岭南心血管病杂志2024，Vol.30Issue(1) ：81-86.DOI:10.3969/j.issn.1007-9688.2024.01.13

血清内皮素-1、血管生成素-2浓度在妊娠期高血压疾病性心脏病患者诊断中的应用

Application of Serum Concentrations of Endothelin-1 and Angiopoiethin-2 on the Diagnosis of Patients with Gestational Hypertensive Disease Heart Disease

徐东魁 禹晓冰 赵爱国 陈曼 李辉
岭南心血管病杂志2024，Vol.30Issue(1) ：81-86.DOI:10.3969/j.issn.1007-9688.2024.01.13
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血清内皮素-1、血管生成素-2浓度在妊娠期高血压疾病性心脏病患者诊断中的应用

Application of Serum Concentrations of Endothelin-1 and Angiopoiethin-2 on the Diagnosis of Patients with Gestational Hypertensive Disease Heart Disease

徐东魁 1禹晓冰 1赵爱国 1陈曼 1李辉1
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作者信息

  • 1. 河北省沧州市中心医院妇产科,河北沧州 061001
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摘要

目的 检测妊娠期高血压疾病性心脏病患者血清内皮素(endothelin,ET-1)、血管生成素-2(angiopoietin-2,Angpt-2)的浓度,并分析血清ET-1、Angpt-2浓度对妊娠期高血压疾病性心脏病患者的诊断价值.方法 选取2018年2月至2022年2月期间沧州市中心医院收治的妊娠期高血压疾病性心脏病患者90例作为研究组,92例妊娠期高血压患者作为妊娠期高血压疾病组,同期95例正常妊娠者作为对照组.受试者入院后,酶联免疫吸附测定法(enzyme-linked immunosorbent assay,ELISA)法测定血清ET-1、Angpt-2浓度.比较3组受试者间左心室射血分数(left ventricular ejection fraction,LVEF)、血清ET-1和Angpt-2浓度、脑钠肽(brain natriuretic pep-tide,BNP)浓度.分析研究组患者血清ET-1、Angpt-2与LVEF、BNP的相关性.绘制受试者工作特征曲线(receiver operating characteristic curve,ROC)分析血清ET-1、Angpt-2浓度对妊娠期高血压疾病性心脏病患者的诊断价值.结果 与对照组相比,妊娠期高血压疾病组患者的LVEF及血清Angpt-2、BNP浓度差异无统计学意义(P>0.05),血清ET-1浓度升高,差异有统计学意义[(63.52±9.07)pg/mL vs.(92.48±13.21)pg/mL,P<0.05];研究组患者LVEF降低,血清ET-1[(63.52±9.07)pg/mL vs.(147.85±21.12)pg/mL,P<0.05]、Angpt-2[(4.55±0.65)ng/mL vs.6.68±0.94)ng/mL,P<0.05]、BNP[(21.35±3.05)pg/mL vs.(47.81±8.25)pg/mL,P<0.05]浓度升高,差异有统计学意义.与妊娠期高血压疾病组相比,研究组患者LVEF降低,血清ET-1[(92.48±13.21)pg/mL vs.147.85±21.12)pg/mL,P<0.05]、Angpt-2[(4.57±0.65)ng/mL vs.(6.68±0.94)ng/mL,P<0.05]、BNP[(22.01±3.14)pg/mL vs.(47.81±8.25)pg/mL,P<0.05]浓度升高,差异有统计学意义.研究组心功能分级Ⅱ级、Ⅲ级、Ⅳ级组患者血清ET-1[(134.16±19.16)pg/mL vs.(145.27±20.75)pg/mL vs.(161.72±23.11)pg/mL]、Angpt-2[(5.23±0.74)ng/mL vs.(6.71±0.95)ng/mL vs.(7.82±1.12)ng/mL]浓度均依次升高,差异有统计学意义(P<0.05).研究组患者血清ET-1浓度与LVEF负相关(r=-0.712,P<0.05),与血清BNP浓度正相关(r=0.565,P<0.05);血清Angpt-2浓度与LVEF负相关(r=-0.554,P<0.05),与血清BNP浓度正相关(r=0.612,P<0.05);血清ET-1、Angpt-2、二者联合检测诊断妊娠期高血压疾病性心脏病的曲线下面积(AUC)分别为0.886(敏感度为91.1%、特异度为73.9%),0.869(敏感度为74.4%、特异度为89.1%),0.967(敏感度为94.4%、特异度为85.9%).结论 血清ET-1、Angpt-2浓度在妊娠期高血压疾病性心脏病患者中均升高,与BNP、LVEF浓度关系密切,二者联合对诊断妊娠期高血压疾病孕妇发生心脏病有一定帮助,为临床提供一定帮助.

Abstract

Objectives To detect the serum concentrations of endothelin(ET-1)and angiopoietin-2(Angpt-2)in patients with gestational hypertensive disease heart disease,and to analyze the diagnostic value of serum concentrations of ET-1 and Angpt-2 in patients with hypertensive heart disease during pregnancy.Methods From February 2018 to February 2022,90 patients with gestational hypertensive disease heart disease treated in Cangzhou Central Hospital of Hebei Province were selected as research group,92 patients with gestational hypertension were selected as pregnancy-induced hypertension(PIH)group,and 95 cases of normal pregnancy were selected as control group.After the subjects were admitted to hospital,the serum concentrations of ET-1 and Angpt-2 were determined by enzyme-linked immunosorbent assay(ELISA).The left ventricular ejection fraction(LVEF),and the serum concentrations of ET-1,Angpt-2 and brain natriuretic peptide(BNP)were compared among the three groups.The correlations of serum concentrations of ET-1 and Angpt-2 with LVEF and BNP in research group were analyzed.The diagnostic value of serum concentrations of ET-1 and Angpt-2 in gestational hypertensive disease heart disease was analyzed by receiver operating characteristic curve(ROC).Results Compared with control group,there were no significant differences of LVEF,serum concentrations of Angpt-2 and BNP in PIH group(P>0.05),but serum concentration of ET-1[(63.52±9.07)pg/mL vs.(92.48±13.21)pg/mL,P<0.05]significantly increased(P<0.05);LVEF in research group decreased,and the serum concentrations of ET-1[(63.52±9.07)pg/mL vs.(147.85±21.12)pg/mL,P<0.05],Angpt-2[(4.55±0.65)ng/mL vs.6.68±0.94)ng/mL,P<0.05]and BNP[(21.35±3.05)pg/mL vs.(47.81±8.25)pg/mL,P<0.05]significantly increased.Compared with PIH group,the LVEF in study group decreased,and the serum concentrations of ET-1[(92.48±13.21)pg/mLvs.(147.85±21.12)pg/mL,P<0.05],Angpt-2[(4.57±0.65)ng/mL vs.(6.68±0.94)ng/mL,P<0.05]and BNP[(22.01±3.14)pg/mL vs.(47.81±8.25)pg/mL,P<0.05]significantly increased.The serum concentrations of ET-1[(134.16±19.16)pg/mL vs.(145.27±20.75)pg/mL vs.(161.72±23.11)pg/mL]and Angpt-2[(5.23±0.74)ng/mL vs.(6.71±0.95)ng/mL vs.(7.82±1.12)ng/mL]in patients with cardiac function grades Ⅱ,Ⅲ,Ⅳ in research group increased in turn(P<0.05).Serum concentration of ET-1 in research group was negatively correlated with LVEF(r=-0.712,P<0.05),and positively correlated with serum concentration of BNP(r=0.565,P<0.05);serum concentration of Angpt-2 was negatively correlated with LVEF(r=-0.554,P<0.05),and positively correlated with serum concentration of BNP(r=0.612,P<0.05).The area under the curve(AUC)of serum concentrations of ET-1,Angpt-2,and their combined detection for the diagnosis of hypertensive heart disease in pregnancy was 0.886(sensitivity of 91.1%,specificity of 73.9%),0.869(sensitivity of 74.4%,specificity of 89.1%),and 0.967(sensitivity of 94.4%,specificity of 85.9%),respectively.Conclusions Serum concentrations of ET-1 and Angpt-2 are both elevated in patients with hypertensive heart disease during pregnancy,closely related to serum concentration of BNP and LVEF.The combination of the two is helpful in diagnosing the occurrence of heart disease in pregnant women with gestational hypertension and provides certain clinical assistance.

关键词

妊娠期高血压疾病性心脏病/内皮素-1/血管生成素-2

Key words

gestational hypertensive disease heart disease/endothelin-1/angiopoietin-2

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基金项目

河北省卫生健康委科研项目(20210763)

出版年

2024
岭南心血管病杂志
广东省心血管病研究所

岭南心血管病杂志

CSTPCD
影响因子：0.872
ISSN：1007-9688
参考文献量22
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