子痫前期患者血清中aD1和aANXA5效价与炎症和凝血指标的相关性  

Serum titers of aD1 and aANXA5 in patients with preeclampsia and their correlation with inflammatory and coagulation indexes

作　　者：刘洪 魏敏 王焱 吴颖 罗彩霞 单燕丽 卡迪丽亚 江雅丽 王晓玉 路宗林 LIU Hong;WEI Min;WANG Yan;WU Ying;LUO Caixia;SHAN Yanli;Kadiliya;JIANG Yali;WANG Xiaoyu;LU Zonglin(Graduate School of Xuzhou Medical University,Xuzhou,Jiangsu 221000,China;Department of Obstetrics and Gynecology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221000,China;Department of Obstetrics,the Firendship Hospital of Ili Kazakh Autonomous Prefecture,Ili,Xinjiang 835000,China;Ili and Jiangsu Joint Institute of Health,Ili,Xinjiang 835000,China)

机构地区：[1]徐州医科大学研究生院,江苏徐州221000 [2]徐州医科大学附属医院妇产科,江苏徐州221000 [3]伊犁哈萨克自治州友谊医院产科,新疆伊犁835000 [4]伊犁哈萨克自治州临床医学研究院,新疆伊犁835000

出　　处：《国际检验医学杂志》2023年第15期1877-1882,共6页International Journal of Laboratory Medicine

基　　金：新疆维吾尔自治区伊犁哈萨克自治州临床医学研究院江苏联合项目(YL2020LH07);伊犁哈萨克自治州科技计划项目(YZ2021YD008)。

摘　　要：目的检测非传统型抗磷脂抗体中抗β2-糖蛋白1-D1抗体(aD1)和抗膜联蛋白A5抗体(aANXA5)在子痫前期患者血清中的表达情况,分析其与炎症及凝血功能相关指标的相关性。方法选取2021年1月至2022年1月于徐州医科大学附属医院妇产科收治的子痫前期重度患者50例(子痫前期重度组)和子痫前期非重度患者50例(子痫前期非重度组)共100例子痫前期患者(子痫前期组)为研究对象。另同期选取在该院产检正常的孕妇50例作为正常对照组。检测各组白细胞计数(WBC)、中性粒细胞计数(NC)、淋巴细胞计数(LY)、C反应蛋白(CRP)、血小板计数(PLT)及凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、D-二聚体(D-D),同时采用化学发光免疫分析法检测aD1效价,用酶联免疫吸附试验法检测aANXA5效价,分析aD1和aANXA5效价与炎症及凝血指标的相关性。结果子痫前期重度组血清中aANXA5效价均较子痫前期非重度组及正常对照组升高,差异均有统计学意义(P<0.05)。相关性分析结果显示,子痫前期患者血清aD1效价与D-D呈正相关(P<0.05),与APTT、TT呈负相关(P<0.05);子痫前期患者血清aANXA5效价与WBC、NC、LY、CRP、TT、FIB、D-D呈正相关(P<0.05),与PLT、PT、APTT呈负相关(P<0.05)。对影响子痫前期重度的多因素Logistic回归分析结果显示,aANXA5效价、CRP、APTT、FIB为子痫前期重度的独立影响因素。Logistic回归模型对发生预测价值的初步评价结果显示,受试者工作特征曲线下面积为0.919(P<0.001)。结论子痫前期孕妇血清中aANXA5效价与炎症和凝血功能相关指标密切相关,其可能通过加重孕妇血液内炎症反应及血栓前状态促进子痫前期的发生发展。Objective To detect the titers of non-traditional antiphospholipid antibodies including domain 1 of anti-beta2-glycoproteinⅠ(aD1)and anti-annexin A5 antibodies(aANXA5)in serum of patients with preeclampsia,and to analyze the correlation of their relationship with inflammation and coagulation indexes.Methods A total of 100 patients with preeclampsia(preeclampsia group)were selected from the Obstetrics and Gynecology Department of the Affiliated Hospital of Xuzhou Medical University from January 2021 to January 2022,including 50 patients with severe preeclampsia(severe preeclampsia group)and 50 patients with non-severe preeclampsia(non-severe preeclampsia group).In the same period,50 pregnant women with normal birth examination in a hospital were selected as normal control group.Detection of white blood cell count(WBC),neutrophil count(NC),lymphocyte count(LY),C-reactive protein(CRP),platelet count(PLT),prothrombin time(PT),activated partial coagulation activity Enzyme time(APTT),thrombin time(TT),fibrinogen(FIB),D-Dimer(D-D)was performed.Furthermore,chemiluminescence analysis(CLIA)was used to detect aD1 titer and enzyme-linked immununosorbent assay was used to detect aANXA5 titer of each group.The correlation between titers of aD1 and aANXA5 and inflammatory and coagulation indexes was analyzed.Results The titer of aANXA5 in serum of severe preeclampsia group was higher than that of non-severe preeclampsia group and normal control group,the differences were statistically significant(P<0.05).The results of correlation analysis showed that aD1 titer in preeclampsia patients was positively correlated with D-D(P<0.05),negatively correlated with APTT and TT(P<0.05);aANXA5 titer in preeclampsia patients was positively correlated with WBC,NC,LY,CRP,TT,FIB,D-D(P<0.05),was negatively correlated with PLT,PT and APTT(P<0.05).Multivariate Logistic stepwise regression analysis revealed that the levels of aANXA5 titer was an independent influencing factor of severe preeclampsia.The preliminary evaluation of the value of Logis

关 键 词：抗β2-糖蛋白1-D1抗体 抗膜联蛋白A5抗体 子痫前期 炎症 凝血 

分 类 号：R714.244[医药卫生—妇产科学]