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目的探讨脐血脂联素(APN)及血管细胞黏附分子-1(VCAM-1)水平与妊娠期糖尿病孕妇分娩巨大儿的相关性。方法选择2013年5月~2014年7月新疆医科大学第一附属医院(以下简称“我院”)分娩的妊娠期糖尿病孕妇54例作为观察组,选取我院同期正常孕妇分娩的新生儿55例作为对照组。检测两组新生儿的脐血APN、胰岛素和VCAM-1水平,记录巨大儿、窒息及高胆红素血症的发生率。结果观察组新生儿脐血APN水平显著低于对照组(t=11.954,P<0.05);观察组新生儿脐血VCAM-1水平显著高于对照组(t=21.410,P<0.05);观察组新生儿体重及血清胆红素值均显著高于对照组(P<0.05);观察组新生儿Apgar评分显著低于对照组(t=2.316,P<0.05)。观察组新生儿巨大儿和高胆红素血症发生率均显著高于对照组(P<0.05)。Pearson相关性分析结果显示,新生儿脐血VCAM-1水平与妊娠期糖尿病孕妇巨大儿体重呈正相关(r=0.191,P<0.05),新生儿脐血APN水平与妊娠期糖尿病孕妇巨大儿体重呈显著负相关(r=-0.617,P<0.05)。结论妊娠期糖尿病孕妇巨大儿、新生儿窒息以及新生儿高胆红素血症等不良结局的风险显著增加,新生儿脐血VCAM-1与妊娠期糖尿病孕妇巨大儿体重呈正相关,新生儿脐血APN水平与妊娠期糖尿病孕妇巨大儿体重呈显著负相关。
Objective To investigate the correlation between cord blood adiponectin (APN) and vascular cell adhesion molecule-1 (VCAM-1) levels in pregnant women with gestational diabetes mellitus. Methods 54 pregnant women with gestational diabetes who were delivered from the First Affiliated Hospital of Xinjiang Medical University (hereinafter referred to as “our hospital”) from May 2013 to July 2014 were selected as the observation group. The newborns 55 cases as a control group. The cord blood levels of APN, insulin and VCAM-1 were measured in two groups of neonates, and the incidence of macrosomia, apnea and hyperbilirubinemia was recorded. Results The level of APN in umbilical cord blood of observation group was significantly lower than that of control group (t = 11.954, P <0.05). The level of VCAM-1 in umbilical cord blood of observation group was significantly higher than that of control group (t = 21.410, P <0.05) Neonatal body weight and serum bilirubin values were significantly higher in the neonatal group than those in the control group (P <0.05). The Apgar score of neonates in the observation group was significantly lower than that of the control group (t = 2.316, P <0.05). The incidence of neonatal giant hyperbilirubinemia and observation group were significantly higher than the control group (P <0.05). Pearson correlation analysis showed that the level of VCAM-1 in neonatal cord blood was positively correlated with the weight of pregnant children with gestational diabetes (r = 0.191, P <0.05). The level of APN in cord blood and the weight of pregnant children with gestational diabetes mellitus Significant negative correlation (r = -0.617, P <0.05). Conclusions The risk of adverse outcomes of hypertensive pregnancy, neonatal asphyxia and neonatal hyperbilirubinemia in pregnant women with gestational diabetes mellitus is significantly increased. VCAM-1 in neonatal cord blood is positively correlated with the weight of pregnant women with gestational diabetes, and neonatal umbilical cord blood APN level and pregnant women with gestational diabetes huge weight was significantly negative correlation.