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目的:检测妊娠期糖尿病(GDM)孕妇血清及脐血血清中晚期糖基化终产物(AGE)的水平,并观察胎盘组织中AGE受体(RAGE)的表达,探讨AGE与胎儿出生缺陷的关系及其在产前筛查中的临床意义。方法:选择经产前筛查诊断为胎儿畸形或胎死宫内的GDM孕妇作为病例组(42例),随机选择GDM无胎儿异常孕妇作为GDM组(30例),无妊娠合并症的健康孕妇作为健康对照组(30例)。采用酶联免疫法检测孕妇血清及脐血血清AGE水平;采用免疫组化方法检测胎盘组织中RAGE蛋白的表达。结果:病例组、GDM组、健康对照组脐血血清AGE水平分别为(223.9±54.6),(160.7±37.2),(108.3±15.8)μg/L,三组差异显著(P<0.05);病例组、GDM组、健康对照组孕妇血清AGE水平分别为(169.1±14.3),(105.4±17.2),(80.6±11.4)μg/L,三组亦有显著差异(P<0.05);病例组孕妇血清与脐血血清中AGE水平呈正相关(r=0.863,P<0.01);病例组、GDM组及健康对照组胎盘组织中RAGE的阳性表达率分别为87.5%、53.1%、29.6%,三组差异显著(P<0.05)。结论:GDM孕妇高AGE血症是导致出生缺陷的危险因素,孕妇血清AGE水平可作为GDM出生缺陷的产前筛查指标。
Objective: To detect the level of advanced glycosylation end products (AGE) in serum of pregnant women with gestational diabetes mellitus (GDM) and umbilical cord serum and to observe the expression of AGE receptor (RAGE) in placenta and the relationship between AGE and birth defects And its clinical significance in prenatal screening. Methods: Forty-two pregnant women with fetal malformation or fetal death diagnosed by prenatal screening were selected as the case group (n = 42). GDM group (n = 30) was randomly selected as GDM non-pregnant women without pregnancy. Healthy pregnant women without pregnancy complications As a healthy control group (30 cases). Serum and cord serum levels of AGE were detected by enzyme-linked immunosorbent assay. The expression of RAGE protein in placentas was detected by immunohistochemistry. Results: Serum AGE level in cases, GDM and healthy controls were (223.9 ± 54.6), (160.7 ± 37.2) and (108.3 ± 15.8) μg / L, respectively, with significant differences among the three groups The levels of serum AGE in pregnant women, pregnant women, pregnant women, pregnant women, pregnant women, pregnant women, pregnant women, pregnant women and pregnant women were significantly higher than those in healthy women (169.1 ± 14.3, 105.4 ± 17.2, 80.6 ± 11.4 μg / L, Serum and cord blood serum AGE levels were positively correlated (r = 0.863, P <0.01); the case group, GDM group and healthy control group placenta RAGE positive expression rates were 87.5%, 53.1%, 29.6%, three groups The difference was significant (P <0.05). CONCLUSION: High AGE hyperlipidemia in GDM pregnant women is a risk factor for birth defects. Serum AGE levels in pregnant women may be used as prenatal screening indicators for GDM birth defects.