血清Endocan、NT-proBNP联合检测对妊娠合并肺动脉高压的诊断意义  

Diagnostic of combined detection of serum Endocan and NT-proBNP in pregnancy complicated with pulmonary hypertension

作　　者：彭贵鑫 王文丽 PENG Guixin;WANG Wenli(Department of Critical Care Medicine,Changzhou Maternal and Child Health Hospital,Changzhou,Jiangsu 213000,China;Department of Obstetrics,Changzhou Maternal and Child Health Hospital,Changzhou,Jiangsu 213000,China)

机构地区：[1]常州市妇幼保健院重症医学科,江苏常州213000 [2]常州市妇幼保健院产科,江苏常州213000

出　　处：《国际检验医学杂志》2025年第6期748-751,756,共5页International Journal of Laboratory Medicine

基　　金：南京医科大学常州医学中心临床研究项目(CMCC202205);常州市妇幼保健院科研立项项目(YJ202404)。

摘　　要：目的探讨血清内皮特异性分子-1(Endocan)、N末端B型脑钠肽前体(NT-proBNP)水平在妊娠合并肺动脉高压(PH)早期预测及病情评估中的价值。方法选取2021年3月至2024年3月该院的妊娠期间出现呼吸困难、心悸等症状的107例孕妇为受试者,根据心脏超声检查结果是否有PH,将患者分为PPH组(62例)和对照组(45例),收集相关临床资料。PPH组依据妊娠期心脏超声测量的肺动脉压力分为轻度PPH组(35例),中度PPH组(16例)和重度PPH组(11例)。比较各组血清Endocan、NT-proBNP水平及不良事件发生率,采用受试者工作特征(ROC)曲线分析Endocan、NT-proBNP水平对妊娠合并PH的预测价值。结果与对照组比较,轻度PPH组、中度PPH组、重度PPH组Endocan、NT-proBNP水平均升高(P<0.05)。ROC曲线结果显示,当Endocan≥9.07 ng/mL时,预测妊娠合并PH的灵敏度为65.7%,特异度为91.1%;NT-proBNP≥51.90 pg/mL时,预测妊娠合并PH的灵敏度为54.3%,特异度为68.9%;Endocan联合NT-proBNP预测妊娠合并PH的灵敏度为80.0%,特异度为80.0%。重度PPH组心力衰竭、入住重症监护病房、医源性流产及早产的发生率高于轻度PPH组、中度PPH组(P<0.05)。结论血清Endocan、NT-proBNP水平升高与妊娠合并PH的发生有关,检测血清Endocan、NT-proBNP水平可辅助妊娠合并PH的早期预测、病情严重程度的评估。Objective To investigate the value of serum endothelium-specific molecule-1(Endocan)and N-terminal pro-B-type natriuretic peptide(NT-proBNP)levels in early prediction and disease evaluation of pregnancy complicated with pulmonary hypertension(PH).Methods From March 2021 to March 2024,107 pregnant women with dyspnea,palpitation and other symptoms during pregnancy in this hospital were selected as subjects.According to the results of echocardiography,the patients were divided into PPH group(62 cases)and control group(45 cases),and the relevant clinical data were collected.According to the pulmonary artery pressure measured by echocardiography during pregnancy,PPH group was divided into mild PPH group(35 cases),moderate PPH group(16 cases)and severe PPH group(11 cases).The levels of serum Endocan and NT-proBNP and the incidence of adverse events in each group were compared.The predictive value of Endocan and NT-proBNP for pregnancy complicated with PH was analyzed by receiver operating characteristic(ROC)curve.Results Compared with the control group,the mild,moderate and severe PPH groups had significant increases in Endocan and NT-proBNP levels(P<0.05).The ROC curve showed that Endocan≥9.07 ng/mL had a sensitivity of 65.7%and a specificity of 91.1%in predicting pregnancy complicated with PH.When NT-proBNP≥51.90 pg/mL,the sensitivity and specificity of predicting pregnancy complicated with PH were 54.3%and 68.9%,respectively.The sensitivity and specificity of Endocan combined with NT-proBNP in predicting pregnancy complicated with PH were 80.0%and 80.0%,respectively.The incidences of heart failure,intensive care unit admission,iatrogenic abortion and preterm birth were significantly higher in the severe PPH group than in the mild and moderate PPH groups(P<0.05).Conclusion The increase of serum Endocan and NT-proBNP levels is related to the occurrence of pregnancy complicated with PH.The detection of serum Endocan and NT-proBNP levels can assist the early prediction of pregnancy complicated with PH and the evalua

关 键 词：肺动脉高压 妊娠 内皮特异性分子-1 N末端B型脑钠肽前体 

分 类 号：R714.25[医药卫生—妇产科学]