首页|血清hs-CRP、sFlt-1水平对妊娠期高血压疾病患者胎儿生长受限的预测价值

血清hs-CRP、sFlt-1水平对妊娠期高血压疾病患者胎儿生长受限的预测价值

The predictive value of serum hs-CRP and sFlt-1 levels for fetal growth restriction in patients with ges-tational hypertension

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目的 研究分析血清超敏C反应蛋白(hs-CRP)、可溶性血管内皮生长因子受体-1(sFlt-1)水平在妊娠期高血压疾病(hypertensive disorder of pregnancy,HDP)患者胎儿生长受限(fetal growth restriction,FGR)中血清水平的变化并评估其对FGR的预测价值.方法 选取2021年12月—2023年5月在赣州市妇幼保健院产科收治的137名妊娠期高血压患者作为研究对象,根据超声影像法判读其胎儿是否发生生长受限.分为受限组(46例)和非受限组(91例).收集患者的一般资料及血清hs-CRP、sFlt-1水平等因素进行单因素分析.采用多因素Logistic回归分析HDP患者胎儿发生生长受限的影响因素,并绘制受试者工作特征(receiver operating characteristic,ROC)曲线评估血清血清hs-CRP、sFlt-1水平在HDP患者胎儿发生生长受限的预测价值.结果 单因素结果提示受限组胎儿的血清叶酸(FA)、维生素B12(VitB12)和胎盘生长因子(PIGF)水平低于非受限组,而血清hs-CRP、sFlt-1水平均高于非受限组,差异具统计学意义(P<0.05).多因素分析结果提示血清hs-CRP、sFlt-1和PIGF水平均是影响HDP患者胎儿发生生长受限的独立危险因素.模型 H-L 检验x2=7.014,P=0.535,拟合度较好;ROC 曲线下面积(AUC)为 0.932,95%Cl 为 0.889~0.975(P<0.05),灵敏度为93.50%,特异度为89.00%.结论 血清hs-CRP、sFlt-1水平在HDP患者FGR中呈高表达状态,故其对FGR的发生具有良好的预测作用.
Objective To investigate the changes in the levels of serum high-sensitivity C-reactive protein(hs-CRP)and soluble fms-like tyrosine kinase-1(sFlt-1)in hypertensive disorder of pregnancy(HDP)patients with fetal growth restriction(FGR),and to evaluate their predictive value for FGR.Methods A total of 137 HDP patients admitted to the Obstetrics De-partment of Ganzhou Maternal and Child Health Hospital from December 2021 to May 2023 were selected as the study subjects.According to whether their fetuses had growth restriction,they were divided into the restricted group(n=46)and the non-re-stricted group(n=91).The general information and serum levels of hs-CRP and sFlt-1 were collected and analyzed.Multiple lo-gistic regression analysis was used to identify the influencing factors for fetal growth restriction in HDP patients,and receiver oper-ating characteristic(ROC)curve was plotted to evaluate the predictive value of serum hs-CRP and sFlt-1 levels for fetal growth restriction in HDP patients.Results Univariate analysis showed that the serum levels of folic acid(FA),vitamin B12(VitB12),and placental growth factor(PIGF)in the restricted group were lower than those in the non-restricted group,while the serum lev-els of hs-CRP and sFlt-1 were higher than those in the non-restricted group,with statistically significant differences(P<0.05).Multivariate analysis showed that serum hs-CRP,sFlt-1,and PIGF levels were independent risk factors for fetal growth restriction in HDP patients.The H-L test of the model showedx2=7.014,P=0.535,indicating a good fit.The area under the ROC curve(AUC)was 0.932,with a 95%CI of 0.889-0.975(P<0.05),a sensitivity of 93.50%,and a specificity of 89.00%.Conclusion Serum hs-CRP and sFlt-1 levels are upregulated in HDP patients with fetal growth restriction,indicating their good predictive value for the occurrence of fetal growth restriction.

hs-CRPsFlt-1HDP patientsFetal growth restrictionRisk factorsPredictive value

王燕枚、刘桂荣、黄婷

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赣州市妇幼保健院 江西赣州 341000

hs-CRP sFlt-1 HDP患者 胎儿生长受限 危险因素 预测价值

江西省卫生健康委科技项目

202312045

2024

现代医院
广东省医院协会

现代医院

影响因子:1.332
ISSN:1671-332X
年,卷(期):2024.24(3)
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