妊娠中晚期血清T、SHBG、CRP、BTP检验预测妊娠高血压疾病价值

The value of serum levels of testosterone,SHBG,CRP and BTP during the second trimester and the third trimester pregnancy for predicting pregnancy induced hypertension

目的:探讨妊娠中、晚期血清睾酮(T)、性激素结合球蛋白(SHBG)、C反应蛋白(CRP)、β?痕迹蛋白(BTP)检测对妊娠高血压疾病的预测价值。方法:选取在本院产科分娩伴妊娠高血压疾病孕妇60例作为观察组,另选取同期分娩的正常妊娠孕妇60例作为对照组。在妊娠中、晚期对两组孕妇进行血清T、SHBG、CRP、BTP检测,分析各项指标对妊娠高血压疾病的预测价值。结果:两组孕妇孕中、晚期的血清T、CRP水平比较无差异(P>0.05);观察组孕中、晚期SHBG水平均低于对照组,BTP水平高于对照组(P<0.05)。观察组中,与无蛋白尿组相比,蛋白尿组孕中、晚期的BTP水平均高,SHBG水平均低(P<0.05)。观察组孕妇血清SHBG、BTP水平均与孕周呈正相关,SHBG与SBP、DBP呈负相关,BTP与SBP、DBP呈正相关(P<0.05)。SHBG以376.3ng/ml作为诊断妊娠高血压疾病的临界值,其对妊娠高血压疾病的诊断敏感性、特异性分别为90.5%和88.6%;BTP以322.4ng/ml作为诊断妊娠高血压疾病的临界值,其对妊娠高血压疾病的诊断敏感性、特异性分别为92.4%和89.5%。结论:妊娠中、晚期血清T、CRP水平与妊娠高血压疾病的发生无显著相关性,血清SHGB、BTP与妊娠高血压疾病的发生显著相关,且对妊娠高血压疾病诊断具有较高的敏感性与特异性,有较好的预测价值。

Objective:To investigate the value of serum testosterone(T),sex hormone binding globulin(SHBG),Creactive protein(CRP),and beta trace protein(BTP)during the second trimester and the third trimester pregnancy for predicting pregnancy induced hypertension.Methods:60 pregnant women with pregnancy induced hypertension in Zhongda hospital affiliated to Southeast university were included in study group,and 60 healthy pregnant women were in control group.The serum levels of T,SHBG,CRP and BTP of all included pregnant women during the second trimester and the third trimester pregnancy were detected,and were compared between the two groups.The predictive value of serum levels of T,SHBG,CRP or BTP for pregnancy induced hypertension was analyzed.Results:There were no significant different in serum levels of T and CRP between the two groups(P>0.05).The serum SHBG level of pregnant women in study group were significant lower than that of pregnant women in control group(P<0.05).The serum BTP level of pregnant women in study group was significant higher than that of pregnant women in control group(P<0.05).In pregnant women of study group,the BTP levels of pregnant women with proteinuria during the second trimester and the third trimester pregnancy were significant higher than those of pregnant women without proteinuria,but the SHBG levels were significant lower than those of pregnant women without proteinuria(P<0.05).The levels SHBG and BTP of pregnant women in study group were positively correlated with gestational weeks,level of SHBG was negatively correlated with SBP and DBP,and level of BTP was positively correlated with SBP and DBP(P<0.05).The critical value of SHBG for diagnosing pregnancy induced hypertension was 376.3 ng/ml,and its sensitivity and specificity was 90.5% and 88.6%,respectively.The critical value of BTP for diagnosing pregnancy induced hypertension was 322.4 ng/ml,and its sensitivity and specificity was 92.4%and 89.5%,respectively.Conclusion:The serum levels of T and CRP are no significant correlation with the occurrence of pregnancy induced hypertension during the second trimester and the third trimester pregnancy.The serum levels of SHGB and BTP are significantly correlated with the occurrence of pregnancy induced hypertension,and have higher sensitivity and specificity for diagnosing pregnancy induced hypertension,which have good predictive value for pregnancy induced hypertension.