血清zonulin、GPC3与妊娠期肝内胆汁淤积症患者不良妊娠结局的关系  

Relationship between serum zonulin,GPC3 and adverse pregnancy outcomes in patients with intrahepatic cholestasis of pregnancy

作　　者：杨姗 穆兰芳 陈玉芬 范晓红 王淑花 YANG Shan;MU Lanfang;CHEN Yufen;FAN Xiaohong;WANG Shuhua(Department of Obstetrics and Gynecology,Qinghai Women′s and Children′s Hospital,Xining,Qinghai 810000,China)

机构地区：[1]青海省妇女儿童医院妇产科,青海西宁810000

出　　处：《国际检验医学杂志》2023年第5期536-540,547,共6页International Journal of Laboratory Medicine

基　　金：青海省2019年卫生计生指导性科研课题(2019-wjqn-29)。

摘　　要：目的探讨血清连蛋白(zonulin)、磷脂酰肌醇蛋白聚糖3(GPC3)联合检测对妊娠期肝内胆汁淤积症(ICP)患者不良妊娠结局的预测价值。方法收集该院2019年1月至2021年5月收治的ICP患者150例为观察组,按照ICP的分度标准分为轻度组和重度组,并纳入同一时间段内正常妊娠中晚期孕妇150例为对照组。统计各组孕妇的临床资料、血清zonulin和GPC3水平及观察组ICP患者妊娠结局。采用多元Logistic回归分析筛选不良妊娠结局危险因素,采用受试者工作特征曲线判断zonulin及GPC3对不良妊娠结局的预测价值。结果对照组血清zonulin、GPC3水平均显著低于轻度组及重度组,差异有统计学意义(P<0.05);轻度组血清zonulin、GPC3水平显著低于重度组,差异有统计学意义(P<0.05)。观察组不良妊娠结局的总发生率显著高于对照组,差异有统计学意义(P<0.05)。年龄、直接胆红素、总胆汁酸、血清zonulin水平、血清GPC3水平及纤维蛋白原水平是ICP患者发生不良妊娠结局的危险因素(P<0.05)。zonulin、GPC3及二者联合预测的曲线下面积分别为0.742(0.557~0.927)、0.721(0.464~0.967)、0.855(0.729~0.979),其中两个指标的联合应用较高。结论血清zonulin及GPC3在ICP患者中表达水平升高,与ICP患者病情和不良妊娠结局相关,且对ICP患者发生不良妊娠结局具有较好的预测价值。Objective To explore the value of combined detection of serum zonulin and glypican-3(GPC3)in predicting adverse pregnancy outcomes in patients with intrahepatic cholestasis of pregnancy(ICP).Methods A total of 150 pregnant women with ICP treated in a hospital from January 2019 to may 2021 were collected as the observation group.According to the classification standard of ICP,they were divided into mild group and severe group,and 150 pregnant women in the middle and late stages of normal pregnancy in the same time period were included as the control group.The clinical data,serum levels of zonulin and GPC3 of pregnant women in each group and the pregnancy outcomes of ICP patients in the observation group were counted.Multiple Logistic regression analysis was used to screen the risk factors of adverse pregnancy outcomes,and the receiver operating characteristic curve was used to judge the predictive value of zonulin and GPC3 on adverse pregnancy outcomes.Results The serum levels of zonulin and GPC3 in control group were significantly lower than those in mild and severe groups,with statistical significance(P<0.05).Serum levels of zonulin and GPC3 in mild group were significantly lower than those in severe group,with statistical significance(P<0.05).The total incidence of adverse pregnancy outcomes in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).Age,direct bilirubin,total bile acid,serum zonulin level,serum GPC3 level and fibrinogen level were risk factors for adverse pregnancy outcomes in ICP patients(P<0.05).The areas under the curve predicted by zonulin,GPC3 and their combination were 0.742(0.557-0.927),0.721(0.464-0.967)and 0.855(0.729-0.979)respectively.The joint application of the two indicators was relatively higher.Conclusion The increased expression levels of serum zonulin and GPC3 in ICP patients are related to the condition and adverse pregnancy outcomes of ICP patients,and have good predictive value for adverse pregna

关 键 词：连蛋白 磷脂酰肌醇蛋白聚糖-3 妊娠期肝内胆汁淤积症 妊娠结局 

分 类 号：R714.255[医药卫生—妇产科学]