妊娠高血压疾病患者血清nesfatin-1、betatrophin水平变化及临床意义

Changes and clinical significance of serum nesfatin-1 and betatrophin levels in patients with hypertensive disorders complicating pregnancy

目的分析妊娠高血压疾病(HDCP)患者血清人新饱食分子蛋白1(nesfatin-1)、betatrophin水平变化及临床意义。方法选取2020年1月至2021年9月在青岛市妇女儿童医院产检的具有HDCP高危因素的孕妇153例,随访至妊娠结局,统计随访结果。比较是否发生HDCP的孕妇相关资料,分析孕妇发生HDCP的影响因素。分析血清nesfatin-1、betatrophin对孕妇发生HDCP的交互作用,构建血清nesfatin-1、betatrophin预测孕妇发生HDCP的模型并进行评价,构建列线图预测模型并以校准曲线验证。结果153例孕妇失访1例,其余152例孕妇中发生HDCP发生率为24.34%(37/152);年龄、孕妇子痫前期史、合并慢性肾炎、nesfatin-1及betatrophin水平升高是孕妇发生HDCP的独立危险因素(P<0.05);采用校准曲线验证列线图预测模型,一致性指数为0.871,精准度、区分度较好。结论HDCP患者血清nesfatin-1、betatrophin呈高水平表达,二者对HDCP发生存在协同作用,二者同时高水平表达表明HDCP发生风险较高,可作为临床早期识别指标,有助于指导临床制定干预措施。

Objective To analyze the changes and clinical significance of serum human neo-satiety protein 1(nesfatin-1)and betatrophin levels in patients with hypertensive disorders complicating pregnancy(HDCP).Methods A total of 153 pregnant women with high risk factors for HDCP who underwent obstetric examination in Qingdao Women’s and Children’s Hospital from January 2020 to September 2021 were selected.All were followed up to pregnancy outcome,and the follow-up results were counted.The related data of pregnant women with or without HDCP were compared,and the influencing factors of HDCP in pregnant women were analyzed.The interaction of serum nesfatin-1 and betatrophin on the occurrence of HDCP in pregnant women was analyzed,and a model of serum nesfatin-1 and betatrophin for predicting HDCP in pregnant women was constructed and evaluated.A nomogram prediction model was constructed and verified by calibration curve.Results One of the 153 pregnant women was lost to follow-up,and the incidence of HDCP in the remaining 152 pregnant women was 24.34%(37/152).Age,history of preeclampsia,chronic nephritis,elevated levels of nesfatin-1 and betatrophin were independent risk factors for HDCP in pregnant women(P<0.05).The Hosmer-Lemeshow goodness-of-fit test showed that the fitting effect was good.The calibration curve was used to verify the nomogram prediction model,the consistency index was 0.871,and the accuracy and discrimination were good.Conclusion Serum nesfatin-1 and betatrophin express high in HDCP patients,and the two have a synergistic effect on the occurrence of HDCP.The high level of expression of the two at the same time indicates that the risk of HDCP occurrence is high,and it can be used as early clinical identification indicators and help guide clinical formulation of intervention measures.