摘要
目的:研究妊娠高血压疾病(HDP)患者血清胎盘生长因子(PLGF)、γ干扰素诱导蛋白16(IFI16)、血管生成素样蛋白2(ANGPTL2)水平及预测妊娠结局价值。方法:选取2020年1月-2023年1月在本院就诊并分娩的126例HDP孕妇,根据病情严重程度分为轻度组(58例)、重度组(68例),依据妊娠结局分为不良组(52例)、良好组(74例)。同期在本院健康分娩的孕妇60例为健康组。检测血清甘油三酯(TG)、总胆固醇(TC)、糖化血红蛋白(HbA1c)、PLGF、IFI16、Angptl2蛋白表达和尿液中24 h尿蛋白、尿酸(UA)、肌酐(Cr)水平,血清。Spearman分析PLGF、IFI16、Angptl2与HDP严重程度和妊娠结局的相关性;logistic分析不良妊娠结局影响因素;受试者工作特征(ROC)曲线分析PLGF、IFI16、ANGPTL2对HDP孕妇不良妊娠结局的预测价值。结果:健康组、轻度组、重度组血清PLGF水平依次降低,IFI16、ANGPTL2依次升高;良好组舒张压、收缩压、24 h尿蛋白、IFI16、ANGPTL2低于不良组,PLGF高于不良组(均P<0.05)。HDP严重程度、不良妊娠结局与PLGF呈负相关,与IFI16、ANGPTL2呈正相关(P<0.05)。舒张压、收缩压、IFI16、ANGPTL2异常升高是影响HDP患者不良妊娠结局的危险因素,PLGF升高是保护因素(P<0.05)。PLGF、IFI16、ANGPTL2联合检测预测HDP患者不良妊娠结局的曲线下面积为0.905,灵敏度98.1%、特异度73.0%,价值高于单独指标检测(P<0.05)。结论:HDP患者血清PLGF较低,IFI16、ANGPTL2较高,PLGF、IFI16、ANGPTL2联合检测可提高不良妊娠结局预测价值。
Objective:To investigate the predictive values of the levels of serum placental growth factor(PLGF),γ-interferon induced protein 16(IFI16),and angiopoietin like protein 2(ANGPTL2)of pregnant women with hypertensive disorders of pregnancy(HDP)for their adverse pregnancy outcomes.Methods:A total of 126pregnant women with HDP who visited to hospital and gave birth from January 2020 to January 2023 were selected in this study.These women were divided into group A1(58 cases with mild HDP)and group A2(68 cases with severe HDP)based on the severity of their HDP.According to the pregnancy outcomes of follow-up,these women were divided into group B1(52 cases with adverse pregnancy outcomes)and group B2(74 cases with normal pregnancy outcomes).60 healthy pregnant women who gave birth in hospital were included in control group.The levels of the serum triglycerides(TG),total cholesterol(TC)and glycated hemoglobin(HbA1c),and the levels of the 24-hour urine protein and uric acid(UA)and the creatinine(Cr)in urine of the women in these groups were detected.Spearman correlation analysis was used to analyze the correlation between the levels of the PLGF,IFI16,Angptl2 of the women with HDP and their severity of HDP and pregnancy outcomes.Logistic regression was used to analyze the influencing factors of the adverse pregnancy outcomes of the women.Receiver operator characteristic(ROC)curve was used to analyze the predictive values of the PLGF,IFI16 and ANGPTL2 levels of the women with HDP for predicting their adverse pregnancy outcomes.Results:The serum PLGF level of the women in the control group,in group A1 and in group A2 had decreased gradually,while the IFI16 and ANGPTL2 level had increased gradually.The values of diastolic blood pressure and systolic blood pressure,and the levels of 24 h urinary protein,IFI16 and ANGPTL2 of the women in group B2 were significantly lower than those in group B1,the PLGF level of the women in group B2 was significantly higher(all P<0.05).The severity of HDP and the adverse pregnancy outcomes of the women were negatively correlated with their PLGF level,and were positively correlated with their IFI16 and ANGPTL2 levels(P<0.05).The abnormal increase of the diastolic blood pressure and systolic blood pressure values,and the IFI16 and ANGPTL2 levels of the women with HDP were the risk factors of their adverse pregnancy outcomes,and the increase of the PLGF level of the women was a protective factor of their adverse pregnancy outcomes(P<0.05).The area under the curve,the sensitivity and the specificity of the combined detections of the PLGF,IFI16,and ANGPTL2 levels of the women with HDP for predicting their adverse pregnancy outcomes were 0.905,98.1% and 73.0%,respectively,and which were significantly higher than those of the PLGF level,the IFI16 level or the ANGPTL2 level alone(P<0.05).Conclusion:The serum PLGF level of the pregnant women with HDP is low,and the serum IFI16 and ANGPTL2 of them are high.The combination detections of the PLGF,IFI16,and ANGPTL2 levels of the pregnant women with HDP can improve the predictive value for their adverse pregnancy outcomes.
作者
林燕敏
盛俊霞
LIN Yanmin;SHENG Junxia(The Second People's Hospital of Yuhang District,Hangzhou,Zhejiang Province,311121)
出处
《中国计划生育学杂志》
2024年第4期926-931,共6页
Chinese Journal of Family Planning
关键词
妊娠高血压疾病
胎盘生长因子
γ干扰素诱导蛋白16
血管生成素样蛋白2
不良妊娠结局
相关性
预测
Hypertensive disorders of pregnancy
Placental growth factor
γ-interferon induced protein 16
Angiopoie-tin like protein 2
Adverse pregnancy outcomes
Correlation
Prediction
