ApoA-1和ApoB-100/ApoA-1比值对子痫前期孕妇的预测诊断价值探讨

The Value of the ApoA-1 and ApoB-100/ApoA-1 Ratio in the Diagnosis of Preeclampsia

目的:检测并比较子痫前期(PE)孕妇和正常健康孕妇血清中载脂蛋白A-1(ApoA-1)、载脂蛋白B-100(ApoB-100)的浓度及ApoB-100/ApoA-1比值,探讨其在预测PE中的诊断价值。方法:收集武汉中心医院2015年6月至2016年6月收治的48例PE孕妇为PE组,另选择同期健康孕妇48例为对照组。ELISA法检测ApoA-1、ApoB-100浓度,比较两组血清ApoA-1、ApoB-100浓度及ApoB-100/ApoA-1比值,ROC工作曲线检测其诊断PE的诊断效能。结果:PE组ApoA-1浓度显著低于对照组(167. 07±14. 61 mg/dl vs 244. 37±20. 84 mg/dl,P<0. 001)。PE组ApoB-100浓度与对照组差异无统计学意义(104. 84±7. 05 mg/dl vs 102. 39±8. 08 mg/dl,P=0. 118)。PE组ApoB-100/ApoA-1比值显著高于对照组(0. 63±0. 07 vs 0. 42±0. 05,P<0. 001)。血清ApoA-1、ApoB-100浓度和ApoB-100/ApoA-1比值在是否重度PE、HELLP综合征、胎儿生长受限及是否需要降压治疗的PE孕妇中差异无统计学意义(P>0. 05)。ROC曲线示ApoA-1截断值为210 mg/dl时,预测诊断PE的敏感性为98%,特异性为92%,AUC=0. 971;当ApoB-100/ApoA-1截断值为0. 49时,预测诊断PE的敏感性为92%,特异性为93%,AUC=0. 931。结论:ApoA-1浓度和ApoB-100/ApoA-1比值是PE患者有价值的预测诊断指标,值得临床进一步研究。

Objective： To detect and compare the serum concentrations of Apolipoprotein A-1（ ApoA-1）,Apolipoprotein B-100（ ApoB-100） and the ApoB-100/ApoA-1 ration in preeclampsia（ PE） and healthy pregnant women,and to explore the clinical significance in diagnosis of PE.Methods： 48 women with PE were enrolled in the preeclampsia group,while 48 matched healthy pregnancy women were selected as the control group from June2015 to June 2016 in our hospital.The serum concentrations of ApoA-1,ApoB-100 were measured by ELISA.The concentration of ApoA-1,ApoB-100 and ApoB-100/ApoA-1 value was compared between the two groups.The diagnostic efficiency of PE was measured by ROC working curve.Results： The concentration of ApoA-1 in the preeclampsia group was significantly lower than that in control group（ 167. 07 ± 14. 61 mg/dl vs 244. 37 ± 20. 84 mg/dl,P〈0. 001）.There was no significant difference between the two groups regarding the ApoB-100 concentration（ 104. 84 ±7. 05 mg/dl vs 102. 39 ±8. 08 mg/dl,P = 0. 118）. The ApoB-100/ApoA-1 ratio of the preeclampsia group was significantly higher than that of control group（ 0. 63±0. 07 vs 0. 42±0. 05,P〈0. 001）.There was no significant difference of ApoA-1,ApoB-100 concentration and ApoB-100/ApoA-1 ratio in the PE group with or without severe preeclampsia,HELLP syndrome,fetal intrauterine growth restriction,and requirement of antihypertensive treatment（ P〈0. 05）.The ROC curve of ApoA-1 showed that when the cutoff value was 210 mg/dl,the sensitivity of ApoA-1 for diagnosis of preeclampsia was 98% and the specificity was 92% with AUC = 0. 971.When the cutoff value of ApoB-100/ApoA-1 was 0. 49,the sensitivity of diagnosis was 92% and the specificity was 93%,with AUC = 0. 931.Conclusions： The concentration of ApoA-1 and ApoB-100/ApoA-1 ratio may be valuable diagnostic indicators for PE.Further clinical investigation for this issue is necessary.