上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

妊娠期糖化血清白蛋白的影响因素、变动趋势及其正常参考值

王凤环1,2，李华萍2   

  1. 1.苏州大学医学部， 苏州 215006； 2.上海交通大学附属第六人民医院妇产科， 上海 200233
  • 出版日期:2014-03-28 发布日期:2014-04-02
  • 通讯作者: 李华萍, 电子信箱: hpli819@sohu.com。
  • 作者简介:王凤环（1986—）， 女， 硕士生; 电子信箱: 619691220@qq.com。
  • 基金资助:

    上海交通大学医学院科技基金（11XJ21059）

Influential factors, change trends, and reference values of serum glycated albumin in pregnancy

WANG Feng-huan1,2, LI Hua-ping2   

  1. 1.School of Medicine, Soochow University, Suzhou 215006, China； 2.Department of Gynecology and Obstetrics, the Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
  • Online:2014-03-28 Published:2014-04-02
  • Supported by:

    Science and Technology Foundation of Shanghai Jiao Tong University School of Medicine，11XJ21059

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摘要：

目的 通过对正常孕妇糖化血清白蛋白(GA)的研究，探讨其影响因素、变动趋势，初步建立妊娠期GA的正常参考值范围。方法 选择2010年12月—2013年2月在上海交通大学附属第六人民医院产科门诊产前检查并分娩的孕妇，采用前瞻性研究，以1 046名无并发症的正常孕妇为研究对象，采用百分位数方法初步建立GA医学参考值范围；采用t检验、多元线性回归分析等方法研究其影响因素和变动趋势。结果 ①正常孕妇1 046名，经简单相关性分析得出：在孕12～16、24～28和36～38周 GA值与孕前体质量指数（BMI）及孕期体质量增长呈负相关关系（P<0.05）；与年龄、孕产次、新生儿出生体质量之间无明显相关性（P>0.05）。多元线性回归分析显示：孕前BMI及孕期体质量增长是影响孕期GA的主要因素。②根据孕前BMI水平，将孕妇分为低BMI组、正常BMI组和超重肥胖组，3组在孕12～16、孕24～28和孕36～38周各组间GA水平差异均有统计学意义(P<0.05)，并且GA值在各孕期差异均具有统计学意义(P<0.05)。③1 046名正常孕妇，以百分位数法取2.5％～97.5％作为孕期GA正常参考值，其范围为9.20％～14.60％；孕12～16、孕24～28和孕36～38周的GA参考值范围分别为10.20％～15.18%、9.70％～13.98%和8.70％～13.20%。不同孕前BMI正常孕妇不同孕期GA值不同。结论 随孕期进展GA水平逐渐降低，9.20％～14.60％可初步作为妊娠期GA的正常参考值范围，但在临床应用中需考虑孕前MBI、孕周和孕期体质量增加等影响因素。

关键词: 妊娠, 糖化血清白蛋白, 参考值, 孕前体质量指数

Abstract:

Objective To explore the relevant influence factors and change trends and to set up normal reference value limits of glycated albumin (GA) of the gestation period through the study of serum GA of normal pregnant women. Methods A total of 1 046 normal pregnant women who presented to obstetric clinics of the Sixth People's Hospital affiliated to Shanghai Jiao Tong University between December, 2010 and February, 2013 were studied with prospective study. The method of percentiles was used to establish the reference range of GA. And t test and multiple linear regression analysis method were used to study the influential factors and change trend. Results ①For 1 046 normal pregnant women, simple correlation analysis showed that GA values of the gestation period of 12-16, 24-28, and 36-38 weeks were negatively correlated with pre-pregnancy BMI and weight gain during the gestation period (P<0.05), and there were no significant correlations between GA and age, birth weight, and gravidity and parity (P>0.05). Multiples stepwise regression analysis showed that pre-pregnancy BMI and weight gain during the gestation period were main influence factors of GA. ②Based on the pre-pregnancy BMI level, pregnant women were divided into three groups, i.e. low BMI group, normal BMI group, and overweight obesity group. The differences of GA level among groups were statistically significant (P<0.05) during 12-16, 24-28, and 36-38 weeks of gestation period. The differences of GA values of gestation periods were statistically significant (P<0.05). ③The values of GA between 2.5％ and 97.5％ of 1 046 normal pregnant women were selected as normal GA reference values of gestation period by the percentile method and the range of GA values was 9.20％-14.60％. The ranges of GA reference values of gestation periods of 12-16, 24-28, and 36-38 weeks were 10.20％-15.18%, 9.70％-13.98%, and 8.70％-13.20%, respectively. The GA values of different gestation periods were different for normal pregnant women with different pre-pregnancy BMI. Conclusion With the progress of the pregnancy, GA level gradually reduces. The normal reference range of the GA of gestation period can be suggested as 9.20%-14.60%. But influence factors such as the pre-pregnancy BMI, gestation period, and weight gain during gestation period should be considered for clinical applications.

Key words: pregnancy, glycated albumin, reference value, body mass index