摘要
目的探讨NGAL、HMW-ADP在妊娠高血压综合征孕妇表达及与继发子痫前期的关系分析。方法研究对象选取2021年6月至2023年8月本院产科收治的妊娠高血压综合征患者129例,为妊娠高血压综合征组,其中继发子痫前期51例,非继发子痫前期78例。选择同期正常妊娠的孕妇120例作为健康孕妇组,对比两组孕妇以及继发子痫前期和非继发子痫前期孕妇血清NGAL、HMW-ADP水平,对比继发子痫前期和非继发子痫前期孕妇相关资料,Logistic回归分析影响妊娠高血压综合征继发子痫前期的影响因素;受试者工作特征(ROC)曲线评估血清NGAL、HMW-ADP水平对妊娠高血压综合征患者继发子痫前期的预测价值。结果与健康孕妇组相比,妊娠高血压综合征组患者血清中NGAL水平明显升高(P<0.05),HMW-ADP水平显著降低(P<0.05);与非继发子痫前期的患者相比,继发子痫前期患者血清中NGAL水平明显升高(P<0.05),HMW-ADP水平显著降低(P<0.05);非继发子痫前期和继发子痫前期患者是否合并妊娠期糖尿病、是否有子痫前期家族史、尿酸、24h尿蛋白定量、红细胞压积、TG、TC、LDL-C对比,差异具有统计学意义(P<0.05);合并妊娠期糖尿病、子痫前期家族史、24h尿蛋白定量、尿酸、LDL-C、NGAL是影响妊娠高血压综合征患者继发子痫前期的危险因素(P<0.05),HMW-ADP是影响妊娠高血压综合征患者继发子痫前期的保护因素(P<0.05);妊娠高血压综合征患者血清NGAL和HMW-ADP水平单独检测继发子痫前期的AUC值分别为0.833和0.887,NGAL联合HMW-ADP检测继发子痫前期的AUC值0.936,NGAL联合HMW-ADP检测的AUC值明显高于血清NGAL和HMW-ADP水平单独检测(Z=3.016,3.682,P<0.05)。结论妊娠高血压综合征患者血清中NGAL水平升高,HMW-ADP水平降低,两者是妊娠高血压综合征患者继发子痫前期的影响因素,联合检测NGAL和HMW-ADP水平对于继发子痫前期具有一定的诊断效能。
Objective To investigate expressions of NGAL and HMW-ADP in pregnant women with pregnancy-induced hypertension syndrome and their relationships with secondary preeclampsia.Methods 129 patients with gestational hypertension syndrome admitted to the Obstetrics Department of our hospital from June,2021 to August,2023 were selected as the gestational hypertension syndrome group,including 51 cases of secondary preeclampsia and 78 cases of non-secondary preeclampsia.120 pregnant women with normal pregnancy during the same period were selected as the healthy pregnant women group.Serum levels of NGAL and HMW-ADP were compared between the two groups and pregnant women with secondary preeclampsia and non-secondary preeclampsia.The relevant data of pregnant women with secondary preeclampsia and non-secondary preeclampsia were also compared.Logistic regression analysis was performed to identify influencing factors of preeclampsia secondary to pregnancy-induced hypertension syndrome.Receiver operating characteristics(ROC)curves were drawn to evaluate the predictive value of serum NGAL and HMV-ADP levels for secondary preeclampsia in patients with pregnancy-induced hypertension syndrome.Results Compared with the healthy pregnant women group,the serum level of NGAL in the pregnancy-induced hypertension syndrome group was significantly increased(P<0.05),while the level of HMW-ADP was significantly decreased(P<0.05).Compared with non-pre-eclampsia pregnant women,the serum NGAL level was significantly increased(P<0.05),while the serum HMW-ADP level was significantly decreased(P<0.05).There were significant differences in gestational diabetes mellitus,family history of preeclampsia,uric acid,24h urinary protein,hematoma,TG,TC and LDL-C between non-secondary preeclampsia and secondary preeclampsia(P<0.05).Combined with gestational diabetes mellitus,family history of preeclampsia,24h urinary protein quantity,uric acid,LDL-C and NGAL were the risk factors for secondary preeclampsia of pregnancy-induced hypertension syndrome(P<0.05),while HMW-ADP was the protective factor(P<0.05).AUC values of serum NGAL and HMW-ADP for the detection of secondary preeclampsia alone were 0.833 and 0.887,respectively,while the AUC value of NGAL combined with HMW-ADP for detection of secondary preeclampsia was 0.936.The AUC value of NGAL combined with HMW-ADP was significantly higher than that of serum NGAL and HMW-ADP alone(Z=3.016,3.682,P<0.05).Conclusion The increase of serum NGAL level and the decrease of HMW-ADP level in patients with pregnancy-induced hypertension syndrome are the influencing factors for the secondary preeclampsia.The combined detection of NGAL and HMW-ADP level has certain diagnostic efficacy for the secondary preeclampsia.
作者
夏蔓
施婷艳
陆怡
XIA Man;SHI Tingyan;LU Yi(Department of Obstetrics and Gynecology Hospital,Tongji University,Shanghai 201204,China)
出处
《标记免疫分析与临床》
CAS
2024年第7期1270-1275,1302,共7页
Labeled Immunoassays and Clinical Medicine
