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目的探讨不同妊娠期胰岛自身抗体变化及其与脐血胰岛自身抗体的关系。方法选择75gOGTT中1项及以上异常的妊娠期妇女311例为研究对象,于常规OGTT次日、分娩前及产后6周空腹抽血检测GADAb、ICA、IAA;分娩时测脐血GADAb、IAA、ICA。结果糖代谢异常妊娠期妇女妊娠中期与妊娠晚期胰岛自身抗体阳性率均为39.6%,但IAA和ICA滴度在妊娠晚期低于妊娠中期(P<0.05);产后IAA、ICA及总抗体阳性率及滴度高于妊娠晚期。妊娠晚期母血与脐血各抗体阳性率差异无统计学意义(P>0.05),但脐血GADAb及IAA滴度高于妊娠晚期母血(P<0.01)。结论糖代谢异常妊娠期妇女产后胰岛自身抗体阳性率达45%,高于妊娠中、晚期;妊娠晚期母血胰岛自身抗体滴度低于胎儿脐血抗体滴度。
Objective To investigate the changes of islet autoantibodies in different gestational stages and its relationship with umbilical cord islet autoantibodies. Methods One hundred and seventy pregnant women with abnormality of one or more abnormalities in 75gOGTT were enrolled in this study. GADAb, ICA and IAA were measured on the following day before delivery and 6 weeks after delivery in normal OGTT. GADAb, IAA, ICA. Results The positive rates of islet autoantibodies in gestation period and late gestation period were both 39.6%, but the titers of IAA and ICA were lower in late gestation than in gestation (P <0.05). The positive rate of IAA, ICA and total antibody in postpartum And titers higher than in the third trimester of pregnancy. There was no significant difference in the positive rates of maternal and umbilical blood antibodies in late pregnancy (P> 0.05). However, the titers of GADAb and IAA in cord blood were higher than those in third trimester of pregnant women (P <0.01). Conclusions The positive rate of postpartum islet autoantibodies in women with abnormal glucose metabolism during pregnancy is 45%, which is higher than that in the second and third trimester of pregnancy. The titers of autoantibodies to islets in late pregnancy are lower than that of fetal umbilical cord blood.