早发型重度子痫前期合并胎儿生长受限患者母血Irisin、Klotho蛋白、Sesn2水平检测及其临床意义  

Detection of maternal blood Irisin,Klotho protein,and Sesn2 levels in patients with early-onset severe preeclampsia complicated with fetal growth restriction and its clinical significance

作　　者：杜德奇[1] 张晓丹[1] 郭莹[1] DU De-qi;ZHANG Xiao-dan;GUO Ying(Department of Obstetrics,Zhengzhou Maternal and Child Health Hospital,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]郑州市妇幼保健院产科,河南郑州450000

出　　处：《海南医学》2024年第23期3425-3429,共5页Hainan Medical Journal

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20210785)。

摘　　要：目的检测早发型重度子痫前期(EOSP)合并胎儿生长受限(FGR)患者母血鸢尾素(Irisin)、Klotho蛋白和应激诱导蛋白2(Sesn2)水平,并分析其临床意义。方法选取2021年1月至2022年12月郑州市妇幼保健院收治的187例EOSP患者进行前瞻性研究,根据是否合并FGR分为FGR组90例和非FGR组97例;FGR组根据新生儿结局分为结局不良组47例和结局良好组43例。采用酶联免疫吸附法(ELISA)检测母血Irisin、Klotho蛋白和Sesn2水平,收集所有患者的临床资料,采用多因素Logistic回归分析EOSP合并FGR的影响因素,采用受试者工作特征(ROC)曲线分析母血Irisin、Klotho蛋白、Sesn2对EOSP合并FGR新生儿结局不良的预测价值。结果FGR组患者的母血Irisin、Klotho蛋白水平分别为(3.64±1.06)mmol/L、(158.37±23.46)pg/mL,明显低于非FGR组的(5.83±1.45)mmol/L、(197.42±33.65)pg/mL,母血Sesn2水平和24 h尿蛋白定量(24 hUPQ)分别为(2.14±0.56)ng/mL、(6.67±2.13)g/24 h,明显高于非FGR组的(1.17±0.32)ng/mL和(4.26±1.78)g/24 h,差异均有统计学意义(P<0.05);多因素Logistics回归分析结果显示,24 hUPQ和Sesn2升高、Irisin和Klotho蛋白降低是EOSP合并FGR的独立危险因素(P<0.05);结局不良组患者的母血Irisin、Klotho蛋白水平分别为(2.98±1.02)mmol/L、(144.68±19.75)pg/mL,明显低于结局良好组的(4.36±1.17)mmol/L、(173.33±25.77)pg/mL,母血Sesn2水平为(2.47±0.63)ng/mL,明显高于结局良好组的(1.78±0.44)ng/mL,差异均有统计学意义(P<0.05);ROC分析曲线结果显示,母血Irisin、Klotho蛋白、Sesn2单独及联合预测EOSP合并FGR患者新生儿结局不良的曲线下面积(AUC)分别为0.813、0.760、0.795、0.935,三项指标联合预测的AUC高于各指标单独预测(P<0.05)。结论EOSP合并FGR患者母血Irisin、Klotho蛋白水平降低,Sesn2水平升高,且均是EOSP合并FGR的独立危险因素。母血Irisin、Klotho蛋白、Sesn2联合检测对EOSP合并FGR患者新生儿结局不良具有较高的预测价值�Objective To detect the maternal blood Irisin,Klotho protein,and Sestrin2(Sesn2)levels in pa-tients with early-onset severe preeclampsia(EOSP)complicated with fetal growth restriction(FGR),and analyze its clini-cal significance.Methods A prospective study was conducted on 187 EOSP patients who were admitted in Zhengzhou Maternal and Child Health Hospital from January 2021 to December 2022,which were divided into FGR group(90 cas-es)and non-FGR group(97 cases)according to whether they were complicated with FGR.The FGR group was divided into poor outcome group(47 cases)and good outcome group(43 cases)according to neonatal outcomes.The maternal blood Irisin,Klotho protein,and Sesn2 levels were detected by enzyme-linked immunosorbent assay(ELISA).The clini-cal data of the patients were collected.The influencing factors of EOSP complicated with FGR were analyzed by multivariate logistic regression.The predictive value of maternal blood Irisin,Klotho protein,and Sesn2 for poor neonatal outcome in pa-tients with EOSP complicated with FGR were analyzed by receiver operating characteristic(ROC)curve.Results The mater-nal blood Irisin and Klotho protein levels in FGR group were(3.64±1.06)mmol/L and(158.37±23.46)pg/mL,respec-tively,which were significantly lower than(5.83±1.45)mmol/L and(197.42±33.65)pg/mL in non-FGR group;the mater-nal blood Sesn2 level was(2.14±0.56)ng/mL,which was significantly higher than(1.17±0.32)ng/mL in non-FGR group,with statistically significant differences(P<0.05).Multivariate logistic regression analysis showed that increased 24-hour urinary protein quantification(24 hUPQ),increased Sesn2,decreased Irisin,and decreased Klotho protein were independent risk factors for EOSP complicated with FGR(P<0.05).The maternal blood Irisin and Klotho protein levels in poor outcome group were(2.98±1.02)mmol/L and(144.68±19.75)pg/mL,respectively,which were significantly low-er than(4.36±1.17)mmol/L and(173.33±25.77)pg/mL in good outcome group;the maternal blood Sesn2 level was(2.47±0.63)ng/mL,which w

关 键 词：早发型重度子痫前期 胎儿生长受限 新生儿结局 鸢尾素 KLOTHO蛋白 Sesn2 

分 类 号：R714.245[医药卫生—妇产科学]