血清TSP-1、VEGF及TSP-1/VEGF对早发型重度子痫前期的预测价值  

Predictive value of serum TSP-1,VEGF and TSP-1/VEGF in early onset severe preeclampsia

作　　者：罗敏 徐晓都[1] 王维[2] 周隽[3] LUO Min;XU Xiaodu;WANG Wei;ZHOU Jun(Department of Clinical Laboratory,the First People′s Hospital of Longquanyi District,Chengdu/West China Longquan Hospital Sichuan University,Chengdu,Sichuan 610100,China;Department of Clinical Laboratory,Longquanyi District of Chengdu Maternal and Child Health Care Hospital,Chengdu,Sichuan 610100,China;Department of Obstetrics,the First People′s Hospital of Longquanyi District,Chengdu/West China Longquan Hospital Sichuan University,Chengdu,Sichuan 610100,China)

机构地区：[1]成都市龙泉驿区第一人民医院/四川大学华西医院龙泉医院检验科,四川成都610100 [2]成都市龙泉驿区妇幼保健院检验科,四川成都610100 [3]成都市龙泉驿区第一人民医院/四川大学华西医院龙泉医院产科,四川成都610100

出　　处：《国际检验医学杂志》2022年第16期1965-1968,1974,共5页International Journal of Laboratory Medicine

基　　金：四川省成都市卫生健康委员会科研项目(2020191)。

摘　　要：目的探讨血清血小板反应蛋白1(TSP-1)、血管内皮生长因子(VEGF)及TSP-1/VEGF对早发型重度子痫前期(EOSP)的预测价值。方法选取2019年8月至2020年8月成都市龙泉驿区第一人民医院/四川大学华西医院龙泉医院收治的孕28~33周EOSP孕妇38例作为病例组,同期门诊正常产检的孕28~33周健康孕妇40例作为对照组,以及行孕中期唐氏筛查(孕15~20周)并分娩的孕妇90例为验证组。分析TSP-1、VEGF、TSP-1/VEGF对EOSP的预测价值及其与不良妊娠结局的相关性。结果病例组血清TSP-1水平及TSP-1/VEGF均高于对照组(P<0.001),血清VEGF水平低于对照组(P<0.001);受试者工作特征(ROC)曲线分析显示,血清TSP-1、VEGF、TSP-1/VEGF均对EOSP有一定预测价值,截断值分别为2.44 ng/mL、319.21 pg/mL、9.13,TSP-1/VEGF预测EOSP的曲线下面积(AUC)最大,为0.750。相关性分析显示,血清TSP-1水平与VEGF水平呈负相关(r=-0.265,P<0.001),TSP-1水平与不良妊娠结局(新生儿出生体重、Apgar 1 min评分、Apgar 5 min评分)呈负相关(r=-0.588、-0.621、-0.593,均P<0.001),而血清VEGF水平与不良妊娠结局呈正相关(r=0.728、0.700、0.712,均P<0.001),TSP-1/VEGF与不良妊娠结局呈负相关(r=-0.817、-0.834、-0.823,均P<0.001)。验证组中,EOSP组TSP-1水平及TSP-1/VEGF高于非EOSP组,VEGF水平低于非EOSP组,差异均有统计学意义(P<0.001)。结论TSP-1/VEGF对EOSP有较高的预测价值,TSP-1/VEGF与不良妊娠结局呈负相关。Objective To explore the predictive value of serum thrombospondin-1(TSP-1),vascular endothelial growth factor(VEGF)and TSP-1/VEGF in early onset severe preeclampsia(EOSP).Methods From August 2019 to August 2020,38 pregnant women with EOSP at 28-33weeks of pregnancy in the First People′s Hospital of Longquanyi District,Chengdu/West China Longquan Hospital Sichuan University were selected as the case group,and 40 healthy pregnant women at 28-33weeks of pregnancy in the outpatient department during the same period were selected as the control group.Meanwhile,90 pregnant women who underwent the second trimester of pregnancy Down′s screening(15-20weeks of pregnancy)and delivered were included in the validation group.The predictive value of TSP-1,VEGF and TSP-1/VEGF for EOSP and their correlation with adverse neonatal pregnancy outcomes were analyzed.Results The serum TSP-1 level and TSP-1/VEGF in case group was higher than those in control group(P<0.001),and the serum VEGF level was lower than that of the control group(P<0.001).Receiver operating characteristic(ROC)curve analysis showed that serum TSP-1,VEGF and TSP-1/VEGF had certain predictive value for EOSP,with cut-off values of 2.44 ng/mL,319.21 pg/mL and 9.13 respectively.The area under the curve(AUC)of TSP-1/VEGF in predicting EOSP was the largest(0.750).Correlation analysis showed that serum TSP-1 level negatively correlated with VEGF level(r=-0.265,P<0.001);there was a negative correlation between TSP-1 level and adverse pregnancy outcome,including newborn birth weight,Apgar 1 min score,Apgar 5 min score(r=-0.588,-0.621,-0.593,all P<0.001).Serum VEGF levels positively correlated with adverse pregnancy outcomes(r=0.728,0.700,0.712,all P<0.001),while TSP-1/VEGF negatively correlated with adverse pregnancy outcomes(r=-0.817,-0.834,-0.823,all P<0.001).In the validation group,TSP-1 level and TSP-1/VEGF level in the EOSP group were higher than those in the non-EOSP group,while VEGF level was lower than those in the non-EOSP group,with statistical significance(P

关 键 词：血小板反应蛋白 血管内皮生长因子 血小板反应蛋白/血管内皮生长因子 早发型重度子痫前期 孕中期 

分 类 号：R714.244[医药卫生—妇产科学]