血清基质金属蛋白酶-3和胱抑素C水平对早发型子痫前期患者妊娠结局的预测价值  

Relationship between serum matrix metalloproteinase-3 and cystatin C levels and pregnancy outcome in pregnant women with early-onset preeclampsia

作　　者：王倩 杜丹丽[1] WANG Qian;DU Danli(Department of Obstetrics,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,Anhui Province,China)

机构地区：[1]蚌埠医学院第一附属医院妇产科,安徽蚌埠233000

出　　处：《新乡医学院学报》2023年第12期1121-1125,共5页Journal of Xinxiang Medical University

基　　金：安徽省重点研究与开发计划项目(编号:S202204295107020115)。

摘　　要：目的探讨早发型子痫前期患者血清基质金属蛋白酶-3(MMP-3)和胱抑素C(Cys C)水平及二者联合对早发型子痫前期不良妊娠结局的预测价值。方法选择2021年11月至2022年8月蚌埠医学院第一附属医院产科收治的早发型子痫前期患者31例为早发型子痫前期组,并选择同时期来本院产科门诊产检的44例正常妊娠孕妇为正常妊娠组。根据妊娠结局是否伴有新生儿Apgar评分≤7分、胎儿宫内窘迫、胎儿生长受限、子痫发作、胎盘早剥等情况将早发型子痫前期组患者分为妊娠结局良好组(n=13)和妊娠结局不良组(n=18)。采用酶联免疫吸附法检测早发型子痫前期组和正常妊娠组孕妇血清MMP-3和Cys C水平,分析血清MMP-3和Cys C水平与早发型子痫前期及其妊娠结局的关系。采用受试者操作特征(ROC)曲线评估血清MMP-3、Cys C水平及二者联合对早发型子痫前期患者不良妊娠结局的预测价值。结果早发型子痫前期组患者血清MMP-3和Cys C水平均高于正常妊娠组(P<0.05)。妊娠结局不良组患者血清MMP-3和Cys C水平均高于妊娠结局良好组(P<0.05)。ROC曲线显示,血清MMP-3预测早发型子痫前期患者发生不良妊娠结局的曲线下面积(AUC)、灵敏度、特异度和约登指数分别为0.885、83.3%、84.6%、0.679,血清Cys C预测早发型子痫前期患者发生不良妊娠结局的AUC、灵敏度、特异度和约登指数分别为0.859、83.3%、76.9%、0.603,二者联合检测预测早发型子痫前期患者发生不良妊娠结局的AUC、灵敏度、特异度、约登指数分别为0.923、72.2%、100%、0.722。结论早发型子痫前期患者血清中MMP-3、Cys C水平呈高表达,血清MMP-3、Cys C水平与早发型子痫前期患者的妊娠结局有关,二者联合检测对早发型子痫前期患者不良妊娠结局有一定的预测效能。Objective To investigate the predictive value of serum matrix metalloproteinase-3(MMP-3)and cystatin C(Cys C)levels and their combination for adverse pregnancy outcomes in patients with early-onset preeclampsia.Methods Thirty-one patients with early-onset preeclampsia admitted to the Department of Obstetrics in the First Affiliated Hospital of Bengbu Medical College from November 2021 to August 2022 were selected as the early-onset preeclampsia group,and 44 pregnant women with normal pregnancies who came to our hospital for labor and delivery during the same period were selected as the normal pregnancy group.Patients in the early-onset preeclampsia group were categorized into good pregnancy outcome group(n=13)and poor pregnancy outcome group(n=18)based on whether the pregnancy outcome was accompanied by a neonatal Apgar score of≤7,intrauterine distress,fetal growth restriction,eclampsia seizures,and placental abruption.The levels of serum MMP-3 and cystatin C were detected by enzyme linked immunosorbent assay.The relationship between serum MMP-3,Cys C level and early-onset preeclampsia and pregnancy outcome were analyzed.The value of seurm MMP-3,cystatin C level and their combination in predicting adverse pregnancy outcomes in patients with early-onset preeclampsia were evaluated by using receiver operating characteristic.Results The levels of serum MMP3 and Cys C in the early-onset preeclampsia group were higher than those in the normal pregnancy group(P<0.05).The levels of serum MMP-3 and Cys C in the poor pregnancy outcome group were higher than those in the good pregnancy outcome group(P<0.05).The area unde the curve(AUC),sensitivity,specificity,Youden index of serum MMP-3 in predicting adverse pregnancy outcome in patients with early-onset preeclampsia were 0.885,83.3%,84.6%,0.679,respectively.The AUC,sensitivity,specificity,Youden index of serum Cys C in predicting adverse pregnancy outcome in patients with early-onset preeclampsia were 0.859,83.3%,76.9%,0.603,respectively.The AUC,sensitivity,specificity,

关 键 词：早发型子痫前期 基质金属蛋白酶3 胱抑素C 妊娠结局 预测价值 

分 类 号：R714.25[医药卫生—妇产科学]