·糖尿病与妊娠·

　　【摘要】 目的 探讨不同孕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75g OGTT一项异常的孕妇311例为研究组,于常规OGTT次日、分娩前及产后6周空腹抽血检测谷氨酸脱羧酶自身抗体(GADA)、胰岛细胞自身抗体(ICA)、胰岛素自身抗体(IAA);分娩时测脐血GADA、IAA、ICA。 结果  糖代谢异常孕妇孕中期与孕晚期胰岛自身抗体阳性率均为39.6%，差异无统计学意义(P>0.05)，但IAA和ICA滴度在孕晚期显著低于孕中期(P<0.05);产后IAA、ICA及总的抗体阳性率及滴度显著高于孕晚期。孕晚期母血与脐血各抗体阳性率之间差异无统计学意义(P>0.05)，但脐血GADA及IAA滴度显著高于孕晚期母血(P<0.01)。 结论 糖代谢异常孕妇产后胰岛自身抗体阳性率高达45%，显著高于孕中期及孕晚期;孕晚期母血胰岛自身抗体滴度低于胎儿脐血抗体滴度。

　　【关键词】 妊娠期糖尿病;谷氨酸脱羧酶自身抗体;胰岛细胞自身抗体;胰岛素自身抗体;糖尿病，1型

Study on the variation of islet cell autoantibodies in the women with gestational hyperglycemia in different periods of pregnancy WU Tian-mei, LI Zhe, XIAO Xiao-min. Department of Obstetrics and Gynecology, the First Affiliated Hospital of Jinan University, Guangzhou 510632, China

Corresponding author: XIAO Xiao-min, E-mail: xiaominxin55@163.com

　　【Abstract】 Objective To evaluate the change of islet cell autoantibodies in titer in different periods of pregnancy and its relationship with the islet cell autoantibodies of cord blood. Methods Three hundred and eleven women with the abnormal result of oral glucose tolerance test (OGTT) were selected as the study group. On the following day of OGTT, before delivery, and about 42 days after delivery, the glutamic acid decarboxylase autoantibody (GADA), islet cell autoantibody (ICA), and insulin autoantibody (IAA) of the fasting blood were tested. And the GADA, IAA, and ICA of the cord blood were also tested during delivery. Results 1. The positive rate of islet cell autoantibodies (ICA) in both mid- and late-period of pregnancy was 39.6% (P>0.05), without significant difference between. But the titer of IAA and ICA in the late-period of pregnancy was lower than that in the mid-period of pregnancy (P<0.05). Compared with the late-period of pregnancy, the positive rate of IAA, ICA, total autoantibodies, and titer were higher in postpartum (P<0.05). 2. In the late-period of pregnancy, there was no statistical difference between the positive rate of islet cell autoantibodies of the mother blood and cord blood (P>0.05), but the titer of GADA and ICA of the cord blood was significantly higher than that of the mother blood in the late-period of pregnancy (P<0.01). Conclusion The positive rate of islet cell auroantibodies of the women with gestational hyperglycemia in postpartum was up to 45%, significantly higher than that in the mid- and late-period of pregnancy. The titer of islet cell auroantibodies of the mother blood in the late-period of pregnancy was lower than that of the cord blood.

　　【Keywords】Gestational diabetes mellitus (GDM); Glutamic acid decarboxylase autoantibodies (GADA); Islet cell autoantibodies (ICA); Insulin antoantibodies (IA); Diabetes mellitus, type 1