血清SESN2、HO-1和sCD163对妊娠期高血压疾病孕妇发生胎儿宫内缺氧的预测价值  

Predictive value of serum SESN2,HO-1 and sCD163 in fetal intrauterine hypoxiaoccurrence in pregnant women with hypertensive disorder complicating pregnancy

作　　者：车磊 施莉雯 CHE Lei;SHI Liwen(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24期3676-3680,3684,共6页Laboratory Medicine and Clinic

摘　　要：目的 观察血清Sestrin 2(SESN2)、血红素氧化酶1(HO-1)和可溶性血红蛋白清道夫受体(sCD163)水平对妊娠期高血压疾病(HDCP)孕妇发生胎儿宫内缺氧的预测价值。方法 选择2021年1月至2022年12月在该院诊治的HDCP孕妇230例为HDCP组,选择同期在该院产检的正常妊娠孕妇75例为正常妊娠组。观察两组血清SESN2、HO-1和sCD163水平的变化,比较不同严重程度的HDCP孕妇各指标水平,根据是否发生胎儿宫内缺氧分为宫内缺氧组和无宫内缺氧组,分析HDCP孕妇发生胎儿宫内缺氧的影响因素,以及血清SESN2、HO-1和sCD163水平对HDCP孕妇发生胎儿宫内缺氧的预测效能。结果 HDCP组血清SESN2和sCD163水平明显高于正常妊娠组(P<0.01),血清HO-1水平明显低于正常妊娠组(P<0.01)。重度子痫前期组血清SESN2和sCD163水平明显高于妊娠高血压组和轻度子痫前期组(P<0.01),血清HO-1水平明显低于妊娠高血压组和轻度子痫前期组(P<0.01);轻度子痫前期组血清SESN2和sCD163水平明显高于妊娠高血压组(P<0.01),血清HO-1水平明显低于妊娠高血压组(P<0.01)。宫内缺氧组血清D-二聚体、纤维蛋白原(FIB)、SESN2和sCD163水平明显高于无宫内缺氧组(P<0.01),而宫内缺氧组的凝血酶原时间及HO-1水平明显低于无宫内缺氧组(P<0.01)。多因素Logistic回归分析显示,D-二聚体、FIB、SESN2和sCD163水平升高均是HDCP孕妇发生胎儿宫内缺氧的危险因素(P<0.05),凝血酶原时间及HO-1水平升高是HDCP孕妇发生宫内缺氧的保护因素(P<0.05)。血清SESN2、HO-1、sCD163单项及联合检测预测HDCP孕妇发生胎儿宫内缺氧的AUC分别为0.823(95%CI:0.768~0.870)、0.868(95%CI:0.817~0.909)、0.848(95%CI:0.795~0.892)、0.960(95%CI:0.926~0.981),联合检测的AUC明显大于SESN2(Z=4.665,P<0.001)、HO-1(Z=4.876,P<0.001)和sCD163(Z=4.228,P<0.001)单项检测。结论 SESN2、HO-1和sCD163参与了HDCP的发生、发展过程,与HDCP严重程度具有密切关系,3项指标联�Objective To observe the predictive value of serum Sestrin 2(SESN2),heme oxygenase-1(HO-1)and soluble hemoglobin scavenger receptor(sCD163)levels for fetal intrauterine hypoxia occurrence in pregnant women with hypertensive disorder complicating pregnancy(HDCP).Methods A total of 230 pregnant women with HDCP diagnosed and treated in this hospital from January 2021 to December 2022 were selected as the HDCP group.Seventy-five normal pregnant women with prenatal examination in this hospital at the same time were selected as the normal pregnancy group.The changes of serum SESN2,HO-1 and sCD163 levels were observed in the two groups,the levels of various indicators were compared among the pregnant women with different degrees of HDCP severity,and they were divide into the intrauterine hypoxia group and non-intrauterine hypoxia group according to whether fetal intrauterine hypoxia occurring.The factors affecting fetal intrauterine hypoxia were analyzed,and the predictive efficiency of serum SESN2,HO-1 and sCD163 levels on the fetal intrauterine hypoxia occurrence in pregnant women with HDCP was analyzed.Results The serum SESN2 and sCD163 levels in the HDCP group were significantly higher than those in the normal pregnancy group(P<0.01),while the serum HO-1 level was significantly lower than that in the normal pregnancy group(P<0.01).The serum SESN2 and sCD163 levels in the severe preeclampsia group were significantly higher than those in the gestational hypertension group and mild preeclampsia group(P<0.01),while the serum HO-1 level was significantly lower than that in the gestational hypertension hypertension group and mild preeclampsia group(P<0.01);the serum SESN2 and sCD163 levels in the mild preeclampsia group were significantly higher than those in the gestational hypertension group(P<0.01),while the serum levels of HO-1 were significantly lower than those in the gestational hypertension group(P<0.01).The levels of serum D-dimer,fibrinogen(FIB),SESN2 and sCD163 in the intrauterine hypoxia group were significant

关 键 词：Sestrin 2 血红素氧化酶1 可溶性血红蛋白清道夫受体 妊娠期高血压疾病 宫内缺氧 

分 类 号：R714.2[医药卫生—妇产科学]