刘娓娣 赵春景 陈丹华 王乃平 韦秀凡 李仲均

[摘要] 目的 分析妊娠糖尿病患者HbA1c與细胞抗氧化水平、脂质过氧化状态的相关性。 方法 选取2018年7月至2020年3月东莞市中医院收治的妊娠糖尿病患者75例作为研究组，分为HbA1c<7.0%组，7.0%≤HbA1c≤9.0%组，HbA1c>9.0%组，每组各25例。同时选择同时期的健康体检人员25名作为对照组。所有人员均进行HbA1c、细胞抗氧化水平、脂质过氧化状态的检测。对四组LPO含量、GSH-Px活性、SOD、血糖情况进行分析HbA1c与LPO含量、GSH-Px活性、SOD、血糖的相关性。 结果 四组人员的LPO含量、GSH-Px活性、SOD、血糖比较，差异有统计学意义（P<0.05），任两组血糖比较，差异有统计学意义（P<0.05）;对照组、HbA1c<7.0%组、7.0%≤HbA1c≤9.0%组、HbA1c>9.0%组的LPO含量、GSH-Px活性、SOD比较，差异有统计学意义（P<0.05）;HbA1c<7.0%组、7.0%≤HbA1c≤9.0%组LPO含量、GSH-Px活性、SOD比较，差异有统计学意义（P<0.05）;HbA1c和GSH-Px活性、SOD呈正相关（r=0.661，0.943，P<0.05），与LPO含量、血糖呈负相关（r=-0.753，-0.638，P<0.05）。 结论 HbA1c可以及时地反应出妊娠糖尿病患者抗氧化状态、细胞内外的氧化状态，帮助医生更加全面的了解患者的病情，临床上应当进一步推广应用。

[关键词] 妊娠糖尿病;HbA1c;细胞抗氧化水平;脂质过氧化状态

[中图分类号] R587.1          [文献标识码] B          [文章编号] 1673-9701（2021）09-0075-03

Correlation analysis between HbA1c and cell antioxidant level and lipid peroxidation status in patients with gestational diabetes mellitus

LIU Weidi1   ZHAO Chunjing1   CHEN Danhua1   WANG Naiping2   WEI Xiufan1   LI Zhongjun3

1.Department of Obstetrics and Gynecology， Dongguan Traditional Chinese Medicine Hospital in Guangdong Province，Dongguan   523000， China; 2.Shenzhen Hehe Medical Inspection Laboratory， Shenzhen   518101， China; 3.Department of Obstetrics and Gynecology， Dongguan People′s Hospital in Guangdong Province， Dongguan   523059， China

[Abstract] Objective To analyze the correlation between HbA1c and cell antioxidant level and lipid peroxidation status in patients with gestational diabetes mellitus（GDM）. Methods Patients with GDM admitted to Dongguan Traditional Chinese Medicine Hospital from July 2018 to March 2020 were selected as the study group（n=75）， including the HbA1c <7.0% group， the 7.0%≤HbA1c≤9.0% group and the HbA1c>9.0% group， each group had 25 cases. Meanwhile， healthy people at the same time were selected as the control group（n=25）. HbA1c， cell antioxidant level and lipid peroxidation status were detected in all personnel. The LPO content， GSH-Px activity， SOD and blood glucose levels of the four groups were compared， and the correlations between HbA1c and LPO content， GSH-Px activity， SOD and blood glucose were analyzed. Results The LPO content，GSH-Px activity， SOD and blood glucose of the four groups of personnel were comparable（P<0.05）， and there were significant differences in blood glucose between each two groups（P<0.05）. There were significant differences in LPO content， GSH-Px-activity and SOD levels in the control group， the HbA1c <7.0% group， the 7.0%≤HbA1c≤9.0% group and the HbA1c>9.0% group （P<0.05）. There were significant differences in LPO content， GSH-Px activity and SOD levels in the HbA1c<7.0% group and the 7.0%≤HbA1c≤9.0% group（P<0.05）. HbA1c was positively correlated with GSH-Px activity and SOD levels（r=0.661， 0.943， P<0.05）， but negatively correlated with LPO content and blood glucose levels（r=-0.753， -0.638， P<0.05）. Conclusion HbA1c can reflect the antioxidant status，intracellular and extracellular oxidation status of patients with GDM in time，and help doctors understand the patient′s condition more comprehensively，so it should be further promoted and applied in clinic.

[Key words] Gestational diabetes mellitus; HbA1c; Cell antioxidant level; Lipid peroxidation status

临床研究显示，长时间高血糖可以通过抗氧化酶、多元醇通路、受损的还原性谷胱甘肽、自氧化、非酶促糖基化的改变等导致自由基的出现，尤其是活性氧的增加，会导致糖尿病慢性并发症的产生[1]。近几年妊娠期糖尿病患者逐年增高，同时诊疗不规范、孕期漏诊等情况会导致母体产科合并症增加以及围生儿病死率增高，对于母婴妊娠结局有较为严重的影响，所以在妇产科中被医生高度的重视。在医学中，糖化血红蛋白（Hemoglobin A1c，HbA1c）可以反映患者血糖控制的水平及代谢糖分的紊乱状况，其水平还可以作为患者治疗后临床疗效、病情恶化、病情发展、疾病出现的参考指标[2]。HbA1c产生的变化是否反映抗氧化状态、细胞内外的氧化状态并不明确，所以在对健康体检人群以及妊娠糖尿病患者身体中的HbA1c与细胞抗氧化水平、脂质过氧化状态进行检测，了解之间的相关性，有效地降低围生儿的死亡概率，现报道如下。……