血清AFABP、MMP-9、PLTP指标预测妊娠期肝内胆汁淤积症价值  

Analysis of the value of combined detections of serum adipocyte fatty acid binding protein,matrix metalloproteinase-9,and phospholipid transport protein for predicting intrahepatic cholestasis of pregnancy

作　　者：陈丽[1] 樊晓君[1] 高强强 刘莹[1] CHEN Li;FAN Xiaojun;GAO Qiangqiang;LIU Ying(Baoji Maternal and Child Health Care Hospital, Shaanxi Province, 721000)

机构地区：[1]陕西省宝鸡市妇幼保健院,721000

出　　处：《中国计划生育学杂志》2021年第12期2588-2592,共5页Chinese Journal of Family Planning

摘　　要：目的:探究血清脂肪细胞型脂肪酸结合蛋白(AFABP)、基质金属蛋白酶-9(MMP-9)、磷脂转运蛋白(PLTP)对妊娠期肝内胆汁淤积症(ICP)的预测价值。方法:回顾性收集本院2019年1月-2020年10月收治的ICP患者80例(观察组)和产前检查健康孕妇80例(对照组)临床资料,根据病情程度将观察组ICP患者分为轻度组29例、中度组26例和重度组25例。比较各组孕妇血清AFABP、MMP-9、PLTP水平及肝功能指标,分析血清AFABP、MMP-9、PLTP对ICP的预测价值。结果:观察组血清AFABP、MMP-9、PLTP及总胆汁酸(TBA)、天冬氨酸转氨酶(AST)、谷丙转氨酶(ALT)、总胆红素(TBIL)、直接胆红素(DBIL)、甘胆酸(CG)水平均高于对照组,且ICP轻度组、中度组、重度组各指标水平依次升高(均P<0.05)。Speaman相关性分析显示,ICP孕妇血清AFABP、MMP-9、PLTP水平与TBA、AST、ALT、TBIL、DBIL、CG水平均呈正相关(P<0.05)。ROC曲线显示,AFABP、MMP-9、PLTP预测ICP的最佳截断值分别为26.77μg/L、707.35ng/ml、3.16 ng/ml,AUC分别为0.899(95%CI:0.844~0.948)、0.721(95%CI:0.602~0.817)、0.923(95%CI:0.897~0.946),灵敏度分别为90.7%、70.4%、91.4%,特异度分别为78.1%、69.0%、92.6%,3项联合检测的AUC为0.969(95%CI:0.912~0.998),灵敏度为96.9%,特异度为98.3%。结论:血清AFABP、MMP-9、PLTP可作为ICP诊断指标之一,联合检测对预测ICP病情价值较高。Objective:To explore the value of the combined detections of the serum adipocyte fatty acid binding protein(AFABP),matrix metalloproteinase-9(MMP-9),and phospholipid transport protein(PLTP)for predicting intrahepatic cholestasis of pregnancy(ICP).Methods:A retrospective analysis was performed on the clinical data of 80 pregnant women with ICP(in observation group)and 80 healthy pregnant women(in control group)from January 2019 to October 2020.The women in the observation group were divided into group A(29 women with mild ICP),group B(26 women with moderate ICP),and group C(25 women with severe ICP).The levels of serum AFABP,MMP-9,and PLTP and the liver function indexes of the women were compared among these groups.The predictive value of the combined detections of serum AFABP,MMP-9,and PLTP levels of the women for their ICP occurrence was analyzed.Results:The levels of serum AFABP,MMP-9,PLTP,total bile acid(TBA),aspartate aminotransferase(AST),alanine transaminase(ALT),total bilirubin(TBIL),direct bilirubin(DBIL),and cholyglycine(CG)of the women in the observation group were significant higher than those of the women in the control group.The levels of serum AFABP,MMP-9,PLTP,TBA,AST,ALT,TBIL,DBIL,and CG of the women in group A,group B,and group C had increased gradually(all P<0.05).Speaman correlation analysis showed that the AFABP,MMP-9,and PLTP levels of the pregnant women with ICP were positively correlated with their serum TBA,AST,ALT,TBIL,DBIL,and CG levels(P<0.05).ROC curve showed that the optimal cut-off values of AFABP level,MMP-9 level,and PLTP level for predicting ICP were 26.77ug/l,707.35ng/ml,and 3.16ng/ml,respectively,and which AUC were 0.899(95%CI:0.844-0.948),0.721(95%CI:0.602-0.817),0.923(95%CI:0.897-0.946),respectively,which sensitivities were 90.7%,70.4%,and 91.4%,,respectively,and which specificity were 78.1%,69.0%,and 92.6%,respectively.The AUC of the combined levels of AFABP,MMP-9,and PLTP for predicting ICP was 0.969(95%CI:0.912-0.998),which sensitivity and specificity were 96.9%and 98.3%.Con

关 键 词：妊娠期肝内胆汁淤积症 脂肪细胞型脂肪酸结合蛋白 基质金属蛋白酶-9 磷脂转运蛋白 预测价值 

分 类 号：R714.255[医药卫生—妇产科学]