摘要
目的 研究子痫前期患者血清抗心磷脂抗体(ACA)、D-二聚体、趋化因子(IP-10)及胎盘生长因子(PIGF)水平变化及预测不良妊娠结局的价值.方法 选取2020年2月至2021年6月张家口市第一医院收治的子痫前期患者62例,分为轻度组(30例)和重度组(32例).另外选取同期于本院分娩的正常产妇58名作为对照组.检测各组血清抗心磷脂抗体-免疫球蛋白G(ACA-IgG)、抗心磷脂抗体-免疫球蛋白M(ACA-IgM)、D-二聚体、IP-10及PIGF水平.随访至妊娠结束,并比较三组妊娠结局.分析血清ACA-IgG、ACA-IgM、D-二聚体、IP-10、PLGF水平与妊娠结局的关系.通过受试者工作特征曲线(ROC)分析血清ACA-IgG、ACA-IgM、D-二聚体、IP-10、PLGF水平预测妊娠结局的效能.结果 ACA-IgG、ACA-IgM、D-二聚体、IP-10组间比较:重度组>轻度组>对照组,差异有统计学意义(F=102.643、155.868、170.863、286.744,均P<0.05).PLGF组间比较:重度组<轻度组<对照组,差异有统计学意义(F=59.953,P<0.05).三组不良妊娠事件发生率:重度组>轻度组>对照组,差异具有统计学意义(χ2=20.284,P<0.05).不良妊娠结局患者血清ACA-IgG、ACA-IgM、D-二聚体、IP-10水平高于良好妊娠结局患者,PIGF低于良好妊娠结局患者(t=6.371、5.573、5.307、7.257、5.734,均P<0.05).血清ACA-IgG、ACA-IgM、D-二聚体、IP-10水平与不良妊娠结局呈正相关,而PLGF水平与不良妊娠结局呈负相关(r=0.292、0.359、0.297、0.282、-0.318,均P<0.05).ROC曲线分析结果显示,sFIt-1、PIGF预测子痫前期患者妊娠结局均具有较高的效能,其中PIGF效能最高,约登指数最高时对应临界值为72.04 pg/mL,曲线下面积为0.856,敏感度为87.20%、特异度为80.18%.结论 子痫前期患者血清ACA、D-二聚体、IP-10异常增高,PLGF异常降低,且与不良妊娠结局密切相关.
Abstract
Objective To study the variations in of serum levels of anticardiolipin antibody(ACA),D-dimer,interferon-inducible protein-10(IP-10)and placental growth factor(PIGF)as well as their predictive value for adverse pregnancy outcomes in patients with preeclampsia.Methods 62 patients with pre-eclampsia admitted to Zhangjiakou First Hospital from February 2020 to June 2021 were selected as the sub-jects.They were divided into two groups:mild(30 cases)and severe(32 cases).In addition,58 normal par-turients who gave birth in the hospital during the same period were included as the control group.The serum levels of anticardiolipin antibody-immunoglobulin G(ACA-IgG),anticardiolipin antibody-immunoglobulin M(ACA-IgM),D-dimer,IP-10 and PIGF were measured in each group.Follow-up was conducted until the end of pregnancy,and the pregnancy outcomes were compared among the three groups.The relationship between serum levels of ACA-IgG,ACA-IgM,D-dimer,IP-10,PLGF,and pregnancy outcomes was analyzed.The efficiency of these serum levels in predicting pregnancy outcomes was analyzed using the receiver operating characteristic curve(ROC).Results The levels of serum ACA-IgG,ACA-IgM,D-dimer and IP-10 were found to be higher in the severe group compared to the mild group and the control group(F=102.643,155.868,170.863,286.744,P<0.05).Conversely,PLGF levels were lower in the severe group compared to the mild group and the control group(F=59.953,P<0.05).The total incidence rate of adverse pregnancy outcomes was higher in the severe group compared to the mild group and the control group(χ2=20.284,P<0.05).Serum levels of ACA-IgG,ACA-IgM,D-dimer and IP-10 in patients with adverse pregnancy outcomes were higher than those in patients with good pregnancy outcomes,while PIGF level was lower than that in patients with good preg-nancy outcomes(t=6.371,5.573,5.307,7.257,5.734,P<0.05).Serum levels of ACA-IgG,ACA-IgM,D-di-mer and IP-10 were positively correlated with adverse pregnancy outcomes,and PLGF level was negatively cor-related with adverse pregnancy outcomes(r=0.292,0.359,0.297,0.282,-0.318,P<0.05).The ROC curve analysis results showed that sFIt-1 and PIGF were effective in predicting pregnancy outcomes in patients with preeclampsia with PIGF being the most efficient.The corresponding cutoff value,area under the curve,sensitivity and specificity were 72.04 pg/mL,0.856,87.20%and 80.18%when the Yoden index was the highest.Conclusion Serum ACA,D-dimer and IP-10 levels are abnormally increased in patients with preeclampsia,while PLGF level is abnormally reduced.These indicators are closely associated with adverse pregnancy outcomes.
NETL
NSTL
维普
万方数据