血清HIF-1α、PLGF及PAPP-A联合预测子痫前期并HELLP综合征的价值探讨

Value of serum HIF-1α,PLGF and PAPP-A in predicting preeclampsia complicated with HELLP syndrome

目的探讨血清缺氧诱导因子-1α(HIF-1α)、胎盘生长因子(PLGF)及妊娠相关α血浆蛋白(PAPP-A)对子痫前期并HELLP综合征的预测价值。方法回顾性分析165例子痫前期孕妇和157例健康孕妇的临床资料,分别记为研究组和对照组。对比2组血清HIF-1α、PLGF、PAPP-A水平;对比研究组中并发HELLP综合征和未并发HELLP综合征患者血清HIF-1α、PLGF、PAPP-A水平;绘制受试者工作特征曲线(ROC)分析血清HIF-1α、PLGF、PAPP-A水平对研究组并发HELLP综合征的预测价值。结果研究组血清HIF-1α及PAPP-A水平均高于对照组,PLGF水平低于对照组,差异均有统计学意义(P<0.05);研究组中HELLP综合征发生率为9.70%,并发HELLP综合征患者血清HIF-1α及PAPP-A水平均高于未并发HELLP综合征患者,PLGF水平低于未并发HELLP综合征患者,差异均有统计学意义(P<0.05);血清HIF-1α、PLGF、PAPP-A联合预测研究组并发HELLP的灵敏度与单独预测相当,特异度、曲线下面积(AUC)均高于单独预测。结论在子痫前期患者中血清HIF-1α及PAPP-A水平偏高,PLGF水平偏低,且与并发HELLP综合征有关,三者联合对并发HELLP综合征有良好的预测价值。

Objective:To investigate the predictive value of serum hypoxia inducible factor-1α(HIF-1α),placental growth factor(PlGF)and pregnancy associated alpha plasma protein(PAPP-A)in preeclampsia complicated with HELLP syndrome.Methods:The clinical data of 165 cases of preeclampsia pregnant women and 157 cases of healthy pregnant women were retrospectively analyzed,who were recorded as study group and control group.The serum levels of HIF-1α,PLGF and PAPP-A were compared between the two groups.The levels of HIF-1α,PLGF and PAPP-A in the study group were compared with and without HELLP syndrome.Receiver operating characteristic curve(ROC)was drawn to analyze the predictive value of serum HIF-1α,PLGF,PAPP-A levels in the study group complicated with HELLP syndrome.Results:The levels of HIF-1αand PAPP-A in the study group were higher than those in the control group,while the PLGF level was lower in the study group,with statistically significant differences(P<0.05).In the study group,the incidence of HELLP syndrome was 9.70%.The levels of HIF-1αand PAPP-A in patients with HELLP syndrome were higher than those in patients without HELLP syndrome,and PLGF level was lower in patients with HELLP syndrome than those without HELLP syndrome,with statistically significant differences(P<0.05).The sensitivity of combined prediction of serum HIF-1α,PLGF and PAPP-A in the study group was similar to that of single prediction,and the specificity and area under curve(AUC)were higher than those of single prediction.Conclusion:The serum levels of HIF-1αand PAPP-A are higher and PlGF levels are lower in preeclampsia patients,which are associated with HELLP syndrome.The combination of the three has a good predictive value for HELLP syndrome.