血清TLR4及MFG-E8与子痫前期患者表达及发生早期肾损伤的关系  

Relationship between serum TLR4 and MFG-E8 expression and early renal injury in preeclampsia patients

作　　者：任春丽[1] 唐兴国[2] 张玉芳 袁晓明[1] REN Chun-li;TANG Xing-guo;ZHANG Yu-fang(Department of Obstetrics,Affiliated Hospital of Chengde Medical College,Chengde 067000,China;Department of Anatomy,Chengde Nursing Vocational College,Chengde 067000,China)

机构地区：[1]承德医学院附属医院产科,河北承德067000 [2]承德护理职业学院解剖教研室,河北承德067000

出　　处：《中国实验诊断学》2020年第11期1770-1773,共4页Chinese Journal of Laboratory Diagnosis

基　　金：河北省医学科学研究重点课题计划项目(项目号:20170874);河北省科技计划项目(项目号:162777102D);河北省承德市科技厅项目(项目号:201706A057)。

摘　　要：目的研究子痫前期患者外周血中TLR4和MFG-E8在子痫前期患者中的表达与诊断意义,并探讨其与子痫前期发生早期肾损伤的关系。方法用酶联免疫吸附法对妊娠期高血压患者30例,轻度子痫前期患者30例、重度子痫前期30例以及正常妊娠30例患者外周血中TLR4和MFG-E8表达水平。结果①外周血TLR4表达水平随病情加重呈逐渐升高趋势,sPE>mPE>GH>NP组;外周血MFG-E8表达水平随病情加重呈逐渐降低趋势,sPE<mPE<GH<NP组。TLR4和MFG-E8表达水平在多组间进行单因素方差分析及组间两两比较,均具有显著性差异(P<0.01)。②外周血TLR4与MFG-E8表达水平随着子痫前期病情进展呈负相关(r=-0.799,P=0.000);在子痫前期并发早期肾损伤的病例中,外周血TLR4与MFG-E8表达水平仍呈明显负相关(r=-0.875,P=0.000)。③外周血TLR4与MFG-E8表达水平诊断PE的敏感度分别为83.33%、78.33%,特异度分别为80.00%、86.67%;TLR4联合MFG-E8诊断PE的敏感度98.00%,特异度78.57%;TLR4、MFG-E8及TLR4联合MFG-E8诊断PE的ROC曲线下面积分别是0.850、0.889及0.928。结论TLR4与MFG-E8均密切参与子痫前期发病机制,且随病情进展,TLR4表达水平呈逐渐升高趋势,而MFG-E8则呈下降趋势,两者之间呈负相关。PE患者并发早期肾损伤时TLR4与MFG-E8负相关更明显。TLR4联合MFG-E8对诊断子痫前期的预测价值更高,为临床上子痫前期患者的早期诊断提高可靠依据。Objective To study the expression and diagnostic significance of peripheral blood TLR4 and MFG-E8 in preeclampsia patients,and to explore its relationship with early renal injury in preeclampsia.Methods The expression of TLR4 and MFG-E8 in serum of 30 patients in gestational hypertension,30 patients in mild preeclampsia,30 patients in severe preeclampsia and 30 patients in normal pregnancy were treated by enzyme-linked immunosorbent assay.Results①The expression level of SerumTLR4 increased gradually with the aggravation of the disease,sPE>mPE>GH>NP group,and the expression level of Serum MFG-E8 decreased gradually with the aggravation of the disease,sPE<mPE<GH<NP group.The expression levels of TLR4 and MFG-E8 were significantly different between two groups and one-way ANOVA(P<0.01).②Peripheral blood TLR4 and MFG-E8 expression levels were negatively correlated with the progression of preeclampsia(r=-0.799,P=0.000),and peripheral blood TLR4 and MFG-E8 expression levels were still negatively correlated in preeclampsia complicated with early renal injury(r=-0.875,P=0.000).③The sensitivity of diagnostic PE of peripheral blood TLR4 and MFG-E8 expression was 83.33%and 78.33%,The specificity was 80.00%and 86.67%respectively;Sensitivity and specificityof TLR4 combined MFG-E8 diagnostic PE was 98.00%and 78.57%;The area under the ROC curve of TLR4、MFG-E8 and TLR4 combined MFG-E8 diagnostic PE was 0.850,0.889 and 0.928.Conclusion TLR4 and MFG-E8 are closely involved in the pathogenesis of preeclampsia,with the progress of the disease,the level of TLR4 expression is gradually increasing,while the MFG-E8 is decreasing,and there is a negative correlation between them.PE patients with early renal injury TLR4 negative correlation with MFG-E8 is more obviously.TLR4 combined MFG-E8 has higher predictive value for the diagnosis of preeclampsia and improves the reliable basis for the early diagnosis of preeclampsia patients.

关 键 词：子痫前期 急性肾损伤 TLR4 MFG-E8 ELISA 

分 类 号：R714.24[医药卫生—妇产科学]