妊娠期肝内胆汁淤积症孕妇血清PAF、ESM-1和 TGF-β_(1)水平与新生儿急性肺损伤的关系  

Relationships between serum PAF,ESM-1 and TGF-β_(1) levels with neonatal acute lung injury in pregnant women with intrahepatic cholestasis during pregnancy period

作　　者：龚敏琴 GONG Minqin(Department of Obstetrics,Affiliated Obstetrics and Gynecology Hospital,Fudan University,Shanghai 200090,China)

机构地区：[1]复旦大学附属妇产科医院产科,上海200090

出　　处：《检验医学与临床》2023年第6期782-786,共5页Laboratory Medicine and Clinic

摘　　要：目的 评价妊娠期肝内胆汁淤积症(ICP)孕妇血清血小板活化因子(PAF)、内皮细胞特异性分子-1(ESM-1)和转化生长因子-β_(1)(TGF-β_(1))水平与新生儿急性肺损伤(ALI)的关系。方法 选择2020年1月至2022年1月在该院诊断为ICP的孕妇128例作为ICP组,选择同期在该院产检的正常孕妇45例作为对照组。比较ICP组和对照组血清PAF、ESM-1和TGF-β_(1)水平;比较血清PAF、ESM-1和TGF-β_(1)在不同严重程度ICP患者及生产不同严重程度ALI新生儿的ICP患者中的水平;分析血清PAF、ESM-1和TGF-β_(1)诊断ICP患者生产的新生儿发生ALI的效能。结果 ICP组血清PAF、ESM-1和TGF-β_(1)水平明显高于对照组(P<0.01);ICP患者重度组血清PAF、ESM-1和TGF-β_(1)水平明显高于轻度组(P<0.01);ALI组ICP患者血清PAF、ESM-1和TGF-β_(1)水平明显高于无ALI组(P<0.01),且RDS组ICP患者血清PAF、ESM-1和TGF-β_(1)水平明显高于TTPN组(P<0.01)。血清PAF、ESM-1和TGF-β_(1)联合检测诊断ICP患者生产的新生儿发生ALI的灵敏度为80.6%,特异度为100.0%,AUC为0.965,AUC明显高于PAF、ESM-1、TGF-β_(1)单项检测(P<0.05);而PAF、ESM-1、TGF-β_(1)单项检测诊断ICP患者生产的新生儿发生ALI的AUC之间差异无统计学意义(P>0.05)。结论 血清PAF、ESM-1和TGF-β_(1)可能是判断ICP严重程度的指标,参与了ALI的发生、发展,PAF、ESM-1和TGF-β_(1)联合检测有助于提高对ICP患者生产的新生儿发生ALI的诊断效能。Objective To evaluate the relationships between serum platelet activating factor(PAF),endothelial cell specific molecule-1(ESM-1) and transforming growth factor-β_(1)(TGF-β_(1)) levels in pregnant women with intrahepatic cholestasis of pregnancy(ICP) and neonatal acute lung injury(ALI).Methods A total of 128 patients with ICP during pregnancy diagnosed in this hospital from January 2020 to January 2022 were selected as the ICP group;forty-five normal pregnant women undergoing the obstetric examination in this hospital during the same period were selected as the control group.The serum PAF,ESM-1 and TGF-β_(1)levels were compared between the ICP group and control group;serum PAF,ESM-1 and TGF-β_(1)levels were compared between the ICP patients with different severity degrees and ICP patients with different severity degrees of ALI newborns;the efficiency of the serum PAF,ESM-1 and TGF-β_(1)E in diagnosing neonatal ALI occurrence in the patients with ICP was analyzed.Results The levels of serum PAF,ESM-1 and TGF-β_(1)in the ICP group were significantly higher than those in the control group(P<0.01).The serum PAF,ESM-1 and TGF-β_(1)levels in the ICP severe group were significantly higher than those in the mild group(P<0.01).The serum PAF,ESM-1 and TGF-β_(1)levels in the ALI group of ICP patients were significantly higher than those in the non-ALI group(P<0.01),moreover,the serum PAF,ESM-1 and TGF-β_(1)levels in the ICP patients of the RDS group were significantly higher than those of the TTPN group(P<0.01).The sensitivity,specificity and AUC of serum PAF,ESM-1 and TGF-β_(1)combined detection for diagnosis of ALI occurrence in newborns among the patients with ICP were 80.6%,100.0% and 0.965 respectively.AUC was significantly higher than that of PAF,ESM-1 and TGF-β_(1)single detection(P<0.05),while there was no statistically significant difference in AUC of PAF,ESM-1 and TGF-β_(1)single test for diagnosing ALI occurrence in newborns among the patients with ICP(P>0.05).Conclusion The serum PAF,ESM-1 and TGF-β

关 键 词：肝内胆汁淤积症 血小板活化因子 内皮细胞特异性分子-1 转化生长因子-β_(1) 急性肺损伤 

分 类 号：R446.1[医药卫生—诊断学] R714.25[医药卫生—临床医学]