母体血清GDF-15、ANGPTL8对胎儿先天性心脏病产前诊断的临床意义  

Clinical significance maternal serum GDF-15 and ANGPTL8 for prenatal diagnosis of fetal congenital heart disease

作　　者：宋筱玉[1] 颉丽[1] 唐中锋 葛婷婷[1] 林晓娟[1] Song Xiaoyu;Jie Li;Tang Zhongfeng;Ge Tingting;Lin Xiaojuan(Prenatal Diagnosis Center,Gansu Maternal and Child Health Hospital,Gansu Province,Lanzhou 730050,China)

机构地区：[1]甘肃省妇幼保健院产前诊断中心,兰州730050

出　　处：《疑难病杂志》2024年第8期967-970,975,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：甘肃省自然科学基金(22JR5RA726)。

摘　　要：目的探讨血清生长分化因子-15(GDF-15)、血管生成素样蛋白8(ANGPTL8)在先天性心脏病(CHD)胎儿母体中的表达及其诊断胎儿CHD的价值。方法收集2020年1月—2023年3月甘肃省妇幼保健院产前诊断中心产前筛查疑似胎儿CHD的120例孕妇作为研究对象,根据产前彩色多普勒超声心动图诊断结果分为CHD组(n=86)和非CHD组(n=34)。比较2组血清GDF-15、ANGPTL8水平;多因素Logistic回归分析胎儿CHD发病的影响因素;ROC曲线分析血清GDF-15、ANGPTL8对胎儿CHD的诊断效能。结果与非CHD组比较,CHD组血清GDF-15、ANGPTL8水平显著升高(t/P=7.860/<0.001、7.334/<0.001);多因素Logistic回归分析结果显示,孕次≥3次、CHD家族史及血清GDF-15、ANGPTL8升高均是胎儿CHD发病的危险因素[OR(95%CI)=1.383(1.082~1.767),1.596(1.148~2.218),3.596(1.694~7.633),3.175(1.571~6.417)];血清GDF-15、ANGPTL8及二者联合预测胎儿CHD的AUC分别为0.805、0.835、0.903,二者联合诊断胎儿CHD优于血清GDF-15、ANGPTL8各自单独诊断(Z=2.052、2.219,P=0.040、0.027)。结论CHD胎儿的母体血清GDF-15、ANGPTL8水平显著升高,二者联合对胎儿CHD具有较高的辅助诊断潜能。Objective To investigate the expression of serum growth differentiation factor-15(GDF-15)and angiopoietin-like protein 8(ANGPTL8)in the mother with fetal congenital heart disease(CHD),and the value of them combined in the diagnosis of fetal CHD.Methods A total of 120 pregnant women suspected of fetal CHD who underwent prenatal screening in our hospital from January 2020 to March 2023 were collected as research subjects.They were separated into CHD group(n=86)and non-CHD group(n=34)based on the results of Color Doppler echocardiography.The expression levels of serum GDF-15 and ANGPTL8 were compared between the two groups;Multivariate Logistic regression was used to analyze the influencing factors of fetal CHD;ROC curve was applied to analyze the diagnostic efficacy of serum GDF-15 and ANGPTL8 in fetal CHD.Results Compared with the non CHD group,the serum levels of GDF-15 and ANGPTL8 in the CHD group were obviously increased(t/P=7.860/<0.001,7.334/<0.001).Multivariate Logistic regression analysis showed that gravidity,family history of CHD,GDF-15 and ANGPTL8 were the influencing factors of fetal CHD[OR(95%CI)=1.383(1.082-1.767),1.596(1.148-2.218),3.596(1.694-7.633),3.175(1.571-6.417)].The AUC of serum GDF-15,ANGPTL8 and their combination in the diagnosis of fetal CHD was 0.805,0.835 and 0.903,the combination of serum GDF-15 and ANGPTL8 in the diagnosis of fetal CHD was better than GDF-15.ANGPTL8 was independently predicted(Z=2.052,2.219,P=0.040,0.027).Conclusion The maternal serum GDF-15 and ANGPTL8 levels in fetal CHD are obviously elevated.Color Doppler echocardiography combined with maternal serum GDF-15 and ANGPTL8 has high diagnostic potential for fetal CHD.

关 键 词：胎儿先天性心脏病 生长分化因子-15 血管生成素样蛋白8 产前诊断 

分 类 号：R714.53[医药卫生—妇产科学]