目的 探究脐动脉血流动力学指标、血脂、促甲状腺激素(TSH)对妊娠期糖尿病患者分娩结局的影响研究。方法 选取我院2021年1月—2021年11月收治的妊娠期糖尿病患者138例,采用随机数字表法分为对照组和研究组,每组各69例。比较2组患者体内脐动脉血流动力学指标、血脂指标及TSH相关指标表达水平差异及妊娠结局,并通过多元线性回归分析探究脐动脉血流动力学指标、血脂指标、TSH等相关指标与妊娠期糖尿病患者不良妊娠结局的相关性。结果 研究组孕妇脐动脉峰值流速/舒张末期流速(S/D)、阻力指数(RI)、三酰甘油(TG)、低密度脂蛋白(LDL)、TSH水平高于对照组,游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平低于对照组(P<0.05);研究组孕妇巨大儿、剖宫产、新生儿低血糖发生率及新生儿体质量均高于对照组(P<0.05);多元线性回归方程显示:S/D、RI、TG、LDL、TSH水平变化均与不良妊娠结局存在相关性(R²=0.224,调整R²=0.201;F=9.504,P<0. 05),且影响顺序由大到小依次为 TG、TSH、RI、S/D、LDL。结论 妊娠期糖尿病孕妇体内的S/D、RI、TG、LDL、TSH水平异常可能会影响妊娠结局,临床可通过监测上述指标的变化,及时采取干预措施。

Objective To investigate the effects of umbilical artery hemodynamic indexes, blood lipids and thyroid stimulating hormone (TSH) on delivery outcomes in patients with gestational diabetes mellitus. Methods A total of 138 patients with gestational diabetes mellitus who were admitted to our hospital from January 2021 to November 2021 were selected and divided into a control group and a study group by random digital table, with 69 cases in each group. The differences in umbilical artery hemodynamic indexes, blood lipid indexes and TSH-related indexes and pregnancy outcomes were compared between the two groups, and multiple linear regression analysis was used to explore the relationship between umbilical artery hemodynamic indexes, blood lipid indexes, TSH, other related indexes and adverse pregnancy outcomes in patients with gestational diabetes mellitus. Results The systolic and diastolic peak volume ratio (S/D), resistive index (RI) of umbilical artery, triglyceride (TG), low density lipoprotein (LDL) and TSH in the study group were higher than those in the control group, while the levels of free triiodothyronine (FT3) and free thyroxine (FT4) were lower than those in the control group (P<0.05). The incidences of macrosomia, cesarean section, neonatal hypoglycemia and neonatal weight in study group were significantly higher than those in the control group (P<0.05). The multiple linear regression equation showed that the adverse pregnancy outcomes were correlated with changes of TG, TSH, RI, S/D, LDL levels (R²=0.224, adjusted R²=0.201; F=9.504, P<0.05), in descending order. Conclusions Abnormal levels of S/D, RI, TG, LDL, TSH and FT4 in pregnant women with gestational diabetes mellitus may affect the pregnancy outcomes. Clinical intervention measures can be taken by monitoring the changes of the above indicators.