妊娠期高血压疾病患者血清B细胞激活因子的测定及临床意义

The detection of serum B cell activating factor of pregnant women with hypertensive disorder complicating pregnancy(HDCP)and its clinical significance

目的:探讨妊娠期高血压疾病患者血清B细胞激活因子(BAFF)水平及其临床意义。方法:选择2014年3月-2016年2月本院产科就诊的妊娠期高血压疾病患者92例为观察组,另选取同期本院产前检查的正常妊娠孕妇87例为对照组。采用酶联免疫吸附法测定两组孕妇血清BAFF水平,采用全血细胞分析仪及全自动凝血分析仪检测血液凝血指标、血小板参数,比较血清BAFF与血液指标的相关性,受试者工作特征曲线(ROC)分析BAFF诊断价值,logistic分析妊娠高血压患者发生不良结局的危险因素。结果:与对照组相比,观察组凝血指标PT、APTT均降低,而FIB升高,血小板计数指标(PLT)与血小板压积(PCT)均降低,而MPV与PDW均升高;观察组血清BAFF水平高于对照组(均P<0.05)。Pearson相关性分析显示,妊娠期高血压疾病患者血清BAFF水平与PT、FIB、PDW呈正相关,而与PLT、PCT呈负相关(P<0.05);ROC分析结果显示,患者血清BAFF的敏感性为98.3%,特异性为66.7%,截断值为198.34pg/ml;logistic分析显示,BAFF为妊娠期高血压疾病患者发生不良结局的独立影响因素。结论:妊娠期高血压疾病患者血清BAFF水平升高,且与其血液指标紧密相关,检测血清BAFF水平有助于早期发现孕妇是否患病及血栓前状态,并可作为临床早期诊断重要指标。

Objective To explore the level of serum B cell activating factor of pregnant with hypertensive disorder complicating pregnancy （HDCP）, and to investigate its clinical significance. Methods： 92 pregnant women with HDCP in Nantong ruici hospital from March 2014 to February 2016 were selected into research group, and another 87 normal pregnant women during the same period were selected into control group. Enzyme linked immunosorbent assay was used to detect the serum BAFF level of all pregnant women. The whole blood cell analyzer and Automatic Coagulation Analyzer were used to detect the blood indexes, such as blood coagulation indexes and platelet indexes. The correlations between serums BAFF with blood indexes of pregnant women were compared between the two groups, receiver operating characteristic curve （ROC） was used to analyze the diagnostic value of serum BAFF level, and multiple logistic regression analysis was also used for analyzing the risk factors of adverse outcomes of pregnant women with HDCP. Results： Compared with pregnant women in control group, the coagulation index, such as the values of PT and APTT of pregnant women in research group were significantly decreased （ P 〈0.05）, but the FIB was significantly increased （ P 〈0.05）. The platelet indexes, such as the values of PLT and PCT of pregnant women in research group were significantly decreased （ P 〈0.05）, but the values of MPV and PDW were significantly higher （ P 〈0.05）. The serum BAFF level of pregnant women in research group was significantly higher than that of pregnant women in control group （ P 〈0.05）. Pearson correlation analysis showed that there was a significant positive correlation between serum BAFF level with the value of PT, FIB or PDW （ P 〈 0.05）, there was a significant negative correlation with the value of PLT or PCT （ P 〈0.05）. ROC analysis showed that the sensitivity of serum BAFF level was 98.3%, the specificity was 66.7 %, and the cut off value was 198.3 pg/mL. The multiple Logistic regression analysis had showed that BAFF level was an independent influencing factor on adverse outcomes of pregnant women with HDCP. Conclusion： Serum BAFF level of pregnant women with HDCP is increased and is closely related to their blood index. The detection of serum BAFF level is helpful for early diognosing hypertensive disorder complicating pregnancy and pre thrombotic state of pregnant women, so it can be used as an important index for diagnosing hypertensive disorder of pregnant women early.