早发子痫前期血清T-钙粘蛋白水平与子宫动脉血流关系研究

Study on the relationship between serum T-cadherin level and the blood flow of uterine artery in early preeclampsia

目的探讨早发子痫前期血清T-钙粘蛋白(T-cadherin)水平与子宫动脉血流的关系。方法选择2017年7月至2018年1月于中国医科大学附属盛京医院门诊及住院检查的孕28~34周单胎妊娠孕妇77例,其中39例子痫前期孕妇为研究组,38例正常孕妇为对照组。采用酶联免疫吸附法(ELISA)检测两组孕妇血清T-cadherin水平,抽血当日行彩色多普勒超声检测两组孕妇的双侧子宫动脉搏动指数(PI)、阻力指数(RI)及收缩期与舒张期血流速度比值(S/D)。比较两组孕妇血清T-cadherin水平的差异及血清T-cadherin水平与子宫动脉血流各个指标间的相关性。记录研究组孕妇分娩时的孕周及新生儿体重,研究T-cadherin水平与妊娠结局的关系。结果研究组T-cadherin为(3.93±0.99)μg/L,低于对照组的(5.03±0.73)μg/L(P<0.01)。研究组子宫动脉S/D、PI及RI值明显高于对照组(P<0.01)。相关性分析显示,研究组血清T-cadherin水平与子宫动脉PI值间r=-0.715,P<0.001,与子宫动脉RI值间r=-0.725,P<0.001,与子宫动脉S/D值间r=-0.63,P<0.001;对照组孕妇血清T-cadherin的水平与子宫动脉PI、RI及S/D之间无相关性(P>0.05)。研究组孕妇血清T-cadherin的水平与分娩孕周之间r=0.605,P<0.001,与新生儿体重之间r=0.671,P<0.001。结论早发子痫前期患者血清T-cadherin与子宫动脉血流呈负相关,并与早发子痫前期发病有关,可能在子痫前期的发病中处于主导地位,且与疾病进展和妊娠结局相关。

Objective To study the relationship between serum T-cadherin level and uterine artery blood flow in early onset preeclampsia（e PE）patients.Methods A total of 77 28-to-34-week single pregnant women were selected from the outpatients and inpatients of the Shengjing hospital of China Medical University from July 2017 to January 2018.Thirty-nine cases of pre-eclampsia were randomly selected as the study group and 38 normal pregnant women were in the control group.Serum T-cadherin levels in two groups were detected by enzyme-linked immunosorbent assay（ELISA）.The pulsation index（PI）,resistance index（RI）and systolic/diastolic（S/D）in the bilateral uterine artery of two groups were determined by doppler color ultrasonography.The differences in the serum T-cadherin level and the correlation between the serum T-cadherin levels and uterine artery blood flow were compared between the two groups.The gestational weeks and neonatal weight were followed up in the study group.The correlation between the serum T-cadherin levels and pregnancy outcomes was compared in the study group.Results T-cadherin concentration in PE women was 3.93±0.99μg/L,which was significantly lower than that of the control group[（5.03±0.73）μg/L]（P〈0.01）.The uterine artery S/D,PI and RI of the study group were significantly higher than those of the control group（P〈0.01）.In study group,the correlation coefficient between serum T-cadherin level and uterine arterial PI value was-0.715（P〈0.001）,which was-0.725 between serum T-cadherin level and uterine artery RI value（P〈0.001）and-0.63 between serum T-cadherin level and S/D value of uterine artery（P〈0.001）.There was no significant correlation between serum T-cadherin level and uterine artery PI,RI or S/D in the control group（P〉0.05）.The correlation coefficient between the serum T-cadherin levels and delivery weeks in study group was 0.605,P〈0.001,which was 0.671 between the serum T-cadherin levels and neonatal weight,P〈0.001.Conclusion T-cadherin is negatively correlated with uterine artery blood flow in patients with e PE.It is related to e PE,and might play a leading role in the onset of preeclampsia and might be associated with the disease progression and pregnancy outcomes.