妊娠期高血压疾病患者血清TMAO、Endocan与心功能和妊娠结局的关系  

Relationship between serum TMAO,Endocan and cardiac function and pregnancy outcome in patients with hypertensive disorders of pregnancy

作　　者：张星星 陶喜敬 刘彩红 李肖 吴盼盼 韩翠娥 ZHANG Xingxing;TAO Xijing;LIU Caihong;LI Xiao;WU Panpan;HAN Cuier(Department of Obstetrics,Handan Maternal and Child Health Hospital,Handan,Hebei 056000,China;Department of Obstetrics,Handan Central Hospital,Handan,Hebei 056000,China;Department of Obstetrics and Gynecology,Gaocheng People′s Hospital of Shijiazhuang,Shijiazhuang,Hebei 052160,China;Department of Obstetrics and Gynecology,Baoding Maternal and Child Health Hospital,Baoding,Hebei 071000,China)

机构地区：[1]邯郸市妇幼保健院产科,河北邯郸056000 [2]邯郸市中心医院产科,河北邯郸056000 [3]石家庄市藁城人民医院妇产科,河北石家庄052160 [4]保定市妇幼保健院妇产科,河北保定071000

出　　处：《国际检验医学杂志》2025年第1期75-80,共6页International Journal of Laboratory Medicine

基　　金：河北省2024年度医学科学研究课题(20241421)。

摘　　要：目的探讨妊娠期高血压疾病(HDP)患者血清氧化三甲胺(TMAO)、内皮细胞特异性分子1(Endocan)与心功能和妊娠结局的关系。方法选取2021年1月至2023年6月邯郸市妇幼保健院收治的HDP患者182例(HDP组)和同时间段于该院产检的98例健康孕妇(对照组),对比两组血清TMAO、Endocan及左室心功能指标[左心室射血分数(LVEF)、左心室舒张末容积(LVEDV)、左心室收缩末期容积(LVESV)]水平。根据妊娠结局将HDP患者分为不良结局组(78例)和良好结局组(104例)。通过Spearman相关性分析血清TMAO、Endocan与HDP患者心功能指标的相关性,采用多因素Logistic回归分析HDP患者不良妊娠结局的影响因素,采用受试者工作特征(ROC)曲线分析血清TMAO、Endocan对HDP患者不良妊娠结局的预测价值。结果与对照组比较,HDP组血清TMAO、Endocan和LVEDV、LVESV升高(P<0.05),LVEF降低(P<0.05)。HDP患者血清TMAO、Endocan与LVEF呈负相关(P<0.05),与LVEDV、LVESV呈正相关(P<0.05)。182例HDP患者不良妊娠结局发生率为42.86%(78/182)。子痫前期(PE)、重度子痫前期(SPE)、24 h尿蛋白升高、LVEDV增加、LVESV增加、TMAO升高、Endocan升高为HDP患者不良妊娠结局的独立危险因素(P<0.05),LVEF增加为保护因素(P<0.05)。血清TMAO联合Endocan预测HDP患者不良妊娠结局的曲线下面积为0.880,大于血清TMAO、Endocan单独预测的0.793、0.788。结论HDP患者血清TMAO、Endocan水平升高,与心功能降低和不良妊娠结局有关,二者联合检测对HDP患者不良妊娠结局有较高的预测价值。Objective To investigate the relationship between serum trimethylamine oxide(TMAO),endothelial cell specific molecule 1(Endocan)and cardiac function and pregnancy outcome in patients with hypertensive disorders of pregnancy(HDP).Methods A total of 182 patients with HDP admitted to Handan Maternal and Child Health Hospital from January 2021 to June 2023(HDP group)and 98 healthy pregnant women admitted to this hospital during the same period(control group)were selected as research subjects.Serum TMAO,Endocan and left ventricular cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume(LVEDV)and left ventricular end-systolic volume(LVESV)]were compared between the two groups.According to pregnancy outcome,HDP patients were divided into poor outcome group(78 cases)and good outcome group(104 cases).Spearman correlation analysis was used to analyze the correlation between serum TMAO and Endocan and cardiac function indexes in HDP patients,and multi-factor Logistic regression was used to analyze the influencing factors of adverse pregnancy outcomes in HDP patients.The predictive value of serum TMAO and Endocan for adverse pregnancy outcomes in HDP patients was analyzed by receiver operating characteristic(ROC)curve.Results Compared with control group,serum TMAO,Endocan,LVEDV and LVESV were increased in HDP group,and LVEF was decreased(P<0.05).Serum TMAO and Endocan in HDP patients were negatively correlated with LVEF(P<0.05),and positively correlated with LVEDV and LVESV(P<0.05).The incidence of adverse pregnancy outcomes in 182 HDP patients was 42.86%(78/182).Preeclampsia(PE),severe preeclampsia(SPE),24 h urine protein increase,LVEDV increase,LVESV increase,TMAO increase,Endocan increase were independent risk factors for adverse pregnancy outcomes in HDP patients,and LVEF increase was protective factor(P<0.05).The area under the curve of serum TMAO combined with Endocan in predicting adverse pregnancy outcomes in HDP patients was 0.880,which was greater than 0.793 and 0.78

关 键 词：妊娠期高血压疾病 氧化三甲胺 内皮细胞特异性分子1 心功能 妊娠结局 

分 类 号：R714.246[医药卫生—妇产科学] R446.1[医药卫生—临床医学]