GDM孕妇血清FABP4水平与子宫-胎盘血流异常间的相关性与临床意义

发布时间：2018-01-22 02:13

本文关键词： GDM FABP4 子宫螺旋动脉脐动脉多普勒超声　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)患者血清脂肪酸结合蛋白4(fatty acid binding protein4,FABP4)水平及其与子宫螺旋动脉、脐动脉血流阻力的关系。方法:选自于寿光市妇幼保健院门诊检查并住院分娩且孕前均无合并内外科疾病的单胎妊娠孕妇。采用病例对照研究的方法,以30例妊娠期糖尿病孕妇为研究组,30例同期分娩的正常孕妇为对照组。采用放射免疫法检测两组孕妇肘静脉血血清脂肪酸结合蛋白4。多普勒彩色超声检测两组孕妇的子宫螺旋动脉及脐动脉的波动指数(PI)、阻力指数(RI)及收缩期最大血流速度(S)与舒张末期血流速度(D)的比值。同时取2组孕妇胎盘做病理学检测。所有数据均用SPSS17.0软件进行统计学处理。结果:孕妇FABP4水平:GDM组(36.67±1.94ng/ml),高于正常对照组(21.76±0.93ng/ml),两组比较有统计学差异(t=75.8,p0.05)。GDM患者FABP4水平与子宫螺旋动脉S/D、PI及RI值呈正相关,与脐动脉血流各参数均无相关性。正常对照组,FABP4水平与子宫螺旋动脉或脐动脉血流各参数均无相关性。GDM组患者胎盘绒毛成熟不良、干绒毛小动脉增厚及绒毛间质毛细血管充盈发生比例与血清FABP4浓度均呈正相关性。结论:1.GDM孕妇血清FABP4水平显著升高,提示FABP4可能参与了GDM的病理生理过程。2.GDM患者血清FABP4水平与子宫螺旋动脉S/D值、PI值及RI值有显著相关性,提示FABP4可通过影响子宫螺旋小动脉阻力参与了GDM的发病机制。3.GDM患者FABP4水平与胎盘病理异常发生率有相关性,提示FABP4可能通过促进胎盘血管内皮增生,引起血管阻力的增加,进而促进GDM的发生。
[Abstract]:Objective: to investigate gestational diabetes mellitus in gestational diabetes mellitus (GDM). Serum fatty acid binding protein (acid binding protein 4) and its association with uterine spiral artery were observed in patients with GDM. The relationship of umbilical artery blood flow resistance. Methods: single pregnancy pregnant women were selected from Shouguang Maternal and Child Health Hospital for outpatient examination and inpatient delivery without any internal and surgical diseases before pregnancy. The method of case-control study was used. The study group consisted of 30 pregnant women with gestational diabetes mellitus. 30 normal pregnant women in the same period were used as control group. Serum fatty acid binding protein (FFABP) was detected by radioimmunoassay in both groups. Doppler color ultrasound was used to detect the uterine spiral artery and umbilical artery in two groups of pregnant women. Volatility index (. Pi). Resistance index (RI), maximum systolic velocity (S) and end diastolic velocity (D). At the same time, the placenta of two groups of pregnant women were taken for pathological examination. All the data were statistically processed by SPSS17.0 software. Results: the pregnant women in the FABP4 level: GDM group (. 36.67 卤1.94 ng / ml). It was higher than the normal control group (21.76 卤0.93ng / ml), there was statistical difference between the two groups (75.8). The level of FABP4 in patients with p0.05. GDM was positively correlated with S- / DX Pi and RI of uterine spiral artery, but not correlated with all parameters of umbilical artery blood flow. There was no correlation between FABP4 level and blood flow parameters of uterine spiral artery or umbilical artery. There was a positive correlation between the thickening of the villous arterioles and the percentage of capillary filling in the villous stroma and the concentration of serum FABP4. Conclusion: 1. The level of serum FABP4 in pregnant women with GDM was significantly higher than that in the control group. The results suggest that FABP4 may be involved in the pathophysiological process of GDM. 2. There is a significant correlation between serum FABP4 level and S / D value, Pi value and RI value of uterine spiral artery in GDM patients. The results suggest that FABP4 may be involved in the pathogenesis of GDM by affecting the resistance of uterine spiral arterioles. 3. The level of FABP4 in GDM patients is correlated with the incidence of placental pathological abnormalities. The results suggest that FABP4 may increase vascular resistance and promote the occurrence of GDM by promoting the proliferation of placental vascular endothelium.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R714.256;R445.1

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