孕妇血浆总循环游离DNA与子痫前期的相关性研究  

Correlation between plasma total free circulating DNA and preeclampsia in pregnant women

作　　者：曾敏[1] 李军英[1] 李小玉 徐敏娟[1] 庞秀贤 ZENG Min;LI Junying;LI Xiaoyu;XU Minjuan;PANG Xiuxian(Department of Obstetrics,Ganzhou People's Hospital,Ganzhou,Jiangxi,341000,China;Department of Clinical Laboratory,Ganzhou People's Hospital,Ganzhou,Jiangxi,341000,China)

机构地区：[1]赣州市人民医院产科,江西赣州341000 [2]赣州市人民医院检验科,江西赣州341000

出　　处：《当代医学》2024年第34期37-41,共5页Contemporary Medicine

基　　金：江西省卫生健康委科技计划项目(20217341)。

摘　　要：目的分析孕妇血浆总循环游离DNA(circulating free DNA,cfDNA)与子痫前期(preeclampsia,PE)的相关性。方法选取2021年11月至2022年9月于赣州市人民医院产检的30例PE单胎妊娠孕妇作为研究组,根据PE的发生时间再分为早发型PE(early onset PE,EOPE)组(n=7)与晚发型PE(late onset PE,LOPE)组(n=23);另选取同期30名健康孕妇作为参照组。比较研究组与参照组、EOPE组与LOPE组不同孕龄可溶性血管内皮生长因子受体1(soluble vascular endothelial growth factor receptor-1,sFlt-1)、胎盘生长因子(placental growth factor,PLGF)、总循环游离DNA(circulating free DNA,cfDNA)水平和sFlt-1/PLGF,采用Spearman相关性分析sFlt-1/PLGF、cfDNA水平与PE严重程度的相关性,并绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析sFlt-1/PLGF、cfDNA对PE的预测价值。结果孕15~19、24~28、32~40周,研究组sFlt-1、cfDNA水平及sFlt-1/PLGF均高于参照组,PLGF水平低于参照组,差异有统计学意义(P<0.05);孕15~19、24~28、32~40周,EOPE组sFlt-1、cfDNA水平及sFlt-1/PLGF均高于LOPE组,PLGF水平低于LOPE组,差异有统计学意义(P<0.05);Spearman相关性分析结果显示,cfDNA、sFlt-1/PLGF与PE的严重程度呈正相关(r>0,P<0.05);ROC曲线分析结果显示,cfDNA预测PE的曲线下面积为0.79(95%CI:0.72~0.87),大于sFlt-1/PLGF的0.61(95%CI:0.46~0.66),差异有统计学意义(P<0.05)。结论cfDNA水平与PE的严重程度呈正相关,可作为预测PE发生的相关指标。Objective To explore and analyze the correlation between plasma circulating free DNA(cfDNA)and preeclampsia(PE)in pregnant women.Methods 30 PE singleton pregnant women who underwent prenatal examination in Ganzhou People's Hospital from November 2021 to September 2022 were selected as the study group,and they were divided into the early onset PE(EOPE)group(n=7)and the late onset PE(LOPE)group(n=23)according to the occurrence time of PE;another 30 healthy pregnant women in the same period were selected as the reference group.The levels of soluble vascular endothelial growth factor receptor-1(sFlt-1),placental growth factor(PLGF),cfDNA and sFlt-1/PLGF were compared between the study group and the reference group,the EOPE group and the LOPE group at different gestating weeks,and Spearman correlation coefficient was used to analyze the correlation between sFlt-1/PLGF and cfDNA levels and PE severity,and receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of sFlt-1/PLGF,cfDNA on PE.Results At 15-19,24-28,and 32-40 weeks of pregnancy,the sFlt-1,cfDNA levels and sFlt-1/PLGF in the study group were higher than those in the reference group,while the PLGF level was lower than that in the reference group,the differences were statistically significant(P<0.05);at 15-19,24-28,and 32-40 weeks of pregnancy,the sFlt-1,cfDNA levels and sFlt-1/PLGF in the EOPE group were higher than those in the LOPE group,while the PLGF level was lower than that in the LOPE group,the differences were statistically significant(P<0.05);Spearman correlation analysis showed that cfDNA,sFlt-1/PLGF were positively correlated with the severity PE(r>0,P<0.05);ROC curve analysis results showed that the area under the curve predicted by cfDNA was 0.79(95%CI:0.72-0.87),which was greater than 0.61(95%CI:0.46-0.66)of sFlt-1/PLGF,and the difference was statistically significant(P<0.05).Conclusion The level of cfDNA is positively correlated with the severity of PE,which can be used as a related index to predict the occurrence of

关 键 词：血浆总循环游离DNA 子痫前期 相关性 

分 类 号：R71[医药卫生—妇产科学]