血清胎盘生长因子及胎盘蛋白13表达与早发型子痫前期患者胎盘早剥的关系  

Relationship of the expression of serum placental growth factors and placental protein 13 with placental abruption in patients with early-onset preeclampsia

作　　者：周晓丽 刘光虹 张丽丽 ZHOU Xiaoli;LIU Guanghong;ZHANG Lili(Department of Obstetrics,People′s Hospital of Zhengzhou,Zhengzhou 450000,Henan Province,China)

机构地区：[1]不详

出　　处：《新乡医学院学报》2025年第5期415-419,425,共6页Journal of Xinxiang Medical University

摘　　要：目的 探讨血清胎盘生长因子(PLGF)、胎盘蛋白13(PP13)表达与早发型子痫前期患者胎盘早剥的关系。方法 选择郑州人民医院产科2020年1月至2023年3月收治的146例早发型子痫前期患者为研究对象。根据是否发生胎盘早剥将患者分为发生组(n=16)和未发生组(n=130)。通过查阅电子病历系统收集患者的年龄、确诊早发型子痫前期孕周、孕次、产次、孕前3个月月经周期、确诊时血压水平、胎盘早剥史、确诊时血小板计数(PLT)及白蛋白(ALB)、D-二聚体(DD)、纤维蛋白原(FIB)、24 h尿蛋白定量、PLGF、PP13水平等临床资料。比较2组患者的临床资料初步筛选早发型子痫前期患者发生胎盘早剥的影响因素,将临床资料比较中差异有统计学意义的指标进一步行logistic回归分析早发型子痫前期患者发生胎盘早剥的影响因素,通过交互作用分析血清PLGF、PP13对早发型子痫前期患者胎盘早剥发生的交互作用,绘制受试者操作特征(ROC)曲线并构建决策曲线,评估血清PLGF、PP13对早发型子痫前期患者胎盘早剥发生风险的预测价值。结果 发生组患者确诊时血清DD水平显著高于未发生组,PLGF、PP13、ALB水平显著低于未发生组(P<0.05);2组患者其他临床资料比较差异均无统计学意义(P>0.05)。Logistic回归分析结果显示,血清PLGF、PP13异常低表达可能是早发型子痫前期患者胎盘早剥发生的危险因素(P<0.05)。血清PLGF、PP13水平与早发型子痫前期患者胎盘早剥存在正向交互作用,二者均低表达时胎盘早剥发生风险是二者高表达时的20.462倍,协同效应为二者单独存在产生效应之和的22.937倍(交互作用指数绝对值=22.937)。ROC曲线结果显示,血清PLGF、PP13单独及联合预测早发型子痫前期患者胎盘早剥风险的曲线下面积为0.807、0.808、0.870,均有一定预测价值。决策曲线结果显示,当阈值为0.1~0.5时,血清PLGF、PP13联合预测早发型�Objective To explore the relationship of the expression of serum placental growth factors(PLGFs)and placental protein 13(PP13)with placental abruption in patients with early-onset preeclampsia.Methods A total of 146 patients with early-onset preeclampsia admitted to the Department of Obstetrics,People′s Hospital of Zhengzhou from January 2020 to March 2023 were included,and were divided into an occurrence group(n=16)and a non-occurrence group(n=130)according to whether placental abruption occurred.The following data of patients were collected from electronic medical records:age,gestational weeks at diagnosis,gravidity,parity,menstrual cycle 3 months before pregnancy,blood pressure level at diagnosis,history of placental abruption,platelet count(PLT)at diagnosis,albumin(ALB),D-dimer(DD),fibrinogen(FIB),24-hour urine protein,PLGF and PP13 levels.The clinical data were compared between the two groups of patients to screen influencing factors of placental abruption in patients with early-onset preeclampsia.Indexes with statistically significant differences were subject to logistic regression for the analysis of influencing factors of placental abruption in patients with early-onset preeclampsia.The relationships of serum PLGF and PP13 levels with placental abruption in patients with early-onset preeclampsia were analyzed.The receiver operator characteristic(ROC)and decision curves were drawn to assess the value of serum PLGF and PP13 levels in predicting the risk of placental abruption in patients with early-onset preeclampsia.Results The occurrence group had higher serum DD levels at diagnosis and lower PLGF,PP13 and ALB levels than the non-occurrence group(P<0.05).There was no statistical significance in other data between the two groups(P>0.05).The logistic regression analysis showed that abnormally low expression levels of serum PLGF and PP13 might be risk factors of placental abruption in early-onset preeclampsia patients(P<0.05).There was a positive interaction between serum levels of PLGF and PP13 and placen

关 键 词：早发型子痫前期 胎盘早剥 胎盘生长因子 胎盘蛋白13 交互作用 

分 类 号：R714.244[医药卫生—妇产科学]