不同程度子痫前期孕妇血脂、血糖、胎盘组织Bcl-2、Bcl-xL表达与维生素E水平的差异研究及其预测价值  

Studies on the differences in blood lipid,blood glucose,placental tissue Bcl-2,Bcl-xL expression and vitamin E level in pregnant women with preeclampsia of different degrees and their predictive value

作　　者：孙美娜 王鑫 彭宏岩 Sun Meina;Wang Xin;Peng Hongyan(Department of Obstetrics and Gynecology,Sixth Medical Center,PLA General Hospital,Beijing 100048,China)

机构地区：[1]中国人民解放军总医院第六医学中心妇产科,北京100048

出　　处：《中国医学前沿杂志（电子版）》2020年第9期88-92,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探究不同程度子痫前期孕妇的血脂、血糖、胎盘组织Bcl-2、Bcl-xL表达与维生素E水平的差异及其临床预测价值。方法选取2016年1月至2019年1月在中国人民解放军总医院第六医学中心产检并分娩的子痫前期孕妇124例,根据病情程度将其分为轻度子痫前期组(68例)、重度子痫前期组(56例);另选取该院同期正常妊娠孕妇62例作为对照组。比较三组孕妇血脂[总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、低密度脂蛋白胆固醇(low density lipoproteincholesterol,LDL-C)]、空腹血糖(fasting plasma glucose,FPG)、维生素E水平及胎盘组织Bcl-2、Bcl-xL的mRNA表达;采用受试者操作特征曲线(receiver operating charac teristic curve,ROC曲线)评估血清TC、TG、LDL-C、FPG、维生素E水平及五项指标联合对重症子痫前期的预测价值。结果三组孕妇TC、TG、LDL-C、FPG水平比较差异均有统计学意义(均P<0.05),且上述指标水平均依次为:重度子痫前期组>轻度子痫前期组>对照组;三组孕妇血清维生素E水平和胎盘组织Bcl-2、Bcl-xL的mRNA表达比较差异均有统计学意义(均P<0.05),且上述指标水平均依次为:重度子痫前期组<轻度子痫前期组<对照组。TC、TG、LDL-C、FPG、维生素E预测重度子痫前期的曲线下面积(area under the curve,AUC)分别为0.689、0.770、0.861、0.709、0.795;五项指标联合预测重度子痫前期的AUC为0.971,灵敏度、特异度分别为96.4%、88.2%,预测价值较高。结论Bcl-2、Bcl-xL、维生素E与子痫前期关系密切,并参与子痫前期的病理生理过程,且维生素E与TC、TG、LDL-C、FPG联合检测对重度子痫前期具有较高预测价值,可为临床防治子痫前期提供依据。Objective To investigate the differences in blood lipid,blood glucose,placental tissue Bcl-2,Bcl-xL expression and vitamin E level in pregnant women with different degrees of preeclampsia(PE)and its clinical predictive value.Method From January 2016 to January 2019,124 pregnant women with PE who were examined and delivered in Sixth Medical Center,PLA General Hospital were selected.According to the condition,they were divided into mild PE group(68 cases)and severe PE group(56 cases).In addition,62 cases of normal pregnant women in that hospital during the same period were selected as control group.Blood lipids[total cholesterol(TC),triglyceride(TG),low density lipoprotein-cholesterol(LDL-C)],fasting plasma glucose(FPG),vitamin E level and mRNA expression of Bcl-2,Bcl-xL in placenta were compared among the three groups.The receiver operating characteristic curve(ROC curve)was used to evaluate the value of TC,TG,LDL-C,FPG,vitamin E and five combined predictive PE.Result The TC,TG,LDL-C and FPG levels of pregnant women in the three groups were all statistically significant(all P<0.05),and the above indicators were all in turn:severe PE group>mild PE group>control group.The vitamin E level and placental tissue Bcl-2,Bcl-xL of pregnant women in the three groups were all statistically significant(all P<0.05),and the above indicators were all in turn:severe PE group<mild PE group<control group.The area under the curve(AUC)of TC,TG,LDL-C,FPG and vitamin E were 0.689,0.770,0.861,0.709 and 0.795,respectively.The combined AUC of the five indexes was 0.971,and the sensitivity and specificity were 96.4%and 88.2%,and the predictive value was higher.Conclusion Bcl-2,Bcl-xL and vitamin E are closely related to PE and is involved in the pathophysiological process of PE.The combined detection of vitamin E and TC,TG,LDL-C and FPG has high predictive value for severe PE,which can provide basis for clinical prevention and treatment.

关 键 词：子痫前期 血脂 血糖 BCL-2 Bcl-xL 维生素E 

分 类 号：R714.244[医药卫生—妇产科学]