VCAM-1、AOPP、HbA1c和FBG在二甲双胍治疗妊娠期糖尿病患者中的意义

目的 研究VCAM-1、AOPP、HbA1c和FBG对二甲双胍治疗GDM患者分娩结局的预测价值.方法 125例GDM患者接受二甲双胍治疗,于治疗前、分娩前后测定VCAM-1、AOPP、HbA1c和FBG,将分娩前指标与分娩结局正常与否进行ROC分析,研究其在分娩结局预测中的价值.结果 分娩前的FBG、HbA1c、VCMA-1和AOPP指标显著低于治疗前(P＜0.05),分娩前后差异无统计学意义(P＞0.05).分娩前,当VCAM-1取截点为40.87 ng/mL时,其预测灵敏度为89.3％,特异性为72.5％,均较高;当AOPP取截点为23.25ng/mL时,其预测灵敏度为82.1％,特异性为67.5％,均较高.VCAM-1和AOPP联合应用于分娩结局预测的灵敏度为90.6％,特异性为70.0％,阳性预测值为90.63％,阴性预测值为70.00％.结论 VCAM-1和AOPP可以有效预测二甲双胍治疗GDM分娩结局.

Significance of VCAM-1 ,AOPP,HbA1c and FBG in the Treatment of Gestational Diabetes Mellitus with Metformin

Objective To evaluate the predictive values of VCAM-1,AOPP,HbA1 c and FBG in the treatment of GDM with metformin.Methods 125 patients with GDM were treated with metformin,and VCAM-1,AOPP,HbA1 c and FBG levels were measured before and after the treatment.ROC analysis was performed with normal/un-normal outcomes of delivery to study its value in the prediction of delivery outcome.Results There were significant differences in FBG,HbA1c,VCMA-1 and AOPP values before the treatment and delivery (P ＜ 0.05).When the level of VCAM-1 was 40.87 ng/mL,the predicted sensitivity was 89.3 ％ and the specificity was 72.5 ％.When the level of AOPP was 23.25 ng/mL,the predicted sensitivity was 82.1％ and the specificity was 67.5 ％.The sensitivity of VCAM-1 and AOPP in the prediction of delivery outcome was 90.6％,while the specificity was 70.0％.The positive predictive value was 90.63％ and the negative predictive value was 70.00％.Conclusion VCAM-1 and AOPP can effectively predict the outcome of metformin treatment of GDM delivery.