胎儿生长受限患者血清Klotho蛋白、ADMA表达及临床意义  

Expression and clinical significance of serum Klotho protein and ADMA in patients with fetal growth restriction

作　　者：秦凤娟 张福娥 王小凤 贾彦海 QIN Fengjuan;ZHANG Fu’e;WANG Xiaofeng;JIA Yanhai(Department of Obstetrics,Baoji People’s Hospital,Baoji 721000,China)

机构地区：[1]宝鸡市人民医院产科,陕西宝鸡721000 [2]宝鸡市人民医院妇科,陕西宝鸡721000 [3]西北妇女儿童医院产科,陕西西安710061 [4]宝鸡市人民医院检验科,陕西宝鸡721000

出　　处：《陕西医学杂志》2022年第4期488-491,共4页Shaanxi Medical Journal

基　　金：中国药学会科普研究重点项目(CMEI2020KPYJ00332)。

摘　　要：目的:研究胎儿生长受限(FGR)患者血清Klotho蛋白、不对称性二甲基精氨酸(ADMA)的表达及临床意义。方法:纳入妊娠早期孕妇180例,均随访至妊娠结局,根据是否发生FGR,分为FGR组和对照组,各90例。测定两组血清Klotho蛋白、ADMA水平,使用ROC曲线分析Klotho蛋白、ADMA、Klotho蛋白联合ADMA对FGR的诊断价值。记录两组的妊娠结局和FGR严重程度指标,使用Pearson检验分析Klotho蛋白、ADMA与分娩孕周、1 min Apgar评分、新生儿体重指数、胎盘质量的相关性。结果:FGR组Klotho蛋白水平低于对照组,ADMA水平高于对照组,差异具有统计学意义(均P<0.05)。Klotho蛋白联合ADMA对FGR的诊断曲线下面积(AUC)高于Klotho蛋白、ADMA单独诊断,差异具有统计学意义(均P<0.05)。FGR组的1 min Apgar评分、新生儿体重指数和胎盘质量均低于对照组,差异具有统计学意义(均P<0.05)。Klotho蛋白与新生儿体重指数呈明显正相关(P<0.05),与胎盘质量无关(P>0.05)。ADMA与新生儿体重指数和胎盘质量呈明显负相关(均P<0.05)。结论:Klotho蛋白联合ADMA对FGR具有较好的诊断价值,且Klotho蛋白、ADMA均与新生儿体重指数相关。临床中可通过对Klotho蛋白、ADMA的早期检测,评估FGR发生风险,以尽早采取相关措施,促进患者妊娠结局的改善。Objective:To study the expression and clinical significance of serum Klotho protein and asymmetric dimethylarginine(ADMA)in patients with fetal growth restriction(FGR).Methods:A total of 180 pregnant women in the first trimester were included and followed up to the pregnancy outcome.According to whether FGR occurred,they were divided into FGR group and control group,with 90 cases in each group.The serum Klotho protein and ADMA levels of two groups were measured.ROC curve was used to analyze the diagnostic value of Klotho protein,ADMA,and Klotho protein combined with ADMA for FGR.Pregnancy outcomes and FGR severity indicators in the two groups were recorded.Pearson test was used to analyze the correlation between Klotho protein,ADMA and gestational age,1-minute Apgar score,neonatal body weight,placental weight.Results:The level of Klotho protein in the FGR group was lower than that in the control group,and the level of ADMA was higher than that in the control group(all P<0.05).The area under the curve(AUC)of Klotho protein combined with ADMA for FGR was higher than that of Klotho protein and ADMA alone(all P<0.05).The 1-minute Apgar score,neonatal body weight and placental weight in the FGR group were lower than those in the control group(all P<0.05).Klotho protein was significantly positively correlated with neonatal body weight(P<0.05),but not with placental weight(P>0.05).ADMA was significantly negatively correlated with neonatal body weight and placental weight(all P<0.05).Conclusion:Klotho protein combined with ADMA has good diagnostic value for FGR,and both are related to neonatal body weight.The risk of FGR can be assessed by early detection of Klotho protein and ADMA in clinic,so as to take relevant measures as soon as possible to improve the pregnancy outcome of patients.

关 键 词：胎儿生长受限 KLOTHO蛋白 不对称性二甲基精氨酸 妊娠结局 联合诊断 新生儿体重指数 

分 类 号：R714.2[医药卫生—妇产科学]