青海地区子痫前期与可溶性人类白细胞相关抗原G和脐动脉血流动力学相关性研究

Correlation Between Serum Level of s HLA-G,Hemodynamic Change of Umbilical Artery and Preeclampsia in Qinghai Province

目的检测青海地区子痫前期患者可溶性人类白细胞相关抗原G(s HLA-G)蛋白水平及脐动脉血流动力学指标,分析其间的相关性。方法选取2014年9—12月在青海大学附属医院分娩的产妇90例,其中正常妊娠妇女30例,轻度子痫前期患者26例,重度子痫前期患者34例。于临产前抽取3组研究对象静脉血,采用酶联免疫吸附试验(ELISA)检测s HLA-G水平;并采用多普勒超声诊断仪,检测脐动脉血流搏动指数(PI)、脐动脉血流阻力指数(RI)以及脐动脉收缩末期最大血流速度与舒张末期最大血流速度的比值(S/D)。结果 3组血清s HLA-G水平、PI、RI及S/D比较,差异均有统计学意义(P<0.001);其中轻度子痫组和重度子痫组血清s HLA-G水平低于正常妊娠组,PI、RI及S/D均高于正常妊娠组;重度子痫组血清s HLA-G水平低于轻度子痫组,PI、RI及S/D均高于轻度子痫组,差异有统计学意义(P<0.05)。3组尿蛋白值分布比较,差异有统计学意义(U=80.416,P<0.05)。相关分析结果显示,子痫前期患者尿蛋白与血清s HLA-G呈负相关(r=-0.873,P<0.05),s HLA-G与S/D呈负相关(r=-0.784,P<0.05),s HLA-G与RI呈负相关(r=-0.522,P<0.05),s HLA-G与PI呈负相关(r=-0.638,P<0.05)。结论 s HLA-G蛋白水平和脐动脉血流动力学指标与子痫前期患者病情严重程度有关,且s HLA-G蛋白水平与脐动脉血流动力学存在相关性,测定SHLA-G和脐动脉血流动力学指标可预测胎儿宫内生长环境及出生结局。

Objective To investigate the correlation between umbilical artery blood flow changes and serum level of sHLA-G in patients with preeclampsia in Qinghai Province. Methods We enrolled 90 pregnant women who underwent childbirth in the Affiliated Hospital of Qinghai University from September to December 2014. Among them,30 subjects were normal in childbirth,26 subjects were with mild preeclampsia and 34 were with severe preeclampsia. Before delivery,venous blood was sampled from the three groups of subjects. Then ELISA method was employed to test serum level of sHLA-G,and doppler ultrasonography was used to detect PI,RI and S/D. Results The three groups were significantly different（P〈0. 001） in serum level of sHLA-G,PI,RI and S/D;the mild preeclampsia group and the severe preeclampsia group were lower（ P〈0. 05）in serum level of sHLA - G and higher（P 〈0. 05）in PI,RI and S/D than normal childbirth group;the severe preeclampsia group was lower（P〈0. 05）in serum level of sHLA-G and higher（P〈0. 05）in PI,RI and S/D than the mild preeclampsia. The three groups were significantly different in the distribution of urine protein（U=80. 416,P〈0. 05）. The correlation analysis showed that,among the patients with preeclampsia,the urine protein was negatively correlated with serum level of sHLA-G（r= -0. 873,P〈0. 05）,serum level of sHLA-G was negatively correlated with S/D（r= -0. 784,P〈0. 05）,serum level of sHLA-G was negatively correlated with RI（r= -0. 522,P〈0. 05）,and serum level of sHLA-G was negatively correlated with PI（r= -0. 638,P〈0. 05）. Conclusion The serum level of sHLA-G and the hemodynamic change of umbilical artery is correlated with severity degree of preeclampsia,and serum level of sHLA-G is correlated with the hemodynamic change of umbilical artery,which helps to predict the intrauterine environment for fetus and childbirth outcome.