首页|HDP患者血清MMP-9、ET-1、sFlt-1水平与不良围产结局相关性分析

HDP患者血清MMP-9、ET-1、sFlt-1水平与不良围产结局相关性分析

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目的:观察血清基质金属蛋白酶9(MMP-9)、内皮素-1(ET-1)、可溶性血管内皮生长因子受体-1(sFlt-1)水平与妊娠期高血压疾病(HDP)患者不良围产结局相关性.方法:回顾性选取2020年1月-2023年10月本院收治的HDP患者80例(HDP组)、健康孕妇80例临床资料,比较两组血清MMP-9、ET-1、sFlt-1水平,并分析其与HDP病情程度的相关性,根据围产结局将HDP组分为良好结局组与不良结局组,采用受试者工作特征(ROC)曲线分析血清MMP-9、ET-1、sFlt-1对HDP患者不良围产结局的预测价值.结果:HDP组血清MMP-9(0.37±0.05 ng/ml)低于对照组(0.66±0.15ng/ml),ET-1(30.63±4.17ng/ml)、sFlt-1(4459.74±62.25ng/L)水平高于对照组(19.67±2.28ng/ml、2371.16±48.52ng/L),观察组轻度患者MMP-9水平高于中度与重度患者,ET-1、sFlt-1水平低于中度与重度患者(均P<0.05),Spesrman相关性分析,HDP病情严重程度与MMP-9水平呈负相关(r=-0.496),与ET-1(r=0.472)、sFlt-1水平(r=0.508)呈正相关(P<0.05).80例HDP出现不良围产结局19例,不良结局患者血清MMP-9水平低于良好结局患者,ET-1、sFlt-1水平高于良好结局患者(均P<0.05).ROC分析,MMP-9、ET-1、sFlt-1预测HDP患者不良围产结局的最佳截断值分别为0.365 ng/ml、29.425 ng/ml、4495.65 ng/L,3项指标联合预测的曲线下面积(0.906)及特异性(91.8%)均高于单一指标预测(均P<0.05).结论:血清MMP-9、ET-1、sFlt-1水平与HDP患者病情程度、围产结局密切相关,联合检测对HDP患者不良围产结局有较高预测价值.
Analysis of the correlation between the levels of the serum matrix metalloproteinase-9,endothelin-1 and soluble fms-like tyrosine kinase-1 of pregnant women with hypertensive disorder complicating pregnancy(HDP)and their perinatal out-comes
Objective:To observe the correlation between the levels of the serum matrix metalloproteinase-9(MMP-9),endothelin-1(ET-1)and soluble fms-like tyrosine kinase-1(sFlt-1)of pregnant women with hypertensive disorder complicating pregnancy(HDP).Methods:A total of 80 pregnant women with HDP from January 2020 to October 2023 were selected in study group retrospectively,and 80 healthy pregnant women during the same period were selected in control group.The levels of serum MMP-9,ET-1 and sFlt-1 of the women were compared between the two groups,and the correlation between which of the women and the disease severity of their HDP was analyzed.According to the perinatal outcomes,the women in the study group were divided into group A(women with normal pregnancy out-comes)and group B(women with adverse pregnancy outcomes).The predictive values of the serum MMP-9,ET-1 and sFlt-1 levels of the women with HDP for their perinatal outcomes were analyzed by receiver operating characteristic(ROC)curve.Results:The serum MMP-9 level(0.37±0.05ng/ml)of the women in the study group was significantly lower than that(0.66±0.15ng/ml)of the women in the control group.The levels of ET-1(30.63±4.17ng/ml)and sFlt-1(4459.74±62.25ng/L)of the women in the study group were significantly higher than those(19.67±2.28 ng/ml and 2371.16±48.52ng/L)of the women in the control group.In the study group,the MMP-9 level of the women with mild HDP was significantly higher than that of the women with moderate or severe HDP,and the levels of ET-1 and sFlt-1 of the women with mild HDP were significantly lower than those of the women with moderate or severe HDP(all P<0.05).Spesrman correlation analysis showed that the severity of HDP of the women with HDP was negatively correlated with their level of MMP-9(r=-0.496),and was positively correlated with their ET-1 level(r=0.472)and their sFlt-1 level(r=0.508)(P<0.05).In 80 women with HDP,there were 19 women with adverse perinatal outcomes.The serum MMP-9 level of the women in group B was significantly lower than that of the women in group A,and the serum ET-1 and sFlt-1 levels of the women in group B were significantly higher than those of the women in group A(all P<0.05).ROC analysis showed that the best cut-off values of the MMP-9 level,the ET-1 lev-el and the sFlt-1 level of the women with HDP for predicting their adverse perinatal outcomes were 0.365 ng/ml,29.425 ng/ml and 4495.65 ng/L,respectively.The area under the curve and the specificity of the combined levels of the MMP-9,ET-1 and sFlt-1 of the women with HDP for predicting their adverse perinatal outcomes were 0.906 and 91.8%,and which were significantly higher than those of the MMP-9 level,the ET-1 level or the sFlt-1 level alone(all P<0.05).Conclusion:The serum levels of MMP-9,ET-1 and sFlt-1 of the pregnant women with HDP are closely re-lated to their disease severity and perinatal outcomes.The combined detection of the MMP-9,ET-1 and sFlt-1 levels of the pregnant women with HDP has higher predictive value for their adverse perinatal outcomes.

Hypertensive disorder complicating pregnancyDifferent disease severityMatrix metalloproteinase 9Endothelin-1Soluble fms-like tyrosine kinase-1Perinatal outcomesPrediction

杨淑娟、罗岳西、刘春艳、彭勇

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四川省南充市中心医院(637000)

妊娠期高血压疾病 不同病情程度 基质金属蛋白酶9 内皮素-1 可溶性血管内皮生长因子受体-1 不良围产结局 预测

吴阶平医学基金会项目

320.6750.2021-25-5

2024

中国计划生育学杂志
国家人口计生委科学技术研究所

中国计划生育学杂志

CSTPCD
影响因子:1.759
ISSN:1004-8189
年,卷(期):2024.32(4)
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