發(fā)布時間：2018-01-22 02:13

  本文關(guān)鍵詞： GDM FABP4 子宮螺旋動脈 臍動脈 多普勒超聲　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討妊娠期糖尿病(gestational diabetes mellitus,GDM)患者血清脂肪酸結(jié)合蛋白4(fatty acid binding protein4,FABP4)水平及其與子宮螺旋動脈、臍動脈血流阻力的關(guān)系。方法:選自于壽光市婦幼保健院門診檢查并住院分娩且孕前均無合并內(nèi)外科疾病的單胎妊娠孕婦。采用病例對照研究的方法,以30例妊娠期糖尿病孕婦為研究組,30例同期分娩的正常孕婦為對照組。采用放射免疫法檢測兩組孕婦肘靜脈血血清脂肪酸結(jié)合蛋白4。多普勒彩色超聲檢測兩組孕婦的子宮螺旋動脈及臍動脈的波動指數(shù)(PI)、阻力指數(shù)(RI)及收縮期最大血流速度(S)與舒張末期血流速度(D)的比值。同時取2組孕婦胎盤做病理學(xué)檢測。所有數(shù)據(jù)均用SPSS17.0軟件進(jìn)行統(tǒng)計學(xué)處理。結(jié)果:孕婦FABP4水平:GDM組(36.67±1.94ng/ml),高于正常對照組(21.76±0.93ng/ml),兩組比較有統(tǒng)計學(xué)差異(t=75.8,p0.05)。GDM患者FABP4水平與子宮螺旋動脈S/D、PI及RI值呈正相關(guān),與臍動脈血流各參數(shù)均無相關(guān)性。正常對照組,FABP4水平與子宮螺旋動脈或臍動脈血流各參數(shù)均無相關(guān)性。GDM組患者胎盤絨毛成熟不良、干絨毛小動脈增厚及絨毛間質(zhì)毛細(xì)血管充盈發(fā)生比例與血清FABP4濃度均呈正相關(guān)性。結(jié)論:1.GDM孕婦血清FABP4水平顯著升高,提示FABP4可能參與了GDM的病理生理過程。2.GDM患者血清FABP4水平與子宮螺旋動脈S/D值、PI值及RI值有顯著相關(guān)性,提示FABP4可通過影響子宮螺旋小動脈阻力參與了GDM的發(fā)病機制。3.GDM患者FABP4水平與胎盤病理異常發(fā)生率有相關(guān)性,提示FABP4可能通過促進(jìn)胎盤血管內(nèi)皮增生,引起血管阻力的增加,進(jìn)而促進(jìn)GDM的發(fā)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 鹵1.94 ng / ml). It was higher than the normal control group (21.76 鹵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.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R714.256;R445.1

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