中国现代医学杂志2026，Vol.36Issue(1)：84-90,7.DOI:10.3969/j.issn.1005-8982.2026.01.013
妊娠糖尿病孕妇子宫螺旋动脉血流参数、血清激活素A及内皮细胞特异性分子1对妊娠结局的影响
Impact of uterine spiral artery blood flow parameters,serum activin A,and endothelial cell-specific molecule 1 on pregnancy outcomes in women with gestational diabetes mellitus
摘要
Abstract
Objective To investigate the uterine spiral artery blood flow parameters,and the expression characteristics of serum activin A and endothelial cell-specific molecule 1(Endocan)in women with gestational diabetes mellitus(GDM),and analyze their predictive value for pregnancy outcomes.Methods A total of 306 pregnant women with GDM admitted to Qingdao Women and Children's Hospital Affiliated to Qingdao University from May 2024 to May 2025 were selected as the study group,and divided into a normal pregnancy outcome group(208 cases)and an adverse pregnancy outcome group(98 cases)according to pregnancy outcomes.Another 50 healthy pregnant women during the same period were selected as the control group.Uterine spiral artery blood flow parameters were measured by ultrasound,and serum activin A and Endocan levels were detected by enzyme-linked immunosorbent assay(ELISA).General multivariate Logistic regression model was used to analyze the risk factors for adverse pregnancy outcomes,and receiver operating characteristic(ROC)curves were drawn to evaluate the predictive efficacy of each indicator for pregnancy outcomes.Results Fasting blood glucose(FPG),glycated hemoglobin(HbA1c),and low-density lipoprotein cholesterol(LDL-C)levels were significantly higher in the adverse outcome group than in the normal outcome group(P<0.05).Pulsatility index(PI),resistance index(RI),and systolic/diastolic ratio(S/D)were elevated in the adverse outcome group(P<0.05),while peak systolic velocity(PSV)was reduced(P<0.05).Serum activin A and Endocan levels were also significantly higher in the adverse outcome group(P<0.05).Multivariate analysis indicated that high PI[O^R=115.898(95%CI:9.558,1 405.364)],high RI[O^R=187.342(95%CI:1.093,32 109.040)],elevated S/D[O^R=4.024(95%CI:1.581,10.242)],low PSV[O^R=0.504(95%CI:0.346,0.733)],high serum activin A[O^R=1.024(95%CI:1.015,1.033)],and high Endocan[O^R=1.029(95%CI:1.009,1.049)]were risk factors for adverse pregnancy outcomes in GDM(P<0.05).The combined detection of uterine spiral artery blood flow parameters,serum activin A,and Endocan for predicting adverse pregnancy outcomes in GDM had an area under the curve(AUC)of 0.988(95%CI:0.975,1.000),a sensitivity of 98.0%(95%CI:0.928,0.998),and a specificity of 94.7%(95%CI:0.907,0.973).Conclusion Abnormal uterine spiral artery blood flow parameters and elevated serum levels of activin A and Endocan in GDM pregnant women are associated with adverse pregnancy outcomes.Combined detection can provide an objective basis for predicting adverse pregnancy outcomes in GDM.关键词
妊娠糖尿病/螺旋动脉/血清激活素A/内皮细胞特异性分子1/妊娠结局Key words
gestational diabetes mellitus/spiral artery/serum activin A/endothelial cell-specific molecule 1/pregnancy outcome分类
医药卫生引用本文复制引用
He Yun,Xu Xu,Wang Song..妊娠糖尿病孕妇子宫螺旋动脉血流参数、血清激活素A及内皮细胞特异性分子1对妊娠结局的影响[J].中国现代医学杂志,2026,36(1):84-90,7.基金项目
山东省科技厅自然科学基金项目(No:ZR2023MH313) （No:ZR2023MH313）
