摘要
目的探讨子痫前期(PE)患者血清、胎盘中内分泌腺源性血管内皮生长因子(EG-VEGF)、前动力蛋白1(PROK1)、前动力蛋白2(PROK2)的表达情况及其临床意义。方法选取2019年1月至2022年1月该院收治的100例PE患者作为研究组,依据病情严重程度分为轻度组和重度组,各50例。同时,选取同期行剖宫产手术的50例健康孕妇作为对照组。比较两组临床指标[γ-谷氨酰转移酶(GGT)、乳酸脱氢酶(LDH)、尿酸(UA)、收缩压、舒张压、血小板计数、新生儿体重、螺旋动脉管壁厚度、螺旋动脉管腔面积、丙二醛(MDA)、超氧化物歧化酶(SOD)、谷氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、尿素氮(BUN)]。对比分析不同组、不同病情严重程度患者血清、胎盘组织中EG-VEGF、PROKR1、PROKR2 mRNA水平。采用免疫组化法检测两组胎盘组织中EG-VEGF、PROKR1、PROKR2阳性表达率,分析研究组血清各指标与临床特征、病情严重程度相关性,以及检测不同新生儿结局的孕妇血清中各指标水平。采用受试者工作特征(ROC)曲线分析血清各指标水平对PE的诊断价值。结果与对照组比较,研究组收缩压、舒张压、血小板计数、螺旋动脉管壁厚度升高,GGT、LDH、UA、ALT、AST、MDA水平升高,新生儿体重、螺旋动脉管腔面积降低,BUN、SOD水平降低,差异均有统计学意义(P<0.05)。与对照组比较,研究组血清、胎盘组织中EG-VEGF、PROKR1、PROKR2 mRNA水平降低(P<0.05),且其水平与新生儿体重、螺旋动脉管腔面积、BUN、SOD呈正相关,而与收缩压、舒张压、螺旋动脉管壁厚度、GGT、LDH、ALT、MDA、病情严重程度呈负相关(P<0.05)。研究组EG-VEGF、PROKR1、PROKR2阳性表达率低于对照组(P<0.05);研究组发生新生儿不良结局的孕妇血清中EG-VEGF、PROKR1、PROKR2水平低于对照组(P<0.05)。EG-VEGF、PROKR1、PROKR2联合诊断PE的曲线下面积大于单项诊断(P<0.05)。结论PE患者血清、胎盘中EG-VEGF、PROKR1、PROKR2呈低表达,且与临床特征、病情严重程度、新生儿不良结局存在相关性,联合检测其水平可提高PE的诊断效能。
Objective To investigate the expression of endocrine gland-derived vascular endothelial growth factor(EG-VEGF),prokinetic protein 1(PROK1),and prokinetic protein 2(PROK2)in serum and placenta of patients with preeclampsia(PE)and their clinical significance.Methods One hundred patients with PE admitted to the hospital from January 2019 to January 2022 were selected as the study group,and were divided into mild group and severe group according to the severity of the disease,with 50 cases in each group.At the same time,50 healthy pregnant women who underwent cesarean section during the same period were selected as the control group.Clinical characteristics[gamma-glutamyl transferase(GGT),lactate dehydrogenase(LDH),uric acid(UA),systolic blood pressure,diastolic blood pressure,platelet count,neonatal weight,spiral artery wall thickness,spiral artery lumen area,malondialdehyde(MDA),superoxide dismutase(SOD),glutamate aminotransferase(ALT),aspartate aminotransferase(AST),and urea nitrogen(BUN)]were compared between the two groups.The levels of EG-VEGF,PROKR1 and PROKR2 mRNA in serum and placental tissues were measured in different groups and patients with different severity of disease,respectively.The positive expression rates of EG-VEGF,PROKR1 and PROKR2 in placental tissues of both groups were detected by immunohistochemical method,and the correlation between serum indicators and clinical characteristics and severity of disease in the study group was analyzed,as well as the levels of serum indicators in pregnant women with different neonatal outcomes.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum indexes for PE.Results Compared with the control group,systolic blood pressure,diastolic blood pressure,platelet count,spiral artery wall thickness,GGT,LDH,UA,ALT,AST and MDA levels were increased in the study group,neonatal weight,spiral artery lumen area were decreased,BUN and SOD levels were decreased,the differences were statistically significant(P<0.05).Compared with the control group,mRNA levels of EG-VEGF,PROKR1 and PROKR2 in serum and placental tissues of the study group were decreased(P<0.05),and their levels were positively correlated with neonatal body weight,spiral artery lumen area,BUN and SOD.It was negatively correlated with systolic blood pressure,diastolic blood pressure,spiral artery wall thickness,GGT,LDH,ALT,MDA and disease severity(P<0.05).The positive expression rates of EG-VEGF,PROKR1,and PROKR2 in the study group were lower those than in the control group(P<0.05).The levels of EG-VEGF,PROKR1 and PROKR2 in serum of pregnant women with adverse neonatal outcomes in the study group were lower than those in the control group(P<0.05).The area under the curve of EG-VEGF,PROKR1 and PROKR2 combined diagnosis of PE was greater than that of single diagnosis(P<0.05).Conclusion EG-VEGF,PROKR1 and PROKR2 are low in serum and placenta of PE patients,and were correlated with clinical features,severity of disease and adverse neonatal outcomes.Combined detection of EG-VEGF,PROKR1 and PROKR2 levels could improve the diagnostic efficiency of PE.
作者
李琼
王永红
刘淼
张桂玲
陈瑶
赵晨阳
LI Qiong;WANG Yonghong;LIU Miao;ZHANG Guiling;CHEN Yao;ZHAO Chenyang(Department of Obstetrics and Gynecology,the First People′s Hospital of Chenzhou/the First Affiliated Hospital of Xiangnan University,Chenzhou,Hunan 423000,China)
出处
《国际检验医学杂志》
CAS
2024年第7期818-823,共6页
International Journal of Laboratory Medicine
基金
湘南学院校级科研项目(2021XJ110)。
关键词
子痫前期
内分泌腺源性血管内皮生长因子
前动力蛋白1
前动力蛋白2
不良结局
preeclampsia
endocrine gland-derived vascular endothelial growth factor
prokinetic protein 1
prokinetic protein 2
adverse outcomes
