基于血清sTNFR-Ⅱ与血栓弹力图评价子痫前期病情及母儿并发症发生风险  

Evaluation of preeclampsia severity and the risk of maternal and fetal complications based on serum sTNFR-Ⅱand thromboelastography

作　　者：娄娟 顾成敏 李洋 鲁会红 冯敏 Lou Juan;Gu Chengmin;Li Yang;Lu Huihong;Feng Min(Department of Obstetrics,Maternal and Child Care Center of Qinhuangdao,Hebei,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市妇幼保健院产科,河北秦皇岛066000

出　　处：《发育医学电子杂志》2025年第2期120-127,共8页Journal of Developmental Medicine (Electronic Version)

基　　金：科学技术研究与发展计划项目(202301A161)。

摘　　要：目的基于血清可溶性肿瘤坏死因子受体(soluble tumor necrosis factor receptor,sTNFR)-Ⅱ与血栓弹力图(thrombelastography,TEG)评价子痫前期病情及母儿并发症发生风险,为改善子痫前期患者预后提供有利参考。方法采用回顾性研究方法,选取2020年3月至2023年1月秦皇岛市妇幼保健院收治的70例子痫前期孕妇,根据病情程度不同分为非重度子痫前期组(n=38)、重度子痫前期组(n=32),另选取同期70例妊娠晚期妊娠期高血压孕妇为妊娠期高血压组、70例正常妊娠晚期孕妇为正常妊娠组,入组后检测血清sTNFR-Ⅱ水平、TEG参数[血凝块形成速率(rate of hemagglutination formationα,α角)、凝血反应时间(coagulation reaction time,R)、凝血综合指数(coagulation index,CI)、血细胞凝集块形成时间(blood clot formation time,K)、血细胞凝集块、最大振幅(blood clot maximum intensity,MA)],并随访至妊娠终止,监测孕妇病情及围产儿并发症情况。比较4组血清sTNFR-Ⅱ水平及TEG参数,分析其与子痫前期凝血指标的关系,比较不同预后患者血清sTNFR-Ⅱ、TEG参数,分析血清sTNFR-Ⅱ、TEG参数对母儿并发症诊断的影响及其与母儿并发症的关系。统计学方法采用单因素方差分析、t检验、χ^(2)检验,采用Spearman法描述各变量之间的相关性,受试者操作特征(receiver operating characteristic,ROC)曲线分析TEG参数对母儿并发症的诊断价值,采用危险度分析TEG参数与母儿并发症的关系。结果重度子痫前期组的血清sTNFR-Ⅱ、α角、CI、MA均高于非重度子痫前期组、妊娠期高血压组、正常妊娠组,差异有统计学意义(P值均<0.05);重度子痫前期组的R、K均低于非重度子痫前期组、妊娠期高血压组、正常妊娠组,差异有统计学意义(P值均<0.05);血清sTNFR-Ⅱ、TEG参数中α角、CI、MA与子痫前期病情程度呈正相关(r值分别为0.681、0.584、0.734、0.610,P值均<0.05),R、K与子痫前期病情程度�Objective To evaluate the severity of preeclampsia and the risk of maternal and fetal complications based on serum soluble tumor necrosis factor receptor(sTNFR)-Ⅱand thrombelastography(TEG),and provide a favorable reference for improving the prognosis of preeclampsia patients.Method Seventy pregnant women with preeclampsia who were admitted to the Maternal and Child Care Center of Qinhuangdao from March 2020 to January 2023 by retrospective study,which were selected and divided into non-severe preeclampsia group(n=38)and severe preeclampsia group(n=32)based on the severity of their condition.Additionally,70 pregnant women with gestational hypertension in the third trimester(gestational hypertension group)and 70 normal pregnant women in the third trimester(normal pregnancy group)were also selected as controls.After enrollment,serum levels of sTNFR-II were measured,and TEG parameters[rate of hemagglutination formation(αangle),coagulation reaction time(R),coagulation index(CI),blood clot formation time(K),and blood clots maximum amplitude(MA)]were assessed.Follow-up visits were conducted until the end of pregnancy to monitor the condition of the pregnant women and perinatal complications.The serum sTNFR-Ⅱlevels and TEG parameters were compared among the four groups,and the relationship between serum sTNFR-Ⅱ,TEG parameters,and coagulation indicators of preeclampsia was analyzed.The serum sTNFR-Ⅱand TEG parameters were compared among patients with different prognoses,and the impact of serum sTNFR-Ⅱand TEG parameters on the diagnosis of maternal and fetal complications and their relationship with maternal and fetal complications were analyzed.Statistical methods included one-way analysis of variance,t-test,χ^(2)test,and Spearman correlation analysis to describe the correlation between variables.Receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic value of TEG parameters for maternal and fetal complications,and risk degree analysis was conducted to explore the relationship

关 键 词：子痫前期 血清可溶性肿瘤坏死因子受体-Ⅱ 血栓弹力图 并发症 危险度 相关性 预测价值 

分 类 号：R71[医药卫生—妇产科学]