妊娠期高血压并发急性肾损伤患者血清白细胞介素-22、硫化氢及护骨素水平的变化与意义

Change and significance of serum interleukin-22,hydrogen sulfide,and osteoprotegerin levels of patients with hypertensive acute kidney injury in pregnancy

目的探究妊娠期高血压疾病(HDP)急性肾损伤(AKI)患者血清白细胞介素-22(IL-22)、硫化氢(H_(2)S)及护骨素(OPG)水平的变化与意义。方法选取2020年5月至2021年12月在本院产科就诊的50例无AKI并发症的HDP产妇为HDP组,50例HDP并发AKI的产妇为HDP-AKI组,50例健康产妇为健康对照组。采用酶联免疫吸附(ELISA)测定IL-22、H_(2)S、OPG及血肌酐、尿素氮、尿蛋白水平。采用Pearson法分析IL-22、H_(2)S、OPG的相关性,Logistic回归分析筛选HDP-AKI产妇妊娠结局的影响因素。结果与健康对照组相比,HDP组患者血清中的IL-22、OPG及血肌酐、尿素氮、尿蛋白升高,H_(2)S降低(P<0.05)。与HDP组比较,HDP-AKI组患者血清中的IL-22、OPG及血肌酐、尿素氮、尿蛋白亦升高,H_(2)S降低(P<0.05)。在HDP-AKI组,IL-22与OPG呈正相关(r=0.386,P<0.001),而IL-22与H_(2)S呈负相关(r=-0.306,P<0.001),OPG亦与H_(2)S呈负相关(r=-0.312,P<0.001)。年龄、身体质量指数(BMI)、H_(2)S、IL-22、OPG、血肌酐、尿素氮、尿蛋白均是HDP合并AKI产妇妊娠结局的影响因素(P<0.05)。结论HDP合并AKI患者血清的IL-22、OPG水平增高、H_(2)S下降,可能会对妊娠结局产生一定的影响。

Objective To explore the change and its significance of serum interleukin-22(IL-22),hydrogen sulfide(H_(2)S),and osteoprotegerin(OPG)levels in patients with hypertensive disorders of pregnancy(HDP)complicated with acute kidney injury(AKI).Methods From May 2020 to December 2021 in the department of obstetrics of the hospital,50 patients with HDP were selected as HDP group,and 50 HDP patients complicated with AKI were selected as HDP-AKI group,while 50 healthy pregnant women were selected as control group.The enzyme-linked immunosorbent assay(ELISA)method was used to measure the levels of serum IL-22,H_(2)S,OPG,creatinine,blood urea nitrogen,and urine protein.The Pearson method was applied to analyze the correlation among IL-22,H_(2)S,and OPG.Logistic regression analysis was performed to screen the influencing factors in the outcomes of the HDP patients complicated with AKI.Results Compared with the control group,the HDP group showed higher levels of serum IL-22,OPG,serum creatinine,and blood urea nitrogen as well as urinary protein,but showed lower level of H_(2)S(P<0.05).Compared with the HDP group,the HDP-AKI group also had higher levels of IL-22,OPG,creatinine,and blood urea nitrogen as well as urinary protein,but had lower level of H_(2)S(p<0.05).In the HDP-AKI group,IL-22 was positively correlated with OPG(r=0.386,P<0.001),while IL-22 was negatively correlated with H_(2)S(r=-0.306,P<0.001),and OPG was also negatively correlated with H_(2)S(r=-0.312,P<0.001).Age,body mass index(BMI),serum H_(2)S,IL-22,OPG,serum creatinine,and blood urea nitrogen as well as urinary protein were all influencing factors in the pregnancy outcome of HDP patients complicated with AKI(P<0.05).Conclusion The HDP patients complicated with AKI had higher levels of serum IL-22 and OPG,but lower level of H_(2)S,which might have a certain impact on the pregnancy outcomes.