血清CTRP5、PCSK9浓度与妊娠期高血压疾病患者病情严重程度的关系

Correlation between Serum Concentrations of CTRP5,PCSK9 and the Sever⁃ity in Patients with Hypertension during Pregnancy

目的研究血清补体C1q肿瘤坏死因子相关蛋白5(complement C1q tumor necrosis factor-related protein 5,CTRP5)、前蛋白转化酶枯草溶菌素9(preprotein invertase subtilisin 9,PCSK9)浓度与妊娠期高血压患者病情严重程度的相关性。方法选取2018年1月至2020年1月在保定市妇幼保健院治疗的妊娠期高血压患者118例作为研究组,另选取同期孕检健康孕妇36例为对照组。检测两组研究对象血清CTRP5、PCSK9浓度。采用Pearson和Spearman分析血清CTRP5、PCSK9浓度以及二者与妊娠期高血压患者病情严重程度的相关性。妊娠期高血压的影响因素采用Logistic回归分析。采用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析血清CTRP5、PCSK9浓度对重度子痫前期的诊断价值。结果研究组患者血清浓度均显著高于对照组[CTRP5:(136.86±11.75)ng/mL vs.(107.00±8.88)ng/mL,P<0.05;PCSK9:(244.99±19.32)ng/mL vs.(214.72±12.57)ng/mL,P<0.05]。妊娠期高血压、轻度、重度子痫前期组患者的血清CTRP5、PCSK9浓度依次升高,差异有统计学意义(P<0.05);重度子痫前期组患者的血清CTRP5、PCSK9浓度均显著高于轻度子痫前期组,差异有统计学意义(P<0.05)。根据Pearson相关性分析结果得知,血清CTRP5和PCSK9浓度呈正相关性(P<0.05),与收缩压和舒张压分别呈正相关(P<0.05)。根据Spearman相关性分析结果得知,血清CTRP5浓度与病情严重程度呈正相关(P<0.05),PCSK9浓度与病情严重程度呈正相关(P<0.05)。根据Logistic回归分析结果得知,CTRP5和PCSK9高表达是妊娠期高血压的危险因素(P<0.05)。血清CTRP5浓度诊断重度子痫前期的曲线下面积(area under the curve,AUC)为0.808,血清PCSK9浓度诊断重度子痫前期的AUC为0.744,二者联合诊断重度子痫前期的AUC为0.852,二者联合优于血清CTRP5、PCSK9浓度各自单独诊断(Z_(联合)vs.CTRP5=2.743、Z_(联合)vs.PCSK9=4.286,均P<0.05)。结论CTRP5和PCSK9浓度随妊娠期高血压疾病患者严重程度增加而升高。

Objectives To study the correlations between serum concentrations of complement C1q tumor necrosis factor-related protein 5(CTRP5),preprotein invertase subtilisin 9(PCSK9)and the severity in patients with hypertension during pregnancy.Methods A total of 118 patients with hypertension during pregnancy treated in Baoding Maternal and Child Health Hospital from January 2018 to January 2020 were selected as study group,and 36 healthy pregnant women during the same period were selected as control group.Serum concentrations of CTRP5 and PCSK9 were measured.Pearson and Spearman were used to analyze serum concentrations of CTRP5 and PCSK9 and their association with the severity in patients with hypertension during pregnancy.The influencing factors of hypertension during pregnancy were analyzed by Logistic regression.The receiver operating characteristics curve(ROC)analyzed the diagnostic value of serum concentra‐tions of CTRP5 and PCSK9 in severe preeclampsia.Results The serum concentrations of CTRP5 and PCSK9 of study group were significantly higher than those of control group[CTRP5:(136.86±11.75)ng/mL vs.(107.00±8.88)ng/mL,P<0.05;PCSK9:(244.99±19.32)ng/mL vs.(214.72±12.57)ng/mL,P<0.05].The serum concentrations of CTRP5 and PCSK9 in patients with hypertension,mild and severe preeclampsia increased sequentially(P<0.05),and the serum concentrations of CTRP5 and PCSK9 in patients with severe preeclampsia were significantly higher than those in patients with mild preeclampsia group(P<0.05).According to Pearson correlation analysis results,serum concentrations of CTRP5 and PCSK9 were positively correlated with systolic blood pressure and diastolic blood pressure respectively(P<0.05).Accord‐ing to Spearman correlation analysis results,serum concentrations of CTRP5 and PCSK9 were both positively correlated with disease severity(P<0.05).According to Logistic regression analysis results,serum concentrations of CTRP5 and PCSK9 were highly risk factors for hypertension during pregnancy(P<0.05).The area under the curve(AUC)of serum concentration of CTRP5 for diagnosis of severe preeclampsia was 0.808,the AUC of serum concentration of PCSK9 for di‐agnosis of severe preeclampsia was 0.744,and the AUC of the combination of the two for diagnosis of severe preeclamp‐sia was 0.852,the combination of the two methods was superior to the separate diagnosis of serum CTRP5 and PCSK9(Z_(combination) vs.CTRP5=2.743,Z_(combination) vs.PCSK9=4.286,P<0.05).Conclusions Serum concentrations of CTRP5 and PCSK9 increase with the increasing severity in patients with hypertension during pregnancy.