子痫前期患者胎盘组织P57kip2 mRNA水平及与血清sFlt-1、PLGF的关系  

P57kip2 mRNA level in placental tissues of patients with preeclampsia and its relationship with serum sFlt‑1 and PLGF

作　　者：张亚南[1] 胡传兵[2] 阮芳[1] 朱科华 谢宁[1] 朱永宁[1] ZHANG Yanan;HU Chuanbing;RUAN Fang;ZHU Kehua;XIE Ning;ZHU Yongning(Dept.of Obstetrics,Affiliated Hospital of Jining Medical College,Jining 272000,Shandong,China;Dept.of Pediatric Surgery,Affiliated Hospital of Jining Medical College,Jining 272000,Shandong,China)

机构地区：[1]济宁医学院附属医院产科,山东济宁272000 [2]济宁医学院附属医院小儿外科,山东济宁272000

出　　处：《武汉大学学报（医学版）》2024年第8期908-913,共6页Medical Journal of Wuhan University

基　　金：济宁市科技局济宁市重点研发计划项目(编号:2021YXNS114);贺林院士新医学科研基金(批准号:JYHL2021 FMS06)。

摘　　要：目的:分析子痫前期患者胎盘组织P57kip2 mRNA水平及与血清可溶性fms样酪氨酸激酶1(sFlt-1)、胎盘生长因子(PLGF)的关系。方法:选择济宁医学院附属医院2021年1月—2022年4月确诊的剖宫产或自然分娩的子痫前期孕妇80例作为子痫前期(PE)组,选择同期在我院分娩的正常孕妇80例作为对照组。依据临床检查将PE组孕妇分为轻度PE组(n=51例)和重度PE组(n=29例)。采用实时定量逆转录聚合酶链反应法(RT-PCR)测定上述不同分组孕妇胎盘组织中P57kip2 mRNA表达,采用酶联免疫吸附试验测定分娩前孕妇血清sFlt-1、PLGF表达;采用Pearson相关性分析P57kip2 mRNA表达与sFlt-1 mRNA和PLGF mRNA的关系,使用受试者工作特征曲线(ROC)预测P57kip2基因表达、sFlt-1 mRNA和PLGF指导PE诊断和严重程度鉴别的效能。结果:PE组P57kip2 mRNA与sFlt-1均高于对照组,PLGF低于对照组(P<0.05);重度PE组P57kip2 mRNA与sFlt均高于轻PE度组,PLGF低于轻度PE组,差异有统计学意义(P<0.05);Pearson相关性分析结果示,PE患者P57kip2与sFlt-1呈正相关(r=0.478,P<0.05),P57kip2与PLGF呈负相关(r=-0.351,P<0.05);ROC曲线结果示,P57kip2、sFlt-1和PLGF诊断PE及鉴别轻度与重度PE的效能均较好,其中P57kip2的cut-off值分别为1.07、1.47时诊断PE和鉴别轻度与重度PE的效能最高,其曲线下面积(AUC)分别为0.860、0.802,约登指数分别为0.725和0.587,敏感度和特异度分别为86.25%、86.25%和72.41%、86.27%。结论:P57kip2 mRNA水平与PE患者病情严重程度密切相关,其中P57kip2 mRNA与sFlt-1水平呈正相关,P57kip2 mRNA与PLGF水平呈负相关,且三者中以P57kip2 mRNA诊断PE疾病发展效能最高,其能为临床预测PE的发生与进展提供指导。Objective To analyze the P57kip2 mRNA level in placental tissues of patients with preeclampsia and its relationship with serum soluble fms like tyrosine kinase 1(sFlt‑1)and placental growth factor(PLGF).Methods Eighty pregnant women with preeclampsia undergoing cesarean section or natural delivery in the Affiliated Hospital of Jining Medical College between January 2021 and April 2022 were selected as the preeclampsia(PE)group,and 80 normal pregnant women who delivered in the hospital during the same period were enrolled as the control group.According to clinical examination,the pregnant women in the PE group were divided into the mild PE(n=51)and severe PE group(n=29).Real‑time quantitative reverse transcription‑polymerase chain reaction(RT‑PCR)was used to determine the expression of P57kip2 mRNA in placental tissues of pregnant women in different groups,and enzyme‑linked immunosorbent assay was applied to determine the expressions of serum sFlt‑1 and PLGF of pregnant women before delivery.Pearson correlation analysis was adopted to analyze the relationship between P57kip2 mRNA expression and sFlt‑1 mRNA and PLGF mRNA,and receiver operating characteristic(ROC)curve was used to predict the efficiency of P57kip2 gene expression,sFlt‑1 mRNA and PLGF on PE diagnosis and severity identification.Results The P57kip2 mRNA and sFlt‑1 in the PE group were higher than those in the control group while the PLGF was lower than that in the control group(P<0.05).The P57kip2 mRNA and sFlt‑1 were higher in the severe PE group than those in the mild PE group while the PLGF was lower than that in the mild PE group(P<0.05).Pearson correlation analysis showed that P57kip2 in patients with PE was positively correlated with sFlt‑1(r=0.478,P<0.05),and P57kip2 was negatively correlated with PLGF(r=-0.351,P<0.05).ROC curve results showed that P57kip2,sFlt‑1,and PLGF were all effective in diagnosing PE and differentiating mild and severe PE.When the cut‑off values of P57kip2 were 1.07 and 1.47,respectively,the eff

关 键 词：子痫前期 P57kip2基因 可溶性fms样酪氨酸激酶1 胎盘生长因子 

分 类 号：R715.9[医药卫生—妇产科学]