PECAM-1、E-选择素和TSP-1对妊娠期高血压疾病发生妊娠结局不良的诊断价值  

Diagnostic value of PECAM-1,E-selectin and TSP-1 in adverse pregnancy outcomes in patients with hypertensive disorders complicating pregnancy

作　　者：郭雪晶 沈丽华[1] GUO Xuejing;SHEN Lihua(Department of Obstetrics and Gynecology,Maternal and Child Health Hospital of Pudong New Area,Shanghai 201206,China)

机构地区：[1]上海市浦东新区妇幼保健院妇产科,上海201206

出　　处：《检验医学与临床》2023年第8期1077-1081,共5页Laboratory Medicine and Clinic

摘　　要：目的观察血小板内皮细胞黏附分子-1(PECAM-1)、E-选择素和血小板反应蛋白-1(TSP-1)对妊娠期高血压疾病(HDCP)患者发生妊娠结局不良的诊断效能。方法选取2020年1月至2022年1月在该院住院治疗的95例HDCP患者作为HDCP组,另选取同期在该院孕期保健检查的48例孕妇作为正常妊娠组。比较两组及不同严重程度HDCP患者血清PECAM-1、E-选择素和TSP-1水平,分析妊娠结局不良的影响因素,以及HDCP患者血清PECAM-1、E-选择素和TSP-1水平对妊娠结局不良的诊断效能。结果HDCP组血清PECAM-1水平明显低于正常妊娠组,其水平随着HCDP患者严重程度升高而降低,而HDCP组血清E-选择素和TSP-1水平均明显高于正常妊娠组,并且随着HDCP严重程度升高而升高,差异均有统计学意义(P<0.05)。妊娠结局不良组发病孕周、分娩孕周和血清PECAM-1水平均明显低于妊娠结局良好组,差异均有统计学意义(P<0.05);妊娠结局不良组血清E-选择素和TSP-1水平均明显高于妊娠结局良好组,差异均有统计学意义(P<0.05);妊娠结局不良组年龄、初产妇、孕前体质量指数、心率、收缩压和舒张压与妊娠结局良好组比较,差异均无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,血清PECAM-1水平降低,血清E-选择素和TSP-1水平升高是HDCP患者发生妊娠结局不良的独立危险因素(P<0.05)。血清PECAM-1、E-选择素和TSP-1水平对HDCP患者发生妊娠结局不良具有较高的诊断效能,3项指标联合检测的灵敏度为82.2%,特异度为96.0%,曲线下面积为0.945,明显高于PECAM-1(Z=2.157,P=0.031)、E-选择素(Z=3.617,P<0.05)和TSP-1(Z=3.326,P=0.001)单项检测。结论血清PECAM-1、E-选择素和TSP-1是反映HDCP病情严重程度的指标,是HDCP患者发生妊娠结局不良的独立影响因素,3项指标联合检测对HDCP患者发生妊娠结局不良具有较高的诊断效能。Objective To observe the diagnostic efficacy of platelet endothelial cell adhesion molecule-1(PECAM-1),E-selectin and thrombospondin-1(TSP-1)in the occurrence of adverse pregnancy outcomes in patients with hypertensive disorders complicating pregnancy(HDCP).Methods A total of 95 HDCP patients who were hospitalized in our hospital from January 2020 to January 2022 were selected as the HDCP group,48 pregnant women who received health check during pregnancy in our hospital during the same period were selected as the normal pregnancy group.The serum levels of PECAM-1,E-selectin and TSP-1 were compared between HDCP group and normal pregnancy group,as well as in HDCP patients with different severity levels,and the influenced factors of adverse pregnancy outcomes were analyzed,and the serum PECAM-1,E-selectin and TSP-1 levels were observed with disease severity in patients with HDCP and diagnostic efficacy of adverse pregnancy outcomes were also observed.Results The serum PECAM-1 level in HDCP group was significantly lower than that in normal pregnancy group(P<0.05),and its level decreased with the increase of the severity of HCDP patients(P<0.05),while the serum E-selectin and TSP-1 levels in the HDCP group were significantly higher than those in the normal pregnancy group(P<0.05),and increased with the increase of HDCP severity(P<0.05).The onset gestational week,childbirth gestational week and serum PECAM-1 levels in the poor pregnancy outcome group were significantly lower than those in the good pregnancy outcome group(P<0.05),while the serum E-selectin and TSP-1 levels in the poor pregnancy outcome group were significantly higher than those in the good pregnancy outcome group(P<0.05),while age,primipara,pre-pregnancy body mass indexes,heart rate,systolic blood pressure and diastolic blood pressure had no significant difference between poor and good pregnancy outcomes(P>0.05).Multivariate Logistic analysis found that decreased PECAM-1 levels,elevated E-selectin and TSP-1 levels were independent risk factors for poor

关 键 词：血小板内皮细胞黏附分子-1 E-选择素 血小板反应蛋白-1 妊娠期高血压疾病 妊娠结局 

分 类 号：R714.246[医药卫生—妇产科学]