血管内皮功能指标与子痫前期严重程度关系及对孕妇流产预测效能研究  

Relationship between vascular endothelial function indexes and the severity of preeclampsia and its predictive efficacy for abortion

作　　者：崔静 朱俊美 张燕 CUI Jing;ZHU Junmei;ZHANG Yan(Department of Obstetrics,Xi’an Jingkai District Women and Children’s Hospital,Xi’an 710018,China)

机构地区：[1]西安经开妇幼医院产科,陕西西安710018 [2]陕西省康复医院妇产科,陕西西安710061 [3]西安国际医学中心医院产二科,陕西西安710100

出　　处：《陕西医学杂志》2023年第5期608-612,共5页Shaanxi Medical Journal

基　　金：陕西省自然科学基础研究计划项目(2018JM7135)。

摘　　要：目的:探讨血管内皮功能指标与子痫前期严重程度的关系及对流产的预测效能。方法:选择114例子痫前期孕妇为观察组,根据临床表现的严重程度,分为轻度子痫前期组和重度子痫前期组;另选同期接受产检的正常孕妇为对照组。检测两组血管内皮功能指标[可溶性细胞内皮因子(sEng)、可溶性血管内皮生长因子受体-1(sFlt-1)、内皮素-1(ET-1)和血管内皮生长因子(VEGF)],分析血管内皮功能指标与24 h尿蛋白水平的关系,使用受试者工作特征(ROC)曲线分析血管内皮功能指标对子痫前期孕妇发生流产的预测效能。结果:观察组血清sEng、sFlt-1、ET-1水平均高于对照组,VEGF水平低于对照组(均P<0.05);重度子痫前期组确诊时血清sEng、sFlt-1、ET-1水平均高于轻度子痫前期组,VEGF水平低于轻度子痫前期组(均P<0.05);观察组产后血清sEng、sFlt-1、ET-1水平较确诊时明显降低,VEGF水平较确诊时明显升高(均P<0.05);经Pearson相关性分析,观察组确诊时24 h尿蛋白水平与血清sEng、sFlt-1、ET-1水平呈正相关,与VEGF水平呈负相关(均P<0.05);观察组114例子痫前期孕妇中,流产发生率为8.77%;经ROC曲线分析,血清sEng、sFlt-1、ET-1联合VEGF预测子痫前期孕妇发生流产的AUC为0.943,明显大于单一指标的AUC。结论:子痫前期孕妇存在血管内皮功能受损,检测sEng、sFlt-1、ET-1、VEGF指标对评估病情严重程度、联合预测流产发生均具有重要意义。Objective:To analyze the relationship between vascular endothelial function indexes and the severity of preeclampsia and its predictive efficacy for abortion.Methods:A total of 114 pregnant women with preeclampsia were selected as the observation group.According to the severity of clinical manifestations,they were divided into mild preeclampsia group and severe preeclampsia group.Normal pregnant women during the same period were selected as the control group.The vascular endothelial function indexes[soluble cellular endothelial factor(sEng),soluble vascular endothelial growth factor receptor(SFLT-1),endothelin-1(ET-1)and vascular endothelial growth factor(VEGF)]of the two groups were detected.The relationship between vascular endothelial function indexes and 24-hour urinary protein level were analyzed.The receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of vascular endothelial function indexes for abortion in pregnant women with preeclampsia.Results:The levels of sEng,SFLT-1 and ET-1 in the observation group were higher than those in the control group,and the level of VEGF was lower than that in the control group(all P<0.05).The serum levels of sEng,SFLT-1 and ET-1 in the severe preeclampsia group were higher than those in the mild preeclampsia group,and the VEGF level was lower than that in the mild preeclampsia group(all P<0.05).The serum levels of sEng,SFLT-1 and ET-1 in the observation group were significantly lower than those at the time of diagnosis,and the level of VEGF was significantly higher than that at the time of diagnosis(all P<0.05).Pearson correlation analysis showed that 24-hour urinary protein level was positively correlated with serum sEng,SFLT-1,ET-1 levels,and negatively correlated with VEGF level(all P<0.05).The incidence of abortion was 8.77%in 114 cases of preeclampsia in the observation group.ROC curve analysis showed that the AUC of serum sEng,SFLT-1,ET-1 combined with VEGF in predicting abortion in preeclampsia pregnant women was 0.943,which was si

关 键 词：子痫前期 可溶性细胞内皮因子 可溶性血管内皮生长因子受体-1 内皮素-1 血管内皮生长因子 流产 预测 

分 类 号：R714.244[医药卫生—妇产科学]