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目的:探究TNF-α、NF-KBp65以及PAI-1在妊娠期糖尿病孕妇血清和胎盘组织中的表达变化及其临床意义。方法:选取自47例定期产检并且住院分娩的妊娠期糖尿病孕妇作为观察组,再选取同期分娩的47例正常孕妇作为对照组,比较两组孕妇血清和胎盘组织中TNF-α、NF-KBp65和PAI-1的表达水平,并分析血清中TNF-α、NF-KBp65、PAI-1表达水平的相关性。结果:观察组孕妇血浆的TNF-α和PAI-1表达水平明显较高,差异具有统计学意义(P均<0.001)。妊娠期糖尿病患者血浆中PAI-1表达水平和TNF-α表达水平呈正相关关系(r=0.843,P<0.001)。观察组孕妇的空腹-OGTT、1h-OGTT、2h-OGTT、空腹胰岛素、空腹血糖以及胰岛素抵抗指数均明显高于对照组(P均<0.001)。胰岛素抵抗指数与妊娠期糖尿病患者血浆中TNF-α的表达水平相关性最高(Beta=0.769);口服葡萄糖耐受实验中1-h的血糖水平与PAI的表达水平相关性最高(Beta=0.637)。观察组孕妇的TNF-α、NF-KBp65和PAI-1的阳性率显著高于对照组,差异具有统计学意义(P<0.001,=0.039,0.007)。结论:血清和胎盘组织中的TNF-α、NF-KBp65和PAI-1可能参与了妊娠期糖尿病的发生与发展。
Objective: To investigate the changes of TNF-α, NF-κBp65 and PAI-1 in serum and placenta of pregnant women with gestational diabetes mellitus and its clinical significance. Methods: Seventy-seven pregnant women with gestational diabetes mellitus who were regular check-up and in-hospital delivery were selected as the observation group. Forty-seven normal pregnant women delivered at the same period were selected as control group. The levels of TNF-α and NF-κBp65 in serum and placenta And PAI-1 expression levels, and analyze the correlation between serum TNF-α, NF-κBp65 and PAI-1 expression levels. Results: The plasma levels of TNF-α and PAI-1 in the observation group were significantly higher, the difference was statistically significant (P <0.001). PAI-1 expression in plasma of patients with gestational diabetes was positively correlated with the level of TNF-α (r = 0.843, P <0.001). The fasting-OGTT, 1h-OGTT, 2h-OGTT, fasting insulin, fasting blood glucose and insulin resistance index of pregnant women in the observation group were significantly higher than those in the control group (all P <0.001). The insulin resistance index had the highest correlation with plasma TNF-α level in gestational diabetes mellitus (Beta = 0.769). The level of 1-h glucose in oral glucose tolerance test correlated with PAI expression level (Beta = 0.637) . The positive rates of TNF-α, NF-κBp65 and PAI-1 in the observation group were significantly higher than those in the control group (P <0.001, = 0.039, 0.007). Conclusion: TNF-α, NF-κBp65 and PAI-1 in serum and placenta may be involved in the occurrence and development of gestational diabetes mellitus.