分析脐血APN、胰岛素水平及其与新生儿出生结局的相关性。结果:观察组脐血APN、胰岛素水平与对照组比较,差异均有统计学意义(t=12.27,P<0.05;t=11.66,P<0.05),观察组脐血APN水平与胰岛素水平呈负相关(r=-0.647,P<0.05);脐血APN水平与巨大儿出生体重呈负相关(r=-0.542,P<0.05),与低血糖症患儿血糖值及高胆红素血症患儿经皮胆红素值均无相关性(r=0.132,P>0.05;r=0.098,P>0.05);观察组脐血胰岛素水平与巨大儿出生体重呈正相关(r=0.609,P<0.05),与低血糖症患儿血糖值呈负相关(r=-0.564,P<0.05),与高胆红素血症患儿经皮胆红素值无明显相关性(r=0.104,P>0.05)。结论:GDM产妇脐血APN、胰岛素可能在胎儿生长发育过程中起重要的调节作用,与新生儿出生结局密切相关。
Objective: To analyze the correlation between cord blood adiponectin (APN), insulin and neonatal outcome in gestational diabetes mellitus (GDM). Methods: Prospectively collected 100 cases of newborn infants born in GDM maternity hospital from June 2012 to January 2013 in Jiangxi Maternal and Child Health Care Hospital as the observation group. Another 100 newborns with normal glucose tolerance in the same period were selected as control group group. Immediately after birth, umbilical venous blood was collected to detect serum APN and insulin levels, and the correlation between cord blood APN and insulin levels and neonatal birth outcomes was analyzed. Results: The levels of APN and insulin in umbilical cord blood in observation group were significantly different from those in control group (t = 12.27, P <0.05; t = 11.66, P <0.05) (R = -0.647, P <0.05). APN level in cord blood was negatively correlated with the birth weight of macrosomia (r = -0.542, P <0.05), and was associated with the blood glucose level and hyperbilirubinemia in children with hypoglycemia There was no correlation between transcutaneous bilirubin value in children and infants (r = 0.132, P> 0.05; r = 0.098, P> 0.05). There was a positive correlation between umbilical cord blood insulin level and birth weight (r = 0.609, 0.05), but negatively correlated with blood glucose level in children with hypoglycemia (r = -0.564, P <0.05). There was no significant correlation between transcutaneous bilirubin level and children with hyperbilirubinemia (r = 0.104, P > 0.05). Conclusion: APN and insulin in umbilical cord blood of GDM maternal may play an important regulatory role in fetal growth and development, which is closely related to the neonatal outcome.