妊娠期高血压疾病患者血清ANGPTL2、ADAM10水平与病情严重程度及预后关系  

Levels of serum angiopoietin-like protein 2 and disintegrin-metalloproteinase 10 of pregnant women with hypertensive disorder complicating pregnancy and their correlation with the severity and prognosis of hypertensive disorder complicating pregnancy

作　　者：李格琳 臧密密 付雪莲 苗艳 孙志敏 LI Gelin;ZANG Mimi;FU Xuelian;MIAO Yan;SUN Zhimin(Cangzhou People's Hospital,Cangzhou,Hubei Province,061000)

机构地区：[1]河北省沧州市人民医院,061000

出　　处：《中国计划生育学杂志》2023年第2期402-406,共5页Chinese Journal of Family Planning

基　　金：河北省2021年度医学科学研究课题计划(20210598)。

摘　　要：目的:探讨血清血管生成素样蛋白2(ANGPTL2)、解整合素-金属蛋白酶10(ADAM10)在妊娠期高血压疾病(HDCP)患者血清中的表达,以及与病情严重程度、预后的关系。方法:收集本院2019年11月-2021年11月收治的106例HDCP患者为HDCP组,其中重度子痫前期28例(重度组)、子痫前期34例(中度组)、妊娠期高血压44例(轻度组),同期产前检查健康孕妇100例为对照组。采用酶联免疫吸附法测定血清ANGPTL2、ADAM10的水平,Spearman分析HDCP病情严重程度与血清ANGPTL2、ADAM10及血压的相关性,根据羊水污染程度、新生儿Apgar评分将HDCP患者分为预后不良组(56例)和预后良好组(50例),多因素logistic回归分析影响HDCP患者预后的因素。受试者工作特征曲线(ROC)分析血清ANGPTL2、ADAM10对HDCP患者预后的预测价值。结果:HDCP组ANGPTL2(8.54±2.13 ng/ml)、ADAM10(1700.54±300.35 pg/ml)高于对照组(6.46±1.21 ng/ml、1348.65±280.32 pg/ml)(均P<0.05)。HDCP患者中,轻度组、中度组、重度组血清ANGPTL2、ADAM10、收缩压、舒张压依次升高,且与患者病情严重程度呈正相关;预后不良组24 h尿蛋白(PRO)、ANGPTL2、ADAM10水平均高于预后良好组(均P<0.05)。24 h PRO、ANGPTL2、ADAM10异常高表达是影响HDCP患者不良预后的因素(均P<0.05)。血清ANGPTL2预测HDCP患者预后的曲线下面积(AUC)为0.838,最佳临界值为8.14 ng/ml;血清ADAM10预测HDCP患者预后的AUC为0.834,最佳临界值为1627.11 pg/ml,两者联合的AUC为0.921,预测效能高于单一指标(均P<0.05)。结论:血清ANGPTL2、ADAM10在HDCP患者中表达上调,二者与其病情严重程度、预后密切相关,并可预测患者预后。Objective: To investigate the expression levels of serum angiopoietin-like protein 2(ANGPTL2) and disintegrin-metalloproteinase 10(ADAM10) of pregnant women with hypertensive disorder complicating pregnancy(HDCP), and to study their correlation with the severity and prognosis of HDCP. Methods: 106 pregnant women with HDCP from November 2019 to November 2021 were collected in group A, which included 28 cases with severe preeclampsia in group A1, 34 cases with moderate preeclampsia in group A2, and 44 cases with gestational hypertension in group A3. 100 healthy pregnant women were selected in group B during the same period. Enzyme-linked immunosorbent assay was used to detect the levels of serum ANGPTL2 and ADAM10 of the women. Spearman analysis was used to analyze the correlation between the severity of HDCP of the women and the levels of their serum ANGPTL2 and ADAM10, and their blood pressure value. According to the degree of amniotic fluid contamination and the neonatal Apgar score, the women in group A were divided group A4(56 cases with poor prognosis) and group A5(50 cases with normal prognosis). Multivariate logistic regression was used to analyze the factors affecting the prognosis of the women with HDCP.The predictive value of the levels of serum ANGPTL2and ADAM10of the women with HDCP for their prognosis was analyzed by receiver operating characteristic(ROC)curve.Results:The levels of ANGPTL2(8.54±2.13ng/ml)and ADAM10(1700.54±300.35pg/ml)of the women in group A were significantly higher than those(6.46±1.21ng/ml and 1348.65±280.32pg/ml)of the women in group B(all P<0.05).The levels of serum ANGPTL2and ADAM10,and the values of systolic blood pressure and diastolic blood pressure of the women in group A3,group A2,and group A1had increased gradually,and which of the women were positively correlated with the severity of their HDCP.The value of 24hurinary protein(PRO),and the ANGPTL2and ADAM10levels of the women in group A4were significantly higher than those of the women in group A5(all P<0.05).The abnor

关 键 词：妊娠期高血压 血管生成素样蛋白2 解整合素-金属蛋白酶10 病情严重程度 预后 

分 类 号：R714.246[医药卫生—妇产科学]